Abstract

Infliximab was shown to be effective and safe in controlled trials regarding psoriatic arthritis (PsA).[1-4] In an open label study we reported a significant clinical benefit accompanied by clearing and healing of psoriatic skin lesions.[5] Thus, we conducted this study to evaluate the efficacy and safety of infliximab in patients with active PsA, and recalcitrant psoriasis in whom treatment with disease modifying anti-rheumatic drugs has failed. Thirty-two patients who had negative purified protein derivative skin test and normal chest radiographs were included. All had active disease which was defined as ¡Ý6 tender or swollen joints count, Psoriasis Area and Severity Index (PASI) score ¡Ý10 [6] and erythrocyte sedimentation rate ¡Ý28 mmHg/h or C-reactive protein ¡Ý10 mg/l. The end points were the percentage of patients who achieved the Psoriatic Arthritis Response criteria (PsARC) [7] and the improvement of PASI. Patients were treated with infliximab (5 mg/kgr/weight) at weeks 0, 2, 6 and every 8 weeks thereafter for a period of 2 years. If the clinical response was insufficient, the interval between infusions was shortened to 6 or 4 weeks. The clinical response according to the American College of Rheumatology (ACR) criteria [8] and the disease activity for 28 joint indices score (DAS-28) were recorded.[9]