Comenius University, Slovakia
Title: Management of psoriasis patients treated with infliximab based on the dynamics of infliximab levels and antibodies to infliximab
Andrea Kovacikova Curkova is a European board certified dermato-venerologist since 2012. She has completed her residency in dermatology and venerology at the Department of Dermatology and Venerology, Comenius University Faculty of Medicine, Bratislava, Slovakia. She is in her last year of Ph.D. at Comenius University Faculty of Medicine in Bratislava with the research topic Psoriasis and Comorbidities. She is involved in various research projects on psoriasis in the role of a sub-investigator. She has been active in presenting lectures at national and international meetings. She has published 5 papers in reputed journals and won multiple awards for young dermatologists.
Infliximab is the fastest acting biologic agent due to intravenous administration and a well-conducted induction phase of treatment. The disadvantages include the risk of infusion reactions and the production of neutralizing antibodies that are responsible for loss of efficacy. The authors enrolled 30 patients with psoriasis treated with infliximab for a period of minimum 1 year at a dose of 5 mg/kg. Based on the clinical picture the patients were divided into responders (almost clear), partial responders (gradual appearance of new lesions towards the last weeks), and non-responders. Levels of infliximab and antibodies to infliximab were examined in venous blood samples taken in one maintenance interval. Infliximab levels were examined in week 0 (before infusion) and later in weeks 2, 4, 6, 7, and 8 of the maintenance interval. In week 8, blood was taken before the administration of infusion. Antibodies to infliximab were examined only in week 8, blood was taken before administering the infusion. According to the obtained data, we divided the patients into 4 groups - responders, responders with shortened period of efficacy, non-responders with production of antibodies, and non-responders without production of antibodies. The dynamics of infliximab levels and the production of antibodies to infliximab were characteristic for each group. An exact therapeutic management was created specifically for each group of patients. Monitoring of the dynamics of infliximab levels and antibodies to infliximab is not only of scientific importance, but it may be crucial in daily clinical practice enabling an objective management of infliximab treatment.