Repeated infusions of low-dose infliximab plus methotrexate in psoriatic arthritis: Immediate benefits are not maintained after discontinuation of infliximab

M. Covelli, C. Scioscia, F. Iannone, G. Lapadula

DIMIMP, Rheumatology Unit, University of Bari, Italy

ABSTRACT
Objective
To assess the long-term efficacy and tolerability of a therapy consisting of infliximab at low dosage plus methotrexate in patients with psoriatic arthritis (PsA). As a second objective, we assessed whether the improvement obtained after 54 weeks of infliximab could be maintained with methotrexate alone.

Methods
A group of 26 patients with peripheral PsA resistant to various DMARDs were treated with infliximab + methotrexate for 54 weeks.

Results
The clinical response after the induction period was constant and progressive, with a high percentage of patients achieving an ACR50 response. The ESR and CRP values also declined continuously and gradually, but only CRP returned to normal values. During the follow-up period after 54 weeks, infliximab was stopped and the improvement obtained lasted for 2-6 months. The secondary end point was not achieved, and an extension period was designed. Results at 78 weeks are presented.

Conclusions
Open questions for treating patients with infliximab and methotrexate are the schedule and the length of the administration and how to preserve the improvement obtained after the drug discontinuation.

Key words
Rheumatoid arthritis, psoriatic arthritis, anti-TNFa.

Please address correspondence to: Dott. Michele Covelli, DIMIMP, Sezione di Reumatologia, Policlinico Piazza G. Cesare 11, 70124 Bari, Italy.
E-mail m.covelli@reumbari.uniba.it

Clin Exp Rheumatol 2005; 23: 145-151.
© CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2005.