title: Infliximab improves health related quality of life and physical function in patients with psoriatic arthritis.
abstract: OBJECTIVE
  To evaluate the effect of infliximab on health related quality of life (HRQoL) and physical function in patients with active psoriatic arthritis (PsA) in the IMPACT 2 trial.
  
  
  METHODS
  200 patients with PsA unresponsive to conventional treatment were randomised to intravenous infusions of infliximab 5 mg/kg or placebo at weeks 0, 2, 6, 14, and 22; patients with inadequate response entered early escape at week 16. HRQoL was assessed using the Short Form-36 (SF-36) at weeks 0, 14, and 24. Functional disability was assessed using the Health Assessment Questionnaire (HAQ) at every visit through week 24. Associations between changes in quality of life (SF-36) and articular (American College of Rheumatology (ACR)) and dermatological (Psoriasis Area and Severity Index (PASI)) responses were examined.
  
  
  RESULTS
  Mean percentage improvement from baseline in HAQ was 48.6% in the infliximab group compared with worsening of 18.4% in the placebo group at week 14 (p < 0.001). Furthermore, 58.6% and 19.4% of infliximab and placebo treated patients, respectively, achieved a clinically meaningful improvement in HAQ (that is, > or = 0.3 unit decrease) at week 14 (p < 0.001). Increases in physical and mental component summary (PCS and MCS) scores and all eight scales of the SF-36 in the infliximab group were greater than those in the placebo group at week 14 (p < or = 0.001). These benefits were sustained through week 24. Patients achieving ACR20 and PASI75 responses had the greatest improvements in PCS and MCS scores.
  
  
  CONCLUSIONS
  In patients with PsA, infliximab 5 mg/kg significantly improved HRQoL and physical function compared with placebo through 24 weeks.
authors.affiliation: Center for Innovative Therapy, Division of Rheumatology, Allergy, and Immunology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0943, USA. akavanaugh@ucsd.edu
authors.forename: A
authors.initials: A
authors.lastname: Kavanaugh
authors.forename: C
authors.initials: C
authors.lastname: Antoni
authors.forename: G G
authors.initials: GG
authors.lastname: Krueger
authors.forename: S
authors.initials: S
authors.lastname: Yan
authors.forename: M
authors.initials: M
authors.lastname: Bala
authors.forename: L T
authors.initials: LT
authors.lastname: Dooley
authors.forename: A
authors.initials: A
authors.lastname: Beutler
authors.forename: C
authors.initials: C
authors.lastname: Guzzo
authors.forename: D
authors.initials: D
authors.lastname: Gladman
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab