Infliximab Benefits Patients with Symptoms of Psoriatic Arthritis
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By Emma Hitt
NEW ORLEANS, LA -- October 28, 2002 -- The anti-TNF-alpha agent infliximab appears to improve both synovitis and the skin lesions in psoriatic arthritis.
The findings from a new trial were presented October 27 at the American College of Rheumatology (ACR) 66th Annual Scientific Meeting.
Dr. Christian Antoni, with the Department of Medicine, Friedrich-Alexander-University, Erlangen, Germany, and colleagues presented week-16 data from the Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT) trial.
The data suggested that infliximab improved both synovitis and skin lesions in patients with psoriatic arthritis.
According to the researchers, TNF alpha appears to play an important role in the pathogenesis of psoriasis, and infliximab -- a monoclonal anti-TNF-alpha antibody -- may benefit patients with the disease.
A total of 102 patients with active psoriatic arthritis were randomised to receive infliximab or placebo over 16 weeks. Of the patients, 68 percent were taking additional disease-modifying anti-rheumatic drugs (DMARDs), primarily methotrexate.
The researchers report that 67 percent achieved a greater than 75 percent improvement in the Psoriasis Area and Severity Index (PASI); and 69 percent were ACR20 (American College of Rheumatology criteria), 49 percent were ACR50, and 29 percent were ACR70. In contrast, less than 10 percent of the placebo group achieved an ACR20.
The authors point out that one joint infection was observed at week 16 of treatment, but, overall, treatment was "well tolerated with a low drop out rate of 3.9 percent."
"Infliximab resulted in a big improvement both in the skin and joints, therefore the clinical implication is good, if not to say impressive," Dr. Antoni said. "No other DMARD has been approved for this disease besides etanercept (Enbrel) in the United States, so it is good to see that this anti-TNF-alpha treatment works."
Dr. Antoni and colleagues are currently undertaking another trial for infliximab in psoriatic arthritis, and he expects that the drug will receive European approval for this use next year, and in the United States in 2004.
The study was funded by Centocor Inc, Malvern, Pennsylvania.