Department of Dermatology, Saifee Hospital, Mumbai, Maharashtra, India.
Indian J Dermatol Venereol Leprol. 2013 Jul;79 Suppl 7:S25-34. doi: 10.4103/0378-6323.115525.
Moderate to severe psoriasis often needs to be addressed with standard disease modifying therapies such as methotrexate, cyclosporine, acitretin or ultraviolet radiation, which have their potential benefits and limitations. The tumor necrosis factor-alpha (TNF-α) is elevated in psoriatic plaques compared to non lesional skin as well as in the plasma of patients with moderate to severe psoriasis. Infliximab, a TNF-α blocker, has been recommended for the treatment of moderate to severe plaque psoriasis in adults who have failed to respond to these therapies or who cannot tolerate them. Its specific action on the bound and membrane forms of the pro-inflammatory cytokine TNF-α has made it the molecule of choice for obtaining quicker and longer remission in recalcitrant cases. However, the widespread use of infliximab in the Indian subcontinent is limited by its cost. This article reviews the international guidelines for use of infliximab, its dosage patterns, and efficacy in chronic plaque psoriasis, nail psoriasis, erythrodermic psoriasis, and pustular psoriasis as well as Indian experience.
中重度银屑病通常需要采用标准的疾病修正治疗方法，如甲氨蝶呤、环孢素、阿维 A 或紫外线辐射等，这些方法都有其潜在的益处和局限性。与非皮损皮肤相比，银屑病斑块中肿瘤坏死因子-α（TNF-α）升高，在中重度银屑病患者的血浆中也是如此。英夫利昔单抗是一种 TNF-α 阻滞剂，已被推荐用于治疗对这些治疗方法无反应或无法耐受的中重度斑块型银屑病成人患者。它对促炎细胞因子 TNF-α的结合形式和膜形式的特异性作用使其成为获得难治性病例更快和更长缓解的首选分子。然而，英夫利昔单抗在印度次大陆的广泛使用受到其成本的限制。本文综述了英夫利昔单抗的国际使用指南、其剂量模式以及在慢性斑块型银屑病、甲银屑病、红皮病型银屑病和脓疱型银屑病中的疗效，以及印度的经验。
