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J Am Acad Dermatol. 2007 Jan;56(1):31.e1-15. Epub 2006 Sep 6.

A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis.

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  • 1Division of Dermatology, Baylor University Medical Center, UT Southwestern Medical School, 5310 Harvest Hill Rd, Ste 260, Dallas, TX 75230, USA. amderm@gmail.com

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.

[PubMed - indexed for MEDLINE]
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