Infliximab then efalizumab, the 'hit and run' approach does not work.
BACKGROUND
In a previous paper we described 2 patients treated with a sequential biologic therapy for chronic plaque psoriasis. We used infliximab as an induction treatment followed by efalizumab. We extended this approach to 3 other patients.


OBJECTIVE
The purpose was to show the feasibility of a sequential approach with biologicals.


METHODS
Five patients received three infusions of infliximab followed by weekly injections of efalizumab from week 10 on.


RESULTS
The most important findings, summarized in a table, show that none of the patients continued the treatment for more than a year either because of non-responsiveness or because of spontaneous stopping. Moreover, 4 out of 5 patients did not respond or had serious adverse events on reintroduction of infliximab.


CONCLUSIONS
Overall, we cannot recommend sequential therapy using infliximab and efalizumab.
Barde
C
C
Clinique et Policlinique de Dermatologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland. caroline.barde@hcuge.ch
Thielen
A M
AM
Saurat
J-H
JH
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002464:Cell Migration Inhibition; D003879:Dermatologic Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; C472181:efalizumab