Back
 JCDSA  Vol.5 No.2 , June 2015
Infliximab Therapy in Iraqi Patients with Moderate to Severe Psoriasis
Abstract: Background: Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine which plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of psoriasis. Objectives: To assess the efficacy and safety of infliximab in Iraqi patients with moderate-to-severe psoriasis. Patients and Methods: In this therapeutic, single-center study, a total of 23 patients with moderate-to-severe psoriasis resistant to conventional treatments were enrolled to receive infusions of infliximab 5 mg/kg at weeks 0, 2, and 6, then every 8 weeks for at least 22 weeks. Psoriasis Area and Severity Index(PASI), Body Surface Area (BSA) and Dermatology Life Quality Index (DLQI) were calculated at each visit to assess the response to treatment and all side effects were recorded. Results: PASI score was reduced from a mean ± SD of 17.41 ± 8.53 before treatment to 2.44 ± 2.68 after 22 weeks. At week 22, 84% of patients achieved PASI 75, 42% achieved PASI 90 and 28% achieved complete clearance. BSA and DLQI score were reduced from a mean ± SD of 35.69 ± 22.44 and 20.04 ± 4.68 before treatment to 3.52 ± 4.94 and 3.87 ± 5.60 after 22 weeks, respectively. Pruritus, boils, infusion reactions were recorded and relapse during treatment was found in 3 patients. Conclusion: Infliximab monotherapy is highly effective in the treatment of moderate-to-severe psoriasis, with rapid onset of action and relatively low side effects.
Cite this paper: Al-Hamamy, H. , Al-Turfy, I. and Abdul-Reda, F. (2015) Infliximab Therapy in Iraqi Patients with Moderate to Severe Psoriasis. Journal of Cosmetics, Dermatological Sciences and Applications, 5, 78-85. doi: 10.4236/jcdsa.2015.52010.
References

[1]   Christophers, E. (2001) Psoriasis—Epidemiology and Clinicalspectrum. Clinical and Experimental Dermatology, 26, 314-320.
http://dx.doi.org/10.1046/j.1365-2230.2001.00832.x

[2]   Naldi, L.N. (2004) Epidemiology of Psoriasis. Current Drug Target-Inflammation & Allergy, 3, 121-128.
http://dx.doi.org/10.2174/1568010043343958

[3]   Gottlieb, A.B. (2003) Clinical Research Helps Elucidate the Role of Tumor Necrosisfactor-α in the Pathogenesis of T1-Mediated Immune Disorders: Use Oftargeted Immunotherapeutics as Pathogenic Probes. Lupus, 12, 190-194.
http://dx.doi.org/10.1191/0961203303lu354xx

[4]   Krueger, J.G. (2002) The Immunologic Basis for the Treatment of Psoriasis with Newbiologic Agents. Journal of the American Academy of Dermatology, 46, 1-23.
http://dx.doi.org/10.1067/mjd.2002.120568

[5]   Ali, A. and Ibrahim, A. (2013) Biologic Systemic Therapy for Moderate-to-Severe Psoriasis: A Review. Journal of Taibah University Medical Sciences, 8, 142-150.
http://dx.doi.org/10.1016/j.jtumed.2013.09.001

[6]   Stephen, K.R. and Joel, M.G. (2012) Immunobiologicals, Cytokines, and Growth Factors in Dermatology. In: Wolf, K., Goldsmith, L.A., Katz, S.I., Gilchrest, B.A., Paller, A.S. and Leffell, D.J., Eds., Fitz Patrick’s Dermatology in General Medicine, 8th Edition, McGraw Hill, New York, 2: 234: 2814-2826.

[7]   Breathnach, S.M., Smith, C.H., Chalmers, R.J. and Hay, R.J. (2010) Systemic Therapy. In: Burns, T., Breathnach, S., Cox, N. and Griffiths, C., Eds., Rook’s Textbook of Dermatology, 8th Edition, Wiley-Blackwell Publishing Company, Singapore, 4: 74.4.

[8]   Severity and Extent of Psoriasis (Psoriasis Area and Severity Index).
http://www.dermnetnz.org/scaly/pasi.html

[9]   Krueger, G.G. (2000) Two Considerations for Patients with Psoriasis and Their Clinicians: What Defines Mild, Moderate, and Severe Psoriasis? What Constitutes a Clinically Significant Improvement When Treating Psoriasis? Journal of the American Academy of Dermatology, 43, 281-285.
http://dx.doi.org/10.1067/mjd.2000.106374

[10]   Quality of Life. Dermatology Life Quality Index.
http://www.dermatology.org.uk/quality/dlqi/quality-dlqi.html

[11]   Smith, C.H., Anstey, A.V., Barker, J.N., Burden, A.D., Chalmers, R.J. and Chandler, D.A. (2009) British Association of Dermatologists Guidelines for Biological Intervention for Psoriasis 2009. British Journal of Dermatology, 161, 987-1019.
http://dx.doi.org/10.1111/j.1365-2133.2009.09505.x

[12]   Mathur, M., Kedia, S.K. and Chimire, R.B.K. (2011) An Intravenous Biological Therapy for Psoriasis: Infliximab. Journal of College of Medical Sciences-Nepal, 7, 69-72.

[13]   Jeniffer, S. and Robert, E. (2008) Infliximab for the Treatment of Plaque Psoriasis. Biologics, 2, 115-124.

[14]   Reich, K. (2005) Infliximab Induction and Maintenance Therapy Formoderate-to-Severe Psoriasis: A Phase III, Multicentre, Double-Blind Trial. Lancet, 366, 1367-1374.
http://dx.doi.org/10.1016/S0140-6736(05)67566-6

[15]   Smith, C.H., Jackson, K., Bashir, S.J., Perez, A., Chew, A.L., Powell, A.M., Wain, M. and Barker, J. (2006) Infliximab for Severe, Treatment-Resistant Psoriasis: A Prospective, Open-Label Study. British Journal of Dermatology, 155, 160-169.
http://dx.doi.org/10.1111/j.1365-2133.2006.07316.x

[16]   Feldman, S.R., Gordon, K.B. and Bala, M. (2005) Infliximab Treatment Results in Significant Improvement in the Quality of Life of Patients with Severe Psoriasis: A Double-Blind Placebo-Controlled Trial. British Journal of Dermatology, 152, 954-960.
http://dx.doi.org/10.1111/j.1365-2133.2005.06510.x

 
 
Top