title: Infliximab treatment results in significant improvement in the quality of life of patients with severe psoriasis: a double-blind placebo-controlled trial.
abstract: BACKGROUND
  Psoriasis is a chronic disease that significantly diminishes the health-related quality of life (HRQOL). Infliximab is a chimeric, tumour necrosis factor alpha monoclonal antibody that has been shown to improve the signs and symptoms of plaque psoriasis.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the effect of infliximab induction therapy on the HRQOL of patients with severe plaque psoriasis.
  
  
  METHODS
  In this double-blind, placebo-controlled trial, 249 patients were randomly assigned to receive intravenous infusions of 3 or 5 mg kg(-1) of infliximab or placebo and were treated at weeks 0, 2 and 6. Patients completed the Dermatology Life Quality Index (DLQI) at baseline and week 10.
  
  
  RESULTS
  Infliximab induction therapy resulted in a substantial improvement in HRQOL. At week 10, patients in the infliximab 3- and 5-mg kg(-1) groups showed a median percentage improvement in DLQI scores of 84.0% and 91.0%, respectively, compared with 0% in the placebo group (P < 0.001). The median decrease from baseline in DLQI score at week 10 was 8.0 and 10.0 for the 3 and 5 mg kg(-1) infliximab groups, respectively, compared with 0 in the placebo group (P < 0.001). Thirty-three per cent and 40% of patients in the 3 and 5 mg kg(-1) infliximab groups, respectively, had a DLQI score of 0 at week 10, compared with 2% in the placebo group (P < 0.001). There was a strong correlation between the percentage change from baseline at week 10 in Psoriasis Area and Severity Index (PASI) scores and the percentage change in DLQI scores during the same period (Spearman's correlation, 0.61, P < 0.001). When the infliximab and placebo treatment groups were combined, patients with at least 75% improvement in PASI scores between baseline and week 10 had a greater mean improvement in DLQI scores (81%) than those with 50-75% improvement in PASI during the same period (60%).
  
  
  CONCLUSIONS
  Infliximab induction therapy resulted in significant improvement in HRQOL in patients with severe psoriasis.
authors.affiliation: Loyola University Medical Center, Maywood, IL, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Feldman
authors.forename: K B
authors.initials: KB
authors.lastname: Gordon
authors.forename: M
authors.initials: M
authors.lastname: Bala
authors.forename: R
authors.initials: R
authors.lastname: Evans
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: L T
authors.initials: LT
authors.lastname: Dooley
authors.forename: C
authors.initials: C
authors.lastname: Guzzo
authors.forename: K
authors.initials: K
authors.lastname: Patel
authors.forename: A
authors.initials: A
authors.lastname: Menter
authors.forename: A B
authors.initials: AB
authors.lastname: Gottlieb
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000523:psychology / Q000534:rehabilitation; D011594:Psychometrics; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D000069285:Infliximab