For the millions of people suffering from psoriasis, help may be on the horizon. In a phase II clinical trial at UMDNJ-Robert Wood Johnson Medical School (RWJMS), patients with moderate to severe psoriasis had significant relief of their symptoms after treatment with infliximab.

"In the study, the majority of patients responded positively to infliximab as compared with placebo, with more than 80 percent achieving an excellent or clear rating," said principal investigator Alice B. Gottlieb, MD, PhD, WH Conzen Chair in Clinical Pharmacology and Director of the Clinical Research Center at RWJMS. She presented the results at the annual meeting of the American Academy of Dermatology in March.

The study was a 10-week, single-center trial involving 33 patients between 18 and 75 years of age with moderate to severe psoriasis over at least 5 percent of their body. Patients received infusions of either infliximab or placebo. Infusions were given at the start of the study and in weeks 2 and 6 of the trial. Patients were evaluated at week 10 and given a rating of good (50 to 74 percent clearing with moderate improvement), excellent (75 to 99 percent clearing with marked improvement) or clear (100 percent clearing).

Infliximab, also known as Remicade, blocks activity of a key inflammatory mediator called tumor necrosis factor alpha (TNF-A). Overproduction of TNF-A leads to inflammation in such conditions as Crohn’s disease, rheumatoid arthritis, and other autoimmune disorders. Research suggests TNF-A may also cause the inflammation associated with psoriasis. Remicade is manufactured and marketed by Centocor, Inc., a Pennsylvania-based company that is a subsidiary of Johnson & Johnson.

Some 6.4 million people in the U.S. suffer from psoriasis, an immune disorder that causes affected skin cells to reproduce 10 times faster than normal ones. Because the skin cannot get rid of the excess cells quickly enough, they build up and form red, raised bumps called plaques. Silvery-white dead skin cells that top these clumps are the scales that slough off. The rash can be painful and itchy, and flaking skin causes patients much embarrassment and anxiety. In a survey of adults with psoriasis, 5 to 10 percent said they had considered suicide, and half stated they would choose a potentially life-threatening therapy if it could clear their skin.

"The potential benefits of biologics like infliximab in the treatment of psoriasis and other autoimmune diseases represent a possible new era in the field of dermatology," says Gottlieb. "Additional clinical research is necessary in a larger study of patients to determine if these benefits can be replicated."