Infliximab Therapy in Iraqi Patients with Moderate to Severe Psoriasis

Abstract

Background: Tumor necrosis factor alpha (TNF- α ) is a proinflammatory cytokine which plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF- α drug widely used for the treatment of psoriasis. Objectives: To assess the efficacy and safety of infliximab in Iraqi patients with moderate-to-severe psoriasis. Patients and Methods: In this therapeutic, single-center study, a total of 23 patients with moderate-to-severe psoriasis resistant to conventional treatments were enrolled to receive infusions of infliximab 5 mg/kg at weeks 0, 2, and 6, then every 8 weeks for at least 22 weeks. Psoriasis Area and Severity Index(PASI), Body Surface Area (BSA) and Dermatology Life Quality Index (DLQI) were calculated at each visit to assess the response to treatment and all side effects were recorded. Results: PASI score was reduced from a mean ± SD of 17.41 ± 8.53 before treatment to 2.44 ± 2.68 after 22 weeks. At week 22, 84% of patients achieved PASI 75, 42% achieved PASI 90 and 28% achieved complete clearance. BSA and DLQI score were reduced from a mean ± SD of 35.69 ± 22.44 and 20.04 ± 4.68 before treatment to 3.52 ± 4.94 and 3.87 ± 5.60 after 22 weeks, respectively. Pruritus, boils, infusion reactions were recorded and relapse during treatment was found in 3 patients. Conclusion: Infliximab monotherapy is highly effective in the treatment of moderate-to-severe psoriasis, with rapid onset of action and relatively low side effects.