Long‐term study of infliximab for psoriasis in daily practice: drug survival depends on combined treatment, obesity and infusion reactions

Abstract

This retrospective review of a cohort of patients with moderate-to-severe psoriasis treated with infliximab in daily practice shows that the PASI75 response rates at 24 and 52 weeks of treatment are similar to those of the pivotal studies, but 37 courses of treatment (59%) had to be discontinued after a median of 12 months. The major cause for discontinuation was loss of response, in 18 cases. Combination treatment, obesity and infusion reactions were found to be predictors of drug survival.

A multicenter, prospective, observational study examining the impact of risk factors, such as BMI and waist circumference, on quality of life improvement and clinical response in moderate‐to‐severe plaque‐type psoriasis patients treated with infliximab in routine care settings of Greece

“…In agreement with other studies with biologic therapies, PASI 75 response attainment was not found to be associated with smoking status, alcohol consumption and age at disease onset, although smoking at initiation of anti‐TNFα therapy has been reported as a predictor of non‐response elsewhere . The only identified negative predictor of PASI 75 response attainment was the presence of comorbidities, supported by reports linking high comorbidity burden with psoriasis disease severity as well as with treatment failure with biologics …”

“…Notably, the mean baseline PASI (22.4 vs. 23.4 herein) and median baseline BMI (27.9 vs. 28.6 kg/m 2 herein) were comparable between the two studies, with the proportion of obese patients only slightly higher in the present study (37.5% vs. 40.4%). Similarly to the results of our study, baseline obesity was not found to be associated with infliximab's response attainment rates in the retrospective study conducted in Spain . Yet, several other studies have reported high BMI to be a negative predictor of response to biologics (including infliximab) .…”

“…In the PP population, PASI 75 response attainment rate was 66.4%, 74.8% and 76.6% at 14, 30 and 54 weeks and 89.3% at any time. Slightly higher rates have been reported in a retrospective study of 56 patients administered a total of 63 treatment courses of infliximab over a mean of 31.6 months of treatment, where the PASI 75 response attainment rates in the as‐treated population were 82.5%, 82.1%, 89.8% and 91.1%, respectively, at 12, 24, 36 and 50 weeks post‐treatment onset . Notably, the mean baseline PASI (22.4 vs. 23.4 herein) and median baseline BMI (27.9 vs. 28.6 kg/m 2 herein) were comparable between the two studies, with the proportion of obese patients only slightly higher in the present study (37.5% vs. 40.4%).…”

Safety profiles and efficacy of infliximab therapy in Japanese patients with plaque psoriasis with or without psoriatic arthritis, pustular psoriasis or psoriatic erythroderma: Results from the prospective post‐marketing surveillance

“…The safety profiles of IFX treatment in patients with rheumatic diseases has been verified by registries in many countries . However, only a few studies including several hundreds of psoriasis patients reported about the safety and efficacy of IFX treatment in real‐world clinical practice …”

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

“…Clinical outcomes (mainly PASI) were reported in 75% of prospective studies [27, 39, 47-53], in about 50% of prospective registries [20, 24, 54-61] and retrospective studies [29, 30, 32, 34, 37, 62-70], and in no retrospective administrative databases/claims. Drug survival of biological therapies was reported in over 60% of prospective registries [14, 20, 21, 24, 25, 31, 54, 57, 71-74], retrospective studies [18, 19, 22, 23, 26, 29, 30, 32, 34, 37, 38, 68, 70, 75-77] and administrative databases/claims [28, 35, 36, 40-42, 46], and less frequently (33%) in prospective studies [27, 33, 52, 78]. Subanalyses on reasons of discontinuation, such as switching, dose augmentation, or biological therapy restarting, were scanty.…”