ABSTRACT
This chapter provides the practicing dermatologist with the use of infliximab in severe plaque-type psoriasis and reviews the mechanism of action, efficacy in psoriasis, and safety profile. Infliximab is the only intravenously infused biologic agent approved for the treatment of chronic severe plaque-type psoriasis in adults. Infliximab is a chimeric immunoglobulin G1 kappa monoclonal antibody composed of human and murine variable regions that was developed to block tumor necrosis factor-α (TNF-α). TNF-α is a proinflammatory cytokine that is elevated in the psoriatic plaques and sera in patients with psoriasis and is a key “driver” cytokine in the pathogenesis of psoriasis. Clinicians may adjust the dosing frequency or amount in order to maintain the optimal therapeutic response. Infliximab is indicated for the treatment of adult patients with chronic severe plaque psoriasis who are candidates for systemic therapy and when other systemic therapies are medically less appropriate.
