title: Infliximab for the treatment of psoriasis in Greece: 4 years of clinical experience at a single centre.
abstract: BACKGROUND
  Infliximab, a chimeric monoclonal antibody, has been shown to be effective for moderate to severe psoriasis. Clinical experience with long-term infliximab therapy for psoriasis is accumulating, and it is therefore important to share our experience with its use in real-life clinical practice.
  
  
  OBJECTIVE
  To report our experience with infliximab (Remicade; Schering Plough, Kenilworth, NJ, U.S.A.) for the treatment of moderate to severe plaque psoriasis (and/or arthritis) from a single clinic in Greece.
  
  
  METHODS
  Between August 2004 and March 2008, 62 patients presenting to our clinic with moderate to severe psoriasis were treated with infliximab. Disease phenotype, clinical course, disease severity and adverse events were assessed throughout the treatment period.
  
  
  RESULTS
  Infliximab resulted in a reduction of median Psoriasis Area and Severity Index (PASI) of 70% at week 6 and 84.4% at week 14. Nineteen patients who have completed 1 year on infliximab treatment experienced sustained efficacy with a median PASI improvement of 92.16% and a Physician's Global Assessment (PGA) of 'clear' or 'almost clear', while nine patients have reached approximately 20 months of continuous therapy. All patients with psoriatic arthritis showed marked improvement in their clinical symptoms following the first infusion. Eight patients (12.9%) experienced adverse events that required discontinuation of treatment. There were no statistically significant differences in PASI and Dermatology Life Quality Index (DLQI) scores between patients with arthritis and those with only skin lesions, or between those who received methotrexate, either from the beginning or during infliximab therapy, and those who did not receive methotrexate at all. Selected patients of interest are discussed.
  
  
  CONCLUSIONS
  The above data confirm previous reports that treatment with infliximab is an efficacious and safe option for patients with moderate to severe plaque psoriasis (and/or arthritis). Long-term follow-up, continued pharmacovigilance, and controlled comparative studies will be required to fully evaluate its use in the treatment of psoriasis.
authors.affiliation: Department of Dermatology, Andreas Syggros Hospital, University of Athens, Dragoumi 5 Street, 16121, Athens 16121, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Antoniou
authors.forename: I
authors.initials: I
authors.lastname: Stefanaki
authors.forename: A
authors.initials: A
authors.lastname: Stratigos
authors.forename: E
authors.initials: E
authors.lastname: Moustou
authors.forename: T
authors.initials: T
authors.lastname: Vergou
authors.forename: P
authors.initials: P
authors.lastname: Stavropoulos
authors.forename: G
authors.initials: G
authors.lastname: Avgerinou
authors.forename: D
authors.initials: D
authors.lastname: Rigopoulos
authors.forename: A D
authors.initials: AD
authors.lastname: Katsambas
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab