title: A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Dermatology, Baylor University Medical Center, UT Southwestern Medical School, 5310 Harvest Hill Rd, Ste 260, Dallas, TX 75230, USA. amderm@gmail.com
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Gerald D
authors.initials: GD
authors.lastname: Weinstein
authors.forename: Kim
authors.initials: K
authors.lastname: Papp
authors.forename: Robert
authors.initials: R
authors.lastname: Evans
authors.forename: Cynthia
authors.initials: C
authors.lastname: Guzzo
authors.forename: Shu
authors.initials: S
authors.lastname: Li
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Dooley
authors.forename: Cynthia
authors.initials: C
authors.lastname: Arnold
authors.forename: Alice B
authors.initials: AB
authors.lastname: Gottlieb
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology / Q000493:pharmacokinetics / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D002170:Canada; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005060:Europe; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069285:Infliximab; D007262:Infusions, Intravenous; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D010361:Patients / Q000523:psychology; D011565:Psoriasis / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014376:Tuberculosis / Q000453:epidemiology / Q000209:etiology; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D000069285:Infliximab