An international team led by a dermatologist at The University ofManchester has found that treatment with the emerging drug infliximab,marketed as Remicade, can quickly and significantly improve psoriasissymptoms.
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."
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