Remicade therapy shown to improve productivity in patients treated for chronic plaque psoriasis

Increased productivity scores paralleled significant improvements in the role-physical domain (RP) and role-emotional domain (RE) scores of SF-36, an eight-domain questionnaire widely used to assess patient health-related quality of life. In EXPRESS II, at baseline, RP scores in the REMICADE 3 mg/kg, REMICADE 5 mg/kg and placebo groups were relatively low compared with the general population (47.5, 46.6 and 44.8, respectively). At week 10, significant mean increases of 4.1 and 5.1 were reported in the REMICADE 3 mg/kg and 5 mg/kg groups, respectively, compared with little increase (0.8) in the placebo group (P < 0.001). At baseline, RE scores were 47.4, 47.8, and 46.4, respectively. At week 10, significant mean increases of 4.8 and 4.4 were reported in the REMICADE 3 mg/kg and 5 mg/kg groups, respectively, compared with little increase (0.9) in the placebo group (P < 0.001).

At 14 weeks, patients in the REMICADE 3 mg/kg and 5 mg/kg induction groups were randomized to receive scheduled treatment every eight weeks or "as-needed" maintenance therapy with REMICADE. Improvement in productivity scores was better maintained in the scheduled dosing groups versus the as-needed dosing group. The greatest productivity improvement through week 50 was seen in the REMICADE 5 mg/kg every-eight-week maintenance group. Additionally, placebo patients who transitioned to REMICADE treatment at week 16 also achieved improvements in productivity through week 50.

Psoriasis is most commonly diagnosed between the ages of 20 and 30, striking in the prime of people's lives, and the extent of skin involvement varies from mild to severe and disabling. People with severe psoriasis may have large areas of their body covered by lesions, which may crack and bleed. The pain and embarrassment associated with such skin lesions may prevent people from participating in social and work-related activities, and the physical and mental effects of psoriasis have been compared to those of other chronic illnesses such as rheumatoid arthritis, hypertension, heart disease, diabetes and depression. Skin lesions associated with psoriasis often result in feelings of sadness, despair, guilt and anger, as well as in low self-esteem. A person's sense of self-worth can be affected, and in some cases, this emotional turmoil can lead to depression.