Infliximab then efalizumab, the 'hit and run' approach does not work.

Author(s): Barde C, Thielen AM, Saurat JH

Affiliation(s): Clinique et Policlinique de Dermatologie, Hopitaux Universitaires de Geneve, Geneva, Switzerland. caroline.barde@hcuge.ch

Publication date & source: 2008, Dermatology., 216(2):171-2. Epub 2008 Jan 23.

Publication type: Case Reports

BACKGROUND: In a previous paper we described 2 patients treated with a sequential biologic therapy for chronic plaque psoriasis. We used infliximab as an induction treatment followed by efalizumab. We extended this approach to 3 other patients. OBJECTIVE: The purpose was to show the feasibility of a sequential approach with biologicals. METHODS: Five patients received three infusions of infliximab followed by weekly injections of efalizumab from week 10 on. RESULTS: The most important findings, summarized in a table, show that none of the patients continued the treatment for more than a year either because of non-responsiveness or because of spontaneous stopping. Moreover, 4 out of 5 patients did not respond or had serious adverse events on reintroduction of infliximab. CONCLUSION: Overall, we cannot recommend sequential therapy using infliximab and efalizumab. (c) 2008 S. Karger AG, Basel.