Drug Breakthrough For Psoriasis Sufferers

The European Infliximab for Psoriasis Efficacy and Safety Study(EXPRESS) was a placebo-controlled trial on 378 patients with moderateto severe psoriasis, to test the efficacy and safety of the drug. Thefindings, published in the 15 October issue of The Lancet, show that80% of patients achieved at least a 75% improvement in symptoms afterten weeks treatment with the drug, as opposed to just 3% of thosereceiving a placebo.

Psoriasis is a chronic condition which results when skin cellsover-produce and accumulate on the surface of the skin, producing red,scaly 'plaques' which may itch and bleed. It is thought to be geneticin origin and is a consequence of an abnormal inflammatory response inthe skin. Around 2% of the population suffer from the disease, withabout 30% of cases considered moderate to severe, but until nowtreatment options have been limited.

Infliximab blocks the activity of 'tumour necrosis factoralpha' (TNF-alpha), a protein involved in inflammation, and the vastmajority of the trial subjects treated with the drug achievedclinically-significant levels of skin clearance. Nearly 60% experiencedat least a 90% improvement in symptoms -- or near-complete skinclearance -- after ten weeks, versus 1% receiving the placebo, whilst26% achieved complete skin clearance (versus 0% receiving the placebo).The improvements continued throughout the 50-week study.

Professor Christopher Griffiths, the University academicleading the trial from the Dermatology Centre at Hope Hospital,Salford, said: "These results indicate that Infliximab is a veryeffective therapy among the newer biological treatments for psoriasis.As a dermatologist, I am very encouraged by the data, which show thatpatients with moderate to severe psoriasis can rapidly achieve skinclearance and that these results can be maintained."

Patients receiving Infliximab also experienced a good responsein nail psoriasis, which is present in 20 -- 50% of psoriasis patientsand often thought of as a treatment-resistant disease. By week 24 ofthe trial, those receiving the drug were experiencing a 56% averagedecrease in this condition, and again this response was maintainedthroughout the trial.

"Physicians' assessments of the patients' conditions backed upour findings," confirmed Professor Griffiths, "with 83% of thosereceiving the drug assessed as having minimal or cleared symptoms byweek 10 of the trial as opposed to just 4% of those receiving theplacebo."