Effectiveness and safety of infliximab for 11 years in a patient with erythrodermic psoriasis and psoriatic arthritis

Trídico, Lívia Arroyo; Antônio, Joäo Roberto; Mathias, Carlos Eduardo; Pozetti, Eurides Maria de Oliveira

doi:10.1590/abd1806-4841.20176565

Cited by 7 publications

(5 citation statements)

References 5 publications

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“… 1 serious AE (erythema multiforme) 3 AE (erythema multiforme, psoriasis, latent tuberculosis) led to treatment discontinuation. Infliximab Case Series Takahashi et al 23 7 Pt 1: 39/M Pt 2: 46/F Pt 3: 46/M Pt 4: 33/M Pt 5: 40/F Pt 6: 49/M Pt: 56/M Not reported PASI90 at W6 None Heikkilä et al 24 4 Pt 1: 16/M Pt 2: 27/M Pt 3: 54M Pt 4: 29/M Not reported Not reported Not reported Case Report Kurokawa et al 25 1 45/M PASI: 43 BSA: >80 PASI: 5.6 at W13 None Trídico et al 26 1 55/M Not reported Infliximab effectiveness maintained over time (11 years) None Anti-IL17 Secukinumab Case Series Damiani et al 27 13 Age: 40 (range 28–52) M: 9 (69.2%) F: 4 (30.8%) PASI: not reported W16: PASI90/100: 5(38.5%)/4(30.8%) W52: PASI90/100: 5(38.5%)/5(38.5%) AEs: 5 (48.5%), with injection-site pain as the commonest (3, 60.0%) Weng et al 28 10 Age: 42.6 ± 11 M: 8 (80.0%) F: 2 (20.0%) PASI: 32.4 ± 5.7 BSA: 89.0 ± 7.1 W8: PASI75/90/100: 5(50.0%)/2(20.0%)/1(10.0%) W12: PASI75/90/100: 7(70.0%)/4(40.0%)1(10.0%) W16: PASI75/90/100: 7(70.0%)/4(40.0%)2(20.0%) W24: PASI75/90/100: 6(60.0%)/4(30.0%)1(10.0%) None …”

Section: Resultsmentioning

confidence: 99%

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Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Potestio¹,

Camela²,

Cacciapuoti³

et al. 2023

CCID

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Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis (less than 3% of cases), characterized by generalized scaling and erythema affecting more than 90% of body surface area. Several systemic symptoms can be present in patients with EP such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia making this condition a possible life-threatening disease, particularly if appropriate treatments are not performed. In this scenario, effective and safe therapies are required. Unfortunately, the rarity of EP makes head-to-head Phase III trials challenging, leading to the lack of established guidelines for its management. Globally, conventional systemic drugs such as cyclosporine, methotrexate, and retinoids often have contraindications linked to patients' comorbidities and have not shown a high profile of efficacy and safety. Recently, the development of biologic drugs including anti-tumor necrosis factor-α and anti-interleukin 12-23, 23, and 17 has revealed favorable results for the management of plaque psoriasis, making them also a possible therapeutic option for EP disease. However, their use in EP is still offlabel. The aim of our study was to review current literature on the use of biologic drugs for the treatment of EPs in order to offer a wide perspective on their possible application in EP management.

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Section: Resultsmentioning

confidence: 99%

“…80 As regards EP, few cases of this form of psoriasis successfully treated with infliximab have been described. [23][24][25][26] Among these, Takahashi et al reported the largest case series on seven patients successfully treated with infliximab. 23 All of the patients achieved PASI90 following the third infusion (week 6).…”

Section: Infliximabmentioning

confidence: 99%

Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Potestio¹,

Camela²,

Cacciapuoti³

et al. 2023

CCID

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“…The reactivation of HBV and/or hepatitis C virus (HCV) infection in response to biological drugs has been suspected, especially with TNF inhibitors [ 6 ]. The efficacy of biologic agents in patients with psoriasis with concomitant viral hepatitis is not well defined [ 7 ], while long-term use of biological agents is needed for EP to maintain efficacy [ 27 ]. For patients with EP with HBV/HCV infection, we need to control the viral load before using biological agents [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Oxymatrine in the Treatment of Patients with Erythrodermic Psoriasis

Shi,

Chen,

et al. 2024

Dermatol Ther (Heidelb)

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Introduction The management of erythrodermic psoriasis (EP), a rare but severe type of psoriasis, is challenging, especially in patients with concomitant chronic hepatitis B (CHB). We previously demonstrated that oxymatrine treatment alleviated severe plaque psoriasis, but its therapeutic potential in treating EP remains unexplored. This study was to assess the efficacy and safety of oxymatrine for the treatment of EP, with attention to concomitant CHB. Methods In this investigator-initiated clinical trial, four consecutive patients with EP, including two (A and B) with concomitant CHB, were treated with intravenous administration of oxymatrine as monotherapy for 8 weeks, and scheduled to be followed up for a minimum of 24 weeks. The primary outcome was at least 75% improvement in the psoriasis area and severity index (PASI 75) at week 32. Secondary outcomes included the body surface area (BSA) score, dermatology life quality index (DLQI)], and safety. Results Patients A, B, and C achieved PASI 75 at treatment completion and week 32, demonstrating improvements of 77.4%, 97.2%, and 100% in PASI, respectively. Their BSA and DLQI were also improved significantly at week 32 and throughout follow-up of 37, 57, and 105 weeks, respectively. The viral loads in patients A and B with CHB decreased modestly. Patient D discontinued after follow-up for 19 weeks, and the primary outcome could not be analyzed. No adverse events were reported during treatment and follow-up. Conclusion Oxymatrine appears to be efficacious and safe for the treatment of patients with EP, including those with concomitant CHB. Trial Registration This study was registered at the Chinese Clinical Trial Registry ( www.chictr.org.cn ; Registration number ChiCTR-TRC-14004301). Supplementary Information The online version contains supplementary material available at 10.1007/s13555-024-01181-5.

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“…49,52 Infliximab Infliximab, a chimeric monoclonal antibody, is considered to be a first-line biologic for EP due to its rapid onset. 1,44,52,53,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] In one multicenter study that included 24 patients, 52 one-third of the patients achieved PASI 75 at week 4 with infliximab treatment. But longterm efficacy is not so promising, as at the same study that only 48% of patients achieved PASI 75 at week 14, 52 and one case reported no further improvement after the sixth infusion of infliximab; the subject's condition was then controlled by administration of etanercept.…”

Section: Mycophenolate Mofetil (Mmf)mentioning

confidence: 99%

Updates on the Treatment of Erythrodermic Psoriasis

Lo¹,

Tsai

2021

PTT

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Erythrodermic psoriasis (EP) is a rare variant of psoriasis, which is potentially life threatening and often resistant to conventional therapy. Biologics have revolutionized the treatment of plaque-type psoriasis, and shown promise in EP. However, due to the lack of head-to-head studies and the rarity of EP, no high level evidence-based treatment guidelines for EP have been established, and the evidence of treatment of EP is limited to case reports or small case series. Here, we present a narrative review focusing on the up-to-date information for the treatment of EP.

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Effectiveness and safety of infliximab for 11 years in a patient with erythrodermic psoriasis and psoriatic arthritis

Cited by 7 publications

References 5 publications

Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Biologics for the Management of Erythrodermic Psoriasis: An Updated Review

Efficacy and Safety of Oxymatrine in the Treatment of Patients with Erythrodermic Psoriasis

Updates on the Treatment of Erythrodermic Psoriasis

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