**3. Discussion**

274 Psoriasis


This is a retrospective study. We revised the list of patients affected with moderate and severe psoriasis and treated with infliximab in our Department since April 2006. Only the first 50 patients were kept, in order to ensure a sufficient trial and analysis period (one year minimum). Four patients were excluded, who were initially treated in the Department but subsequently received follow-up in another hospital. 46 patient files were analyzable in total. Of these, the PASI follow-up data were complete for 41 patients. Analysis of the files was carried out respecting privacy laws, according to the procedures in force for

 As prior treatment for psoriasis, all patients but 2 (44/46) previously received PUVA therapy and cyclosporine and methotrexate, according to Belgian regulations for the prescription of biological therapy. Two patients did not receive cyclosporine: one due to an absolute renal contra-indication and another who had begun biological therapy in a

 Concerning biological therapy, 15 patients began infliximab as first-line treatment (biotherapy naive patients). 31 took infliximab as second- or third-line treatment. The average length of infliximab therapy on day of analysis was 604 days (14 – 1666) Best results obtained were PASI 100 (19 patients), PASI 90 (6), PASI 75 (6), PASI 50 (4), PASI <50 (6). Among the 19 patients who achieved PASI 100, 4 had a complete relapse, and 6 a partial relapse. 9 maintained a complete response. Of the patients scoring

 As significant adverse events, we noticed 2 cases of arthritis and atypical lupus, 2 typical lupus syndromes, 2 true anaphylactic reactions. We did not see any significant infection. The lupus syndromes required hospitalization and took six months to

In clinical follow-up, we did not notice any global tendency to weight loss or gain and

 In the serie, we have one death, by suicide, deemed to be unrelated to the treatment Infliximab was used in monotherapy in 41 cases; 5 in combination with methotrexate Dosage was secondarily adapted in 8 cases (3 increases in frequency due to insufficient response, 5 dose reductions due to complete and sustained clinical response) Temporary interruption and subsequent reintroduction were observed in 10 cases: for non-compliance (2), personal choice (1), intercurrent illness (1), waiting to settle social security (1), extended trip (1), clinical trial (1), temporary treatment switch (3). The reintroduction was accompanied by manifestations of hypersensitivity in one case only.

country where prior treatment with cyclosporine was not required.

between 50 and 99%, 8 completely relapsed, and 3 partially.


**2. Retrospective study 2.1 Patients and methods** 

retrospective analyses.

disappear.

no change in blood pressure.

Patients were 13 women and 33 men.

Age range was 19 to 72 years.

**2.2 Results** 

controlled clinical studies
