Infliximab treatment results in significant improvement in the quality of life of patients with severe psoriasis: a double-blind placebo-controlled trial

Authors

  • S.R. Feldman,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • K.B. Gordon,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • M. Bala,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • R. Evans,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • S. Li,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • L.T. Dooley,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • C. Guzzo,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • K. Patel,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • A. Menter,

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • A.B. Gottlieb

    1. Wake Forest University School of Medicine, Winston-Salem, NC, U.S.A.
      *Loyola University Medical Center, Maywood, IL, U.S.A.
      †Centocor, Inc., Malvern, PA, U.S.A.
      ‡Baylor University Medical Center, Dallas, TX, U.S.A.
      §University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 51 French Street, New Brunswick, NJ 08901-0019, U.S.A.
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  • Conflicts of interest: The following conflicts of interest are declared: SRF, KBG, ABG and AM with Centocor, Inc., MB, LTD, CG, RE, SL and KP are employees of Centocor, Inc. This study (C0168T31) was sponsored by Centocor, Inc.

Alice B. Gottlieb, MD, PhD.
E-mail: alice.gottlieb@umdnj.edu

Summary

Background  Psoriasis is a chronic disease that significantly diminishes the health-related quality of life (HRQOL). Infliximab is a chimeric, tumour necrosis factor α monoclonal antibody that has been shown to improve the signs and symptoms of plaque psoriasis.

Objectives  The objective of this study was to evaluate the effect of infliximab induction therapy on the HRQOL of patients with severe plaque psoriasis.

Methods  In this double-blind, placebo-controlled trial, 249 patients were randomly assigned to receive intravenous infusions of 3 or 5 mg kg−1 of infliximab or placebo and were treated at weeks 0, 2 and 6. Patients completed the Dermatology Life Quality Index (DLQI) at baseline and week 10.

Results  Infliximab induction therapy resulted in a substantial improvement in HRQOL. At week 10, patients in the infliximab 3- and 5-mg kg−1 groups showed a median percentage improvement in DLQI scores of 84·0% and 91·0%, respectively, compared with 0% in the placebo group (P < 0·001). The median decrease from baseline in DLQI score at week 10 was 8·0 and 10·0 for the 3 and 5 mg kg−1 infliximab groups, respectively, compared with 0 in the placebo group (P < 0·001). Thirty-three per cent and 40% of patients in the 3 and 5 mg kg−1 infliximab groups, respectively, had a DLQI score of 0 at week 10, compared with 2% in the placebo group (P < 0·001). There was a strong correlation between the percentage change from baseline at week 10 in Psoriasis Area and Severity Index (PASI) scores and the percentage change in DLQI scores during the same period (Spearman's correlation, 0·61, P < 0·001). When the infliximab and placebo treatment groups were combined, patients with at least 75% improvement in PASI scores between baseline and week 10 had a greater mean improvement in DLQI scores (81%) than those with 50–75% improvement in PASI during the same period (60%).

Conclusions  Infliximab induction therapy resulted in significant improvement in HRQOL in patients with severe psoriasis.

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