Infliximab monotherapy provides rapid and sustained benefit for plaque-type psoriasis

Gottlieb, Alice B.; Chaudhari, Umesh; Mulcahy, Lisa D.; Li, Shu; Dooley, Lisa T.; Baker, Daniel

doi:10.1067/mjd.2003.307

Cited by 142 publications

(112 citation statements)

References 9 publications

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“…17 Trials of new agents-such as alefacept, efalizumab, and tumour necrosis factor a (TNFa) inhibitors such as etanercept and infliximab-have demonstrated that patients' quality of life clearly improves with treatment. [18][19][20][21][22][23] Detailed examination of some of these trials has shown that even in those patients who achieve only 50% improvement in the PASI, but not 75% improvement in the PASI, have significant improvement in their DLQI scores, meaning that patients with this level of improvement in the skin lesions are achieving clinical significant improvement in their quality of life. 4 An important feature of the quality of life score is that it is complementary to the lesion severity scores.…”

Section: More Recent Assessment Toolsmentioning

confidence: 99%

Psoriasis assessment tools in clinical trials

Feldman

Krueger²

2005

Annals of the Rheumatic Diseases

413

386

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Section: More Recent Assessment Toolsmentioning

confidence: 99%

Psoriasis assessment tools in clinical trials

Feldman

Krueger²

2005

Annals of the Rheumatic Diseases

413

386

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“…One study was too limited in size to be included and another study was excluded because it was a phase II study [52,53]. In the first study an induction therapy with three dosages of (3 mg/kg or 5 mg/kg at 0, 2 en 6 weeks was compared to placebo.…”

Section: Efficacy Infliximabmentioning

confidence: 99%

Biologicals in the Treatment of Plaque Psoriasis: Drug Selection by Means of the SOJA Method

Janknegt¹

2016

J Pharma Care Health Sys

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The treatment of plaque psoriasis is changing because of the introduction of new treatment options. The goal of this article is to allow a transparent and rational choice of medicines by means of the System of Objectified Judgement Analysis. The following selection criteria (relative weight) were applied: approved indications (40), drug interactions (60), clinical efficacy (400), safety (300), dosage frequency (100) and documentation (100). Acquisition cost was not taken into consideration to allow a preselection on quality aspects only. Adalimumab, etanercept, infliximab and ustekinumab were compared on these criteria. Infliximab and ustekinumab showed the highest scores and are the most suitable medicines for the treatment of severe plaque psoriasis. Of course, cost will play a key role in the final selection in individual hospitals. Weight Approved indications 40 Drug Interactions 60Clinical efficacy 400Safety 300Dosage frequency 100 Documentation 100Total 1000 Selection Criteria Approved IndicationsThe number of licensed indications is a good measure of the applicability and documentation of the drugs. Although this analysis is limited to the treatment of plaque psoriasis, the fact that a drug is approved for (almost) all indications listed below is, from a formulary point of view, advantageous to another drug, which is approved for only one or two applications.The percentage of the maximum score for approved indications was obtained as follows (Table 2): IndicationMaximum Score (%)Plaque psoriasis 50% Psoriatric arthritis 20%Rheumatoid arthritis 10% Spondylitis ankylopoetica 10%Inflammatory bowel disease 10% Drug interactionsInteractions play a role only in patients who use other drugs which may interact with biologicals. However, it is a relevant criterion from a formulary point of view.The score for each drug was dependent on the frequency and severity of observed drug interactions. Clinical efficacyClinical efficacy is always a very important selection criterion for any group of drugs. The score for each drug was derived from the results of double-blind comparative studies. SafetyThe extent and the severity of adverse effects is another important selection criterion for drugs. A distinction was made between "minor" side effects, such as gastrointestinal disturbances or skin reactions, occurring in clinical trials and severe or even life-threatening adverse reactions observed with large scale use of the drugs. The evaluation of the "minor" adverse effects was based on results of double blind comparative clinical studies.

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“…37 Sustained remissions with limited retreatments have been possible in open label trials with both of these agents. 38 Although inhibiting a late step in the psoriatic pathway, these Psoriasis and the new biologics anti-TNF-α agents have yielded the highest response rates among all of the biologics thus far investigated. [36][37][38] In contrast to TNF-α inhibitors, success with blocking other proinflammatory cytokines has been limited.…”

Section: T-ap 4: Blocking Cytokinesmentioning

confidence: 99%

“…38 Although inhibiting a late step in the psoriatic pathway, these Psoriasis and the new biologics anti-TNF-α agents have yielded the highest response rates among all of the biologics thus far investigated. [36][37][38] In contrast to TNF-α inhibitors, success with blocking other proinflammatory cytokines has been limited. Studies with a fully humanized antibody to IL-8 (Abx-IL8) showed only modest improvement in preliminary trials, suggesting that there might be significant redundancy in the role of this cytokine in psoriasis pathogenesis.…”

Section: T-ap 4: Blocking Cytokinesmentioning

confidence: 99%

Psoriasis and the new biologic agents: interrupting a T-AP dance

Walsh

Shear²

2004

Canadian Medical Association Journal

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PSORIASIS IS AN IMMUNE-MEDIATED SKIN DISEASE in which chronic Tcell stimulation by antigen-presenting cells (APC) occurs in the skin. This interplay between the T-cell and APC has been likened to a "T-AP dance" where specific steps must occur in sequence to result in T-cell activation and the disease phenotype; otherwise Tcell anergy would occur. Several novel engineered proteins designed to block specific steps in immune activation (biologic agents) have demonstrated efficacy in the treatment of psoriasis. These agents include fusion proteins, monoclonal antibodies and recombinant cytokines. These medications act at specific steps during the T-AP dance either to inhibit T-cell activation, costimulation and subsequent proliferation of T-cells, lead to immune deviation or induce specific cytokine blockades. The potential increased selectivity for specific pathways in immune activation, clinical efficacy and relative safety of these new agents offers an alternative for the treatment of moderate to severe psoriasis.

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Infliximab monotherapy provides rapid and sustained benefit for plaque-type psoriasis

Cited by 142 publications

References 9 publications

Psoriasis assessment tools in clinical trials

Psoriasis assessment tools in clinical trials

Biologicals in the Treatment of Plaque Psoriasis: Drug Selection by Means of the SOJA Method

Psoriasis and the new biologic agents: interrupting a T-AP dance

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