No serious side effects were reported from use of the drug, which appeared to be well tolerated, the authors report.
Remicade is targeted against a chemical messenger called tumor necrosis factor alpha, or TNF-a, believed to be involved in the over-proliferation of skin cells that occurs in psoriasis. This medication has been shown to be effective against rheumatoid arthritis and the inflammatory bowel condition Crohn's disease, which has been linked genetically to psoriasis.
"It's not a completely safe treatment, but it's relatively safe," says Marcus Clark, MD, associate professor and chief of rheumatology at the University of Chicago, who commented on the drug for WebMD. "But the cost is high, so I don't know if it will ever be a primary therapy for psoriasis." He adds that as with any immune therapy, there is likely to be a rapid flare-up of the disease when the drug is stopped.
Gottlieb tells WebMD that although the study is ongoing, the remissions appear to be long-lasting in the small group of patients followed for six months or more.
"If this is all borne out by [further] studies, then you'll have a drug that clears as well and as quickly and in as high a proportion of patients as cyclosporine without the rapid relapse," she says. "If cyclosporine were safe to use long-term there would be no more drug development in psoriasis -- it's terrific at clearing psoriasis -- the problem is that it's toxic for long-term use, and when we stopped it all of our patients relapsed within a month. We're not apparently seeing this with Remicade."
Gottlieb is currently a consultant to Centocor, the manufacturer of Remicade.