To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - ACR: Infliximab Effective For Psoriatic Arthritis URL: http://www.pslgroup.com/dg/1E8D12.htm Doctor's Guide October 31, 2000
By Maria Bishop Special to DG News
PHILADELPHIA, PA -- October 31, 2000 -- One-year data demonstrate that infliximab, which has already proven effective in the treatment of rheumatoid arthritis, is also effective for psoriatic arthritis, research suggests.
These findings were presented by German researchers at the 64th Annual Scientific Meeting of the American College of Rheumatology (ACR), Philadelphia, Pennsylvania.
It is well known that, in psoriatic arthritis, tumour-necrosing factor (TNF)-alpha is elevated in the synovial fluid and skin lesions. Led by Claudia Dechant, MD, professor at the Medizinische Klinik III mit Poliklinik, Friedrich-Alexander University, Erlangen, Germany, this research team attempted to discover whether anti-TNF therapy could thus be effective in the treatment of psoriatic arthritis as well.
A ten-patient study was initiated, comprising only participants with severe psoriatic arthritis and a polyarticular disease. All patients were treated with infliximab (5 mg/kg at baseline, week 2 and week 6). Seven patients also received concomitant methotrexate therapy; one patient received sulfasalazine therapy. Two patients were naïve to disease-modifying anti-rheumatic drugs (DMARDs).
At week 10, all patients showed a dramatic response to infliximab treatment, with a reduction in the signs, symptoms and serological activity of psoriatic arthritis, noted Dr. Dechant. Following the 10-week study, infliximab treatment was adapted to the individual needs of the patients. One patient stopped infliximab treatment at this time, for personal reasons.
At one year, the other nine patients were followed up according to the ACR criteria for rheumatoid arthritis.
One-year results show that five patients (four with an ACR response of 70, indicating remission, and one with an ACR response of 50 at 10 weeks) were further treated with a lower dose of infliximab (3-4 mg/kg and an infusion interval of eight weeks or more). In three of these cases, the infliximab therapy was discontinued altogether after five, seven and eight months because of remission. One case was discontinued after eight months because of an infusion reaction and newly detected pregnancy. At one-year follow-up, all of these patients still had an ACR 70 response.
The other four patients received ongoing infusions of infliximab at the same reduced dose. Three of these patients had an ACR 70 response at week 10 and an ACR 50 response at one year. The other patient developed an arthritis flare after nine months of therapy; but by increasing the dose and shortening the infusion intervals to four weeks, a moderate response of ACR 50 was once again achieved, the researchers stated.
After one year, six of the nine patients reported no swollen or tender joints.
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