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This article is from the WebMD News Archive
Remicade 'Highly Effective' for Psoriasis
Oct. 13, 2005 -- Remicade is a "highly effective" treatment for moderate-to-severe psoriasis, a major clinical trial shows.
Few diseases cause more suffering than psoriasis. Caused by immune responses gone wild, the disease causes scaly, red blotches on the skin. In more severe disease, patches of psoriasis may become itchy or painful and cover large areas of skin. Psoriasis can also cause a type of arthritis.
There are several standard treatments that work fairly well for people with milder forms of the disease. But patients often become frustrated when one treatment after another fails to offer relief. The impact on a person's quality of life can be as bad as or worse than diabetes, arthritis, or even cancer.
Recently, several new drugs have become available. These drugs -- which include Amevive, Enbrel, and Raptiva -- slow down the immune reactions responsible for psoriasis.
Another drug that slows down runaway immune responses is Remicade. It's approved for psoriatic arthritis and other autoimmune conditions. Some doctors already prescribe it for severe psoriasis.
Now there's strong evidence that Remicade really does work for psoriasis. A large clinical trial shows that 61% of patients who take Remicade for a year see at least a 75% improvement in their psoriasis symptoms. Nearly half of the patients showed at least a 90% improvement, the researchers report in the Oct. 15 issue of The Lancet.
The findings impress psoriasis expert Michael Schön, MD, University of Würzburg, Germany. His editorial comments also appear in The Lancet.
"Remicade works in a larger proportion of patients than other new arthritis treatments," Schön tells WebMD. "It is stronger. It is the big dog."
Remicade Potent, Well Tolerated by Patients
The study involved 32 medical centers in Europe and Canada. It enrolled 378 patients with moderate-to-severe psoriasis. Four out of five patients were treated with Remicade for 46 weeks. The remaining patients received an inactive placebo for 22 weeks and then switched over to Remicade. No other treatments except anti-inflammatory steroid creams were allowed during the study.
Remicade maker Centocor, Inc. funded the study.
Patients began responding to Remicade quickly and were doing significantly better than placebo recipients after six weeks of treatment.
Complete clearing of psoriasis was seen in about one-fourth of patients after 10 weeks of treatment. Fingernail psoriasis -- a particularly disturbing and hard-to-treat psoriasis symptom -- improved by 56% for patients who had this condition.
There are, however, two big drawbacks to Remicade treatment. One is that the drug must be given by intravenous infusion. Patients in the study got infusions at the start of the study, another infusion two weeks later, a third infusion four weeks after the second, and subsequent infusions every eight weeks.
But having to get infusions means that doctors likely will try other treatments first, says Robert Swerlick, MD, associate professor of dermatology at Emory University in Atlanta. Swerlick served on the study's safety-monitoring panel.
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