Журнал клинических и экспериментальных дерматологических исследований
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Management of Infliximab Treated Patients with Psoriasis Based On Infliximab Plasma Levels and Antibodies to Infliximab

Peter Kozub, Andrea Kovacikova Curkova, Maria Zuzulova and Maria Simaljakova

Background: Infliximab is the fastest acting biological agent in psoriasis treatment due to the possibility of intravenous administration and a well-conducted induction phase of treatment (week 0, 2, and 6). Another advantage is the weight-based dosing. However, disadvantages include the risk of infusion reactions and the production of neutralizing antibodies that are responsible for the secondary loss of efficacy.

Objectives: To analyze the dynamics of infliximab levels during one maintenance interval as well as the levels of anti-infliximab antibodies in patients with psoriasis treated with infliximab for a period of at least 22 weeks.

Methods: We followed 25 patients with psoriasis treated with infliximab for a period of at least 22 weeks at a dose of 5 mg/kg. Based on the clinical picture at the time of blood sample collection, the patients were divided into responders, partial responders and non-responders. Plasma levels of infliximab and antibodies to infliximab were examined in venous blood samples taken during one maintenance interval. The levels of infliximab were examined in week 0, 2, 4, 6, 7 and 8 and anti-infliximab antibodies were examined in week 8.

Results: According to the obtained data of infliximab levels and anti-infliximab antibodies, we divided the patients into 4 groups-responders, responders with shortened period of efficacy, non-responders with production of antibodies, and non-responders without production of antibodies. The dynamics of infliximab levels and the production of antiinfliximab antibodies were characteristic for each group. A definitive therapeutic management was created specifically for each group of patients.

Conclusions: Monitoring the dynamics of infliximab levels and anti-infliximab antibodies is not only of scientific importance, but it may be crucial in daily clinical practice, enabling an objective management of infliximab treatment.