express: response rates at week 10 0.0 25.6 0 20 40 60 80 100 placebo (n=77) infliximab 5 mg/kg...
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EXPRESS: Response Rates at Week 10
0.0
25.6
0
20
40
60
80
100
Placebo(n=77)
Infliximab 5 mg/kg(n=301)
Per
cen
t of p
atie
nts
Per cent of patients withPASI Score of 0 (Clear)
0.0
39.0
Placebo(n=77)
Infliximab 5 mg/kg(n=292)
Per cent of patients withPhysician’s Global Assessment
of Cleared
1.3
47.1
Placebo(n=77)
Infliximab 5 mg/kg(n=291)
Per cent of patients withDLQI of 0
Adapted from presentations during Dermatology Update 2006
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EXPRESS: Phase III
*P<0.001 vs. placebo
0
20
40
60
80
100
Placebo (n=77) Infliximab 5 mg/kg (n=301)
Per
cen
t of p
atie
nts
with
75%
Impr
ovem
ent i
n P
AS
I
0 2 6 10 14 22 24
Weeks
*
* * * *80.4% 82.2%
Adapted from presentations during Dermatology Update 2006
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Efficacy of Systemic Therapies in Psoriasis
21%27%
34%49%
80%
0%
20%
40%
60%
80%
100%
Alefacept i.m. 15 mg Efalizumab 1 mg/kg/wk
Etanercept 25 mg BIW Etanercept 50 mg BIW
Infliximab 5 mg/kg
83%71% 68%
60%50%
0%
20%
40%
60%
80%
100%
PUVA CyA UVB MTX FAE
Alefacept: Lebwohl et al. Arch Dermatol 2003Efalizumab: Gordon et al. JAMA 2003 Menter et al. Arch Dermatol 2005Etanercept: Leonardi et al. N Engl J Med 2003Infliximab: Reich et al. Lancet 2005
PUVA, UVB: Spuls et al. Br J Dermatol 1997CyA, MTX: Heydendael et al. N Engl J Med 2003FAE: Altmeyer et al. J Am Acad Dermatol 1994
PASI 75 or equivalent; induction therapy (10 to 16 weeks)
Adapted from presentations during Dermatology Update 2006
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Treat active TB to resolution
New patient office visit
PPD test positiveand active TB
Initiate latent TB treatment
Initiate therapyInitiate therapy
Administer appropriate TB screening test(PPD skin test + CXR + family history)
Evaluate test results
Test negative
Initiate therapy
PPD test positiveand normal CXR
Arend SM et al. Neth J Med 2003;61(4):111-9
Algorithm for TB Testing: European-based Recommendations