Department of Dermatology, Andreas Syggros Hospital, University of Athens, Dragoumi 5 Street, 16121, Athens 16121, Greece.
Br J Dermatol. 2010 May;162(5):1117-23. doi: 10.1111/j.1365-2133.2009.09578.x. Epub 2009 Nov 10.
Infliximab, a chimeric monoclonal antibody, has been shown to be effective for moderate to severe psoriasis. Clinical experience with long-term infliximab therapy for psoriasis is accumulating, and it is therefore important to share our experience with its use in real-life clinical practice.
To report our experience with infliximab (Remicade; Schering Plough, Kenilworth, NJ, U.S.A.) for the treatment of moderate to severe plaque psoriasis (and/or arthritis) from a single clinic in Greece.
Between August 2004 and March 2008, 62 patients presenting to our clinic with moderate to severe psoriasis were treated with infliximab. Disease phenotype, clinical course, disease severity and adverse events were assessed throughout the treatment period.
Infliximab resulted in a reduction of median Psoriasis Area and Severity Index (PASI) of 70% at week 6 and 84.4% at week 14. Nineteen patients who have completed 1 year on infliximab treatment experienced sustained efficacy with a median PASI improvement of 92.16% and a Physician's Global Assessment (PGA) of 'clear' or 'almost clear', while nine patients have reached approximately 20 months of continuous therapy. All patients with psoriatic arthritis showed marked improvement in their clinical symptoms following the first infusion. Eight patients (12.9%) experienced adverse events that required discontinuation of treatment. There were no statistically significant differences in PASI and Dermatology Life Quality Index (DLQI) scores between patients with arthritis and those with only skin lesions, or between those who received methotrexate, either from the beginning or during infliximab therapy, and those who did not receive methotrexate at all. Selected patients of interest are discussed.
The above data confirm previous reports that treatment with infliximab is an efficacious and safe option for patients with moderate to severe plaque psoriasis (and/or arthritis). Long-term follow-up, continued pharmacovigilance, and controlled comparative studies will be required to fully evaluate its use in the treatment of psoriasis.
英夫利昔单抗是一种嵌合型单克隆抗体，已被证实对中重度银屑病有效。随着临床中长期应用英夫利昔单抗治疗银屑病经验的积累，分享其在真实临床实践中的应用经验非常重要。
报告我们在希腊的一家诊所应用英夫利昔单抗（Remicade；先灵葆雅，美国新泽西州肯尼沃斯）治疗中重度斑块状银屑病（和/或关节炎）的经验。
2004 年 8 月至 2008 年 3 月，62 例中重度银屑病患者在我们的诊所接受英夫利昔单抗治疗。在整个治疗期间评估疾病表型、临床过程、疾病严重程度和不良反应。
英夫利昔单抗治疗 6 周时患者的银屑病面积和严重程度指数（PASI）中位数降低 70%，14 周时降低 84.4%。19 例完成英夫利昔单抗治疗 1 年的患者疗效持续，PASI 中位数改善 92.16%，医生总体评估（PGA）为“清除”或“几乎清除”，9 例患者的连续治疗时间已接近 20 个月。所有伴银屑病关节炎的患者在首次输注后其临床症状均显著改善。8 例（12.9%）患者发生需要停药的不良反应。伴关节炎与仅皮肤受累、或开始时或英夫利昔单抗治疗期间应用甲氨蝶呤与未应用甲氨蝶呤的患者之间，PASI 和皮肤病生活质量指数（DLQI）评分无统计学差异。对部分有意义的患者进行了讨论。
上述数据证实了先前的报告，即英夫利昔单抗治疗中重度斑块状银屑病（和/或关节炎）是一种有效且安全的选择。需要进行长期随访、持续药物警戒和对照比较研究，以全面评估其在银屑病治疗中的应用。
