title: Moderate to severe psoriasis treated with infliximab - 53 patients: patients profile, efficacy and adverse effects.
abstract: BACKGROUND
  Psoriasis exerts a significant negative effect on quality of life and is associated with comorbidities. The inflammatory activity of the psoriasis plaques is partially triggered by activation of the Th1 lymphocytes, which release proinflammatory cytokines such as TNF-alpha. Infliximab neutralizes the biological activity of TNF-alpha. Adverse reactions that occur during infusion or up to 24 hours afterwards are referred to as acute reactions. Delayed reactions are those occurring between 24 hours and 14 days after an infusion.
  
  
  OBJECTIVE
  To evaluate the profile of patients with moderate to severe psoriasis that is resistant to conventional treatment, and to assess adverse reactions to infliximab.
  
  
  METHODS
  Fifty-three patients, 40 men and 13 women, were treated with infliximab. The dose used was 5 mg/kg in weeks 0, 2 and 6 (induction phase), followed by maintenance therapy every 8 weeks.
  
  
  RESULTS
  Of the 53 patients, 6 participated only in the induction phase. These patients reached Psoriasis Area Severity Index (PASI) of 90-100 and opted to discontinue treatment. Forty-seven patients continued therapy with the drug for at least 2-3 years. Of these, 55.3% (n=26) experienced some type of adverse event. Acute adverse events were recorded in 34% of the patients and delayed adverse events in 36.1%. The prevalence of comorbidities was 57.4%.
  
  
  CONCLUSIONS
  In the present study, infliximab was found to constitute a safe and effective form of therapy. Of the comorbidities recorded in the patients in this study, obesity was associated with a delayed and less effective response to treatment. When adequately monitored, neither acute nor delayed adverse events require discontinuation of therapy, since they do not represent an uncontrolled risk to the patient.
authors: Faculdade de Medicina Santo Amaro, Universidade de Santo Amaro, São Paulo, SP, Brasil.
authors: Artur Antonio
authors: AA
authors: Duarte
authors: Flavia Barbour
authors: FB
authors: Chehin