Infliximab treatment improves productivity among patients with moderate-to-severe psoriasis

This study examined the impact of infliximab maintenance therapy on productivity in patients with moderate-to-severe psoriasis. Patients from the multicentre, double-blind, placebo-controlled EXPRESS study (n = 378) were randomised to receive infusions of placebo or infliximab 5 mg/kg at weeks 0, 2, and 6 and every 8 weeks through week 46, with placebo crossover to infliximab at week 24. Main outcome measures were a 10-cm productivity visual analog scale (VAS), role-physical and role-emotional domain scores of the Short Form 36-Item questionnaire (SF-36), and Dermatology Life Quality Index (DLQI) scores. The productivity VAS score was 5.9 cm at baseline. Mean change through week 10 with infliximab was significantly greater than that with placebo (2.7 cm vs. - 0.1 cm) and was sustained through week 24. Similar trends were observed for SF-36 scores. The proportion of patients whose skin condition prevented them from working and/or studying per DLQI scores decreased through week 10 with infliximab (12.1% and 1.4%, respectively), but increased slightly with placebo (9.1% and 11.6%, respectively). At week 50, improvements in productivity and SF-36 scores were sustained with infliximab. In placebo patients who crossed over to infliximab, these scores improved and approached those seen with infliximab at week 50. Infliximab significantly improved productivity and ability to work in psoriasis patients.