The Effectiveness of Tumor Necrosis Factor α Antibody (Infliximab) in Treating Recalcitrant Psoriasis

Erythrodermic Psoriasis: Current and Future Role of Biologicals

“…The efficacy of infliximab as a monotherapy in EP is sustained by several case series/single case reports [23,[40][41][42][43]45] and one open-label, uncontrolled, multicenter clinical trial [20]. These studies comprised a total of 38 patients, with 24 subjects (63 %) showing ''improvement'', defined as reduction of Psoriasis Area and Severity Index (PASI) score from baseline of 50 % (PASI 50) or 75 % (PASI 75) (13/27 patients for both indexes; 48 %) [20,23,45], or achievement of physician's global assessment of ''clear'' or ''almost clear''/subjective report of the investigator (11/11 patients; 100 %) [40][41][42][43].…”

“…Infliximab is the most frequently used biological agent in the treatment of EP, with a total of 53 reported instances [20,23,37,38,[40][41][42][43][44][45]. It was administered as a secondline biological therapy in only three cases (after the failure of etanercept in one patient [42] and of an unknown agent in the other two subjects [20]), while the remaining patients were naive to biological drugs.…”

“…These studies comprised a total of 38 patients, with 24 subjects (63 %) showing ''improvement'', defined as reduction of Psoriasis Area and Severity Index (PASI) score from baseline of 50 % (PASI 50) or 75 % (PASI 75) (13/27 patients for both indexes; 48 %) [20,23,45], or achievement of physician's global assessment of ''clear'' or ''almost clear''/subjective report of the investigator (11/11 patients; 100 %) [40][41][42][43]. Clinical improvement has been achieved very quickly in most subjects, with 16 (67 %) and 24 (100 %) patients reaching the outcome at week 6 and 12, respectively [20,23,[40][41][42][43]45]. Significant adverse events observed during follow-up included S. aureus septicemia, myocardial infarction, erysipelas, anaphylactic shock, and a suicide attempt occurring at 6 weeks, 2 years, 6 weeks, 2 weeks, and 22 weeks after starting infliximab, respectively [20].…”

“…Significant adverse events observed during follow-up included S. aureus septicemia, myocardial infarction, erysipelas, anaphylactic shock, and a suicide attempt occurring at 6 weeks, 2 years, 6 weeks, 2 weeks, and 22 weeks after starting infliximab, respectively [20]. The follow-up duration ranged from 4 weeks to 24 months [20,23,[40][41][42][43]. Although infliximab was administered during the whole follow-up period in several patients (with retention of achieved clinical results) [23,[40][41][42][43], it is important to note that the above-mentioned clinical trial (involving 24 EP cases treated with infliximab) revealed a drug survival rate at week 48 of only 36 %.…”

Infliximab as a Therapy for Idiopathic Hypereosinophilic Syndrome

“…We report the first case (to our knowledge) of l-IHES that was responsive to infliximab therapy. Infliximab is a chimeric, human-mouse antibody for tumor necrosis factor (TNF) ␣ that has been shown to be effective in the treatment of Crohn disease, rheumatoid arthritis, severe psoriasis (ie, recalcitrant erythrodermic psoriasis), [9][10][11] and pityriasis rubra pilaris. 12 Tumor necrosis factor ␣ is a proinflammatory cytokine that contributes to lymphocyte and eosinophil recruitment by upregulating vascular cell adhesion molecule 1 (VCAM-1), endothelial leukocyte adhesion molecule 1 (ELAM-1), and intercellular adhesion molecule 1 (ICAM-1) on activated endothelial cells.…”