A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis - 12/08/11
Dallas, Texas; Winston-Salem, North Carolina; Irvine and Fremont, California; Waterloo, Ontario, Canada; Malvern, Pennsylvania; and Boston, Massachusetts
Abstract |
Background |
Previous studies of infliximab in psoriasis have demonstrated rapid improvement with induction therapy and sustained response with regularly administered maintenance therapy.
Objective |
The efficacy and safety of continuous (every–8-week) and intermittent (as-needed) maintenance regimens were compared.
Methods |
Patients with moderate-to-severe psoriasis (n = 835) were randomized to induction therapy (weeks 0, 2, and 6) with infliximab 3 mg/kg or 5 mg/kg or placebo. Infliximab-treated patients were randomized again at week 14 to continuous or intermittent maintenance regimens at their induction dose.
Results |
At week 10, 75.5% and 70.3% of patients in the infliximab 5 mg/kg and 3 mg/kg groups, respectively, achieved PASI 75; 45.2% and 37.1% achieved PASI 90 (vs 1.9% [PASI 75] and 0.5% [PASI 90] for placebo; P < .001). Through week 50, PASI responses were better maintained with continuous compared with intermittent therapy within each dose, and with 5 mg/kg compared with 3 mg/kg continuous therapy.
Limitations |
Longer term (>1 year) maintenance therapy and further study of infliximab serum concentrations over this period, in both PASI 75 responders and non-responders, would be preferable.
Conclusions |
Through week 50, response was best maintained with continuous infliximab therapy. Infliximab was generally well-tolerated in most patients.
Le texte complet de cet article est disponible en PDF.Abbreviations used : ALT, AST, ANOVA, BSA, DLQI, EXPRESS, EXPRESS II, PASI, PASI 75, PASI 90, PGA, PPD, QOL, TB, TNF⍺, ULN
Plan
Supported by Centocor, Inc, Malvern, Penn, and Schering-Plough, Kenilworth, NJ. Conflicts of interest can be found in the appendix. Please visit www.eblue.org for a listing of EXPRESS II study investigators. Presented at the 64th Annual Meeting of the American Academy of Dermatology, San Francisco, Calif, March 3-7, 2006. |
Vol 56 - N° 1
P. 31.e1-31.e15 - janvier 2007 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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