, Volume 17, Issue 3, pp 187–199 | Cite as

Role of Novel Biological Therapies in Psoriatic Arthritis

Effects on Joints and Skin
Therapy Review


Psoriatic arthritis (PsA) is a partly debilitating disease that may affect small and large joints and the spine. Patients with PsA are divided into different subgroups according to joint involvement and their disease may be classified as part of the spectrum of spondyloarthritides or seronegative rheumatoid arthritis. Traditional treatment comprises nonsteroidal anti-inflammatory drugs, systemic and intra-articular corticosteroids and disease-modifying antirheumatic drugs such as sulfasalazine, methotrexate and cyclosporin. On the basis of the very recent studies performed in the US and Germany, patients with severe disease can be treated with anti-tumour necrosis factor (TNF) therapy. Biologicals such as etanercept and infliximab have been used successfully to treat PsA. While etanercept is a 75kD TNF receptor fusion protein that binds to TNFα and TNFβ, infliximab is a chimeric monoclonal antibody that binds to TNFα both in its soluble form in the serum and on the cell membrane. Adalimumab is a fully humanised antibody recognising TNFα that has not been tested in PsA to date. Another biological agent, alefacept, is directed against the adhesion molecule lymphocyte function-associated antigen (LFA)-2, which is known to interfere with T-cell activation. Alefacept has been shown to be efficacious in a limited number of patients with PsA. Taken together, there has been definite recent progress in the treatment of PsA. Severely affected patients may especially have substantial benefit from therapy with biologicals directed against TNFα and other targets.



Professors Braun and Sieper are members of advisory boards of the following companies: Centocor, Schering-Plough, Wyeth, Amgen, Abbott.


  1. 1.
    Gladman DD, Stafford-Brady F, ChangC-H, et al. Longitudinal study of clinical and radiological progression in psoriatic arthritis. J Rheumatol 1990; 17: 809–12PubMedGoogle Scholar
  2. 2.
    Torre-Alonso JC, Rodriguez Perez A, Arribas CastrilloJM, et al. Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients. Br J Rheumatol 1991; 30: 245–50PubMedGoogle Scholar
  3. 3.
    Jones G, Crotty M, Brooks P. Interventions for treating psoriatic arthritis (Cochrane Review). Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software; 2001Google Scholar
  4. 4.
    Robert C, Kupper TS. Psoriasis: inflammatory skin diseases, T cells and immune surveillance. N Engl J Med 1999; 341: 1817–28PubMedGoogle Scholar
  5. 5.
    Partsch G, Steiner G, Leeb BF, et al. Highly increased levels of tumor necrosis factor-α and other proinflammatory cytokines in psoriatic arthritis synovial fluid. J Rheumatol 1997; 24: 518–23PubMedGoogle Scholar
  6. 6.
    Husby G, Williams RC Jr. Synovial localization of tumor necrosis factor in patients with rheumatoid arthritis. J Autoimmun 1988; 1: 363–71PubMedGoogle Scholar
  7. 7.
    Deleuran BW, Chu CQ, Field M, et al. Localization of interleukin-lα, type 1 interleukin-1 receptor and interleukin-1 receptor antagonist in the synovial membrane and cartilage/pannus junction in rheumatoid arthritis. Br J Rheumatol 1992; 31: 801–9PubMedGoogle Scholar
  8. 8.
    Ritchlin C, Haas-Smith SA, Hicks D, et al. Patterns of cytokine production in psoriatic synovium. J Rheumatol 1998; 25: 1544–52PubMedGoogle Scholar
  9. 9.
    Nawroth PP, Bank I, Handley D, et al. Tumor necrosis factor/cachectin interacts with endothelial cell receptors to induce release of interleukin 1. J Exp Med 1986; 163: 1363–75PubMedGoogle Scholar
  10. 10.
    Brennan FM, Chantry D, Jackson A, et al. Inhibitory effect of TNF-α antibodies on synovial cell interleukin-1 production in rheumatoid arthritis. Lancet 1989; II: 244–7Google Scholar
  11. 11.
    Butler DM, Maini RN, Feldmann M, et al. Modulation of proinflammatory cytokine release in rheumatoid synovial membrane cell cultures: comparison of monoclonal anti TNF-α antibody with the interleukin-1 receptor antagonist. Eur Cytokine Netw 1995; 6: 225–30PubMedGoogle Scholar
  12. 12.
    Haworth C, Brennan FM, Chantry D, et al. Expression of granulocyte-macrophage colony-stimulating factor in rheumatoid arthritis: regulation by tumor necrosis factor-α. Eur J Immunol 1991; 21: 2575–9PubMedGoogle Scholar
  13. 13.
    Saklatvala J. Tumour necrosis factor alpha stimulates resorption and inhibits synthesis of proteoglycan in cartilage. Nature 1986; 322: 547–9PubMedGoogle Scholar
  14. 14.
    Bertolini DR, Nedwin GE, Bringman TS, et al. Stimulation of bone resorption and inhibition of bone formation in vitro by human tumour necrosis factors. Nature 1986; 319: 516–8PubMedGoogle Scholar
  15. 15.
    Shinmei M, Masuda K, Kikuchi T, et al. The role of cytokines in chondrocyte mediated cartilage degradation. J Rheumatol 1989; 6Suppl. 18: 32–4Google Scholar
  16. 16.
    Dayer JM, Beutler B, Cerami A. Cachectin/tumor necrosis factor stimulates collagenase and prostaglandin E2 production by human synovial cells and dermal fibroblasts. J Exp Med 1985; 162: 2163–8PubMedGoogle Scholar
  17. 17.
    Partsch G, Wagner E, Leeb BF, et al. Upregulation of cytokine receptors sTNF-R55, sTNF-R75, and sIL-2R in psoriatic arthritis synovial fluid. J Rheumatol 1998; 25: 105–10PubMedGoogle Scholar
  18. 18.
    Cope AP, Aderka D, Doherty M, et al. Increased levels of soluble tumor necrosis factor receptors in the sera and synovial fluid of patients with rheumatic diseases. Arthritis Rheum 1992; 35: 1160–9PubMedGoogle Scholar
  19. 19.
    Roux-Lombard P, Punzi L, Hasler F, et al. Soluble tumor necrosis factor receptors in human inflammatory synovial fluids. Arthritis Rheum 1993; 36: 485–9PubMedGoogle Scholar
  20. 20.
    Mohler KM, Torrance DS, Smith CA, et al. Soluble tumor necrosis factor (TNF) receptors are effective therapeutic agents in lethal endotoxemia and function simultaneously as both TNF carriers and TNF antagonists. J Immunol 1993; 151: 1548–61PubMedGoogle Scholar
  21. 21.
    Elliott MJ, Maini RN, Feldmann M, et al. Treatment of rheumatoid arthritis with chimeric monoclonal antibodies to tumor necrosis factor alpha. Arthritis Rheum 1993 Dec; 36(12): 1681–90PubMedGoogle Scholar
  22. 22.
    Elliott MJ, Maini RN, Feldmann M, et al. Randomised double-blind comparison of chimeric monoclonal antibody to tumour necrosis factor alpha (cA2) versus placebo in rheumatoid arthritis. Lancet 1994 Oct 22; 344(8930): 1105–10PubMedGoogle Scholar
  23. 23.
    Elliott MJ, Maini RN, Feldmann M, et al. Repeated therapy with monoclonal antibody to tumour necrosis factor alpha (cA2) in patients with rheumatoid arthritis. Lancet 1994 Oct 22; 344(8930): 1125–7PubMedGoogle Scholar
  24. 24.
    Maini RN, Elliott MJ, Brennan FM, et al. Monoclonal anti-TNF alpha antibody as a probe of pathogenesis and therapy of rheumatoid disease. Immunol Rev 1995 Apr; 144: 195–223PubMedGoogle Scholar
  25. 25.
    Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis: Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000; 343: 1594–602PubMedGoogle Scholar
  26. 26.
    Moreland LW, Baumgartner SW, Schiff MH, et al. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75) —Fc fusion protein. N Engl J Med 1997; 337: 141–8PubMedGoogle Scholar
  27. 27.
    Bathon JM, Martin RW, Fleischmann RM, et al. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. N Engl J Med 2000; 343: 1586–93PubMedGoogle Scholar
  28. 28.
    Brandt J, Haibel H, Comely D, et al. Successful treatment of active ankylosing spondylitis with the anti-tumor necrosis factor alpha monoclonal antibody infliximab. Arthritis Rheum 2000; 43: 1346–52PubMedGoogle Scholar
  29. 29.
    Brandt J, Haibel H, Reddig J, et al. Treatment of patients with severe ankylosing spondylitis with infliximab: a one year follow up. Arthritis Rheum 2001; 44(12): 2936–7PubMedGoogle Scholar
  30. 30.
    Braun J, Brandt J, Listing J, et al. Treatment of active ankylosing spondylitis with infliximab: a double-blind placebo controlled multicenter trial. Lancet 2002; 359: 1187–93PubMedGoogle Scholar
  31. 31.
    Van den Bosch F, Kruithof E, Baeten D, et al. Effects of a loading dose regimen of three infusions of chimeric monoclonal antibody to tumour necrosis factor alpha (infliximab) in spondyloarthropathy: an open pilot study. Ann Rheum Dis 2000 Jun; 59(6): 428–33PubMedGoogle Scholar
  32. 32.
    Van den Bosch F, Kruithof E, Baeten D, et al. Randomized double-blind comparison of chimeric monoclonal antibody to tumour necrosis factor alpha (infliximab) versus placebo in active spondyloarthropathy. Arthritis Rheum 2002; 46: 755–65Google Scholar
  33. 33.
    Stone M, Salonen D, Lax M, et al. Clinical and imaging correlates of response to treatment with infliximab in patients with ankylosing spondylitis. J Rheumatol 2001 Jul; 28(7): 1605–14PubMedGoogle Scholar
  34. 34.
    Maksymowych WP, Jhangri GS, Lambert RG, et al. Infliximab in ankylosing spondylitis: a prospective observational inception cohort analysis of efficacy and safety. J Rheumatol 2002; 29: 959–65PubMedGoogle Scholar
  35. 35.
    Antoni C, Dechant C, Ogilvie A, et al. Successful treatment of psoriatic arthritis with infliximab in an MRI controlled study [abstract]. J Rheumatol 2000; 27Suppl. 59: 24Google Scholar
  36. 36.
    Antoni C, Dechant C, Lorenz HM, et al. Open-label study of infliximab treatment for psoriatic arthritis: clinical and magnetic resonance imaging measurements of reduction of inflammation. Arthritis Care Res 2002; 47: 506–12Google Scholar
  37. 37.
    Marzo-Ortega H, McGonagle D, O’Connor P, et al. Efficacy of etanercept in the treatment of the entheseal pathology in resistant spondylarthropathy: a clinical and magnetic resonance imaging study. Arthritis Rheum 2001 Sep; 44(9): 2112–7PubMedGoogle Scholar
  38. 38.
    Gorman JD, Sack KE, Davis Jr JC. Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 2002 May 2; 346(18): 1349–56PubMedGoogle Scholar
  39. 39.
    Brandt J, Haibel H, Reddig J, et al. Successful treatment of severe undifferentiated spondyloarthropathy with the anti-tumor necrosis factor α monoclonal antibody infliximab. J Rheumatol 2002; 29: 118–22PubMedGoogle Scholar
  40. 40.
    Van den Bosch F, Kruithof E, De Vos M, et al. Crohn’s disease associated with spondyloarthropathy: effect of TNF-alpha blockade with infliximab on articular symptoms. Lancet 2000; 356(9244): 1821–2PubMedGoogle Scholar
  41. 41.
    Braun J, Bollow M, Neure L, et al. Use of immunohistologic and in situ hybridization techniques in the examination of sacroiliac joint biopsy specimens from patients with ankylosing spondylitis. Arthritis Rheum 1995; 38: 499–505PubMedGoogle Scholar
  42. 42.
    Mielants H, Veys EM, Goemaere S, et al. A prospective study of patients with spondyloarthropathy with special reference to HLA-B27 and to gut histology. J Rheumatol 1993 Aug; 20(8): 1353–8PubMedGoogle Scholar
  43. 43.
    Sandborn WJ. Anti-tumor necrosis factor therapy for inflammatory bowel disease: a review of agents, pharmacology, clinical results and safety. Inflamm Bowel Dis 1999; 5: 119–33PubMedGoogle Scholar
  44. 44.
    Sandborn WJ, Hanauer SB, Katz S, et al. Etanercept for active Crohn’s disease: a randomized, double-blind, placebo-controlled trial. Gastroenterology 2001 Nov; 121(5): 1088–94PubMedGoogle Scholar
  45. 45.
    Sands BE, Tremaine WJ, Sandborn WJ, et al. Infliximab in the treatment of severe, steroid-refractory ulcerative colitis: a pilot study. Inflamm Bowel Dis 2001 May; 7(2): 83–8PubMedGoogle Scholar
  46. 46.
    Lichtenstein GR. Is infliximab effective for induction of remission in patients with ulcerative colitis? Inflamm Bowel Dis 2001 May; 7(2): 89–93PubMedGoogle Scholar
  47. 47.
    Krueger GG. Selective targeting of T cell subsets: focus on alefacept — a remittive therapy for psoriasis. Expert Opin Biol Ther 2002 Apr; 2(4): 431–41PubMedGoogle Scholar
  48. 48.
    da Silva AJ, Brickelmaier M, Majeau GR, et al. Alefacept, an immunomodulatory recombinant LFA-3/IgG1 fusion protein, induces CD 16 signaling and CD2/ CD16-dependent apoptosis of CD2 (+) cells. J Immunol 2002 May 1; 168(9): 4462–71Google Scholar
  49. 49.
    Lebwohl M, Ali S. Treatment of psoriasis: Part 1. topical therapy and phototherapy. J Am Acad Dermatol 2001 Oct; 45(4): 487–98PubMedGoogle Scholar
  50. 50.
    Lebwohl M, Ali S. Treatment of psoriasis: Part 2. systemic therapies. J Am Acad Dermatol 2001 Nov; 45(5): 649–61PubMedGoogle Scholar
  51. 51.
    Krueger GG. Clinical features of psoriatic arthritis. Am J Manag Care 2002 Apr; 8(6 Suppl.): S160–70PubMedGoogle Scholar
  52. 52.
    Mease PJ. Tumour necrosis factor (TNF) in psoriatic arthritis: pathophysiology and treatment with TNF inhibitors. Ann Rheum Dis 2002 Apr; 61(4): 298–304PubMedGoogle Scholar
  53. 53.
    Ruddle NH. Lymphoid neo-organogenesis: lymphotoxin’s role in inflammation and development. Immunol Res 1999; 19: 119–25PubMedGoogle Scholar
  54. 54.
    Barone D, Krantz C, Lambert D, et al. Comparative analysis of the ability of etanercept and infliximab to lyse TNF-expressing cells in a complement dependent fashion [abstract]. Arthritis Rheum 1999; 42 Suppl.: S90Google Scholar
  55. 55.
    Mease PJ. Cytokine blockers in psoriatic arthritis. Ann Rheum Dis 2001 Nov; 60 Suppl. 3: iii37–40Google Scholar
  56. 56.
    Mease PJ, Goffe BS, Metz J, et al. Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 2000; 356: 385–90PubMedGoogle Scholar
  57. 57.
    Clegg DO, Reda DJ, Mejias E, et al. Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis: a Department of Veterans Affairs Cooperative Study. Arthritis Rheum 1996; 39: 2013–20PubMedGoogle Scholar
  58. 58.
    Felson DT, Andersen JJ, Boers M, et al. American College of Rheumatology preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38: 727–35PubMedGoogle Scholar
  59. 59.
    Mease PJ, Goffe BS, Metz J, et al. Enbrel® (etanercept) in patients with psoriatic arthritis and psoriasis. Ann Rheum Dis 2001; 60Suppl. I: 146Google Scholar
  60. 60.
    Mease P, Kivitz A, Burch F, et al. Improvement in disease activity in patients with psoriatic arthritis receiving etanercept (Enbrel®): results of a phase 3 multicenter clinical trial [abstract]. Arthritis Rheum 2001; 44 Suppl.: S90Google Scholar
  61. 61.
    Gottlieb AB, Lowe NJ, Matheson RT, et al. Efficacy of etanercept in patients with psoriasis. Presented at: American Academy of Dermatology; 2002 Feb 24–26; New Orleans (LA)Google Scholar
  62. 62.
    Iyer S, Yamauchi P, Lowe NJ. Etanercept for severe psoriasis and psoriatic arthritis: observations on combination therapy. Br J Dermatol 2002; 146: 118–21PubMedGoogle Scholar
  63. 63.
    Yazici Y, Erkan D, Lockshin MD. A preliminary study of etanercept in the treatment of severe, resistant psoriatic arthritis. Clin Exp Rheumatol 2000; 18: 732–4PubMedGoogle Scholar
  64. 64.
    Yazici Y, Erkan D, Lockshin MD. Etanercept in the treatment of severe, resistant psoriatic arthritis: continued efficacy and changing patterns of use after two years [letter]. Clin Exp Rheumatol 2002; 20: 115PubMedGoogle Scholar
  65. 65.
    Elkayam O, Yaron M, Caspi D. From wheels to feet: a dramatic response of severe chronic psoriatic arthritis to etanercept [letter]. Ann Rheum Dis 2000; 59: 839PubMedGoogle Scholar
  66. 66.
    Kurschat P, Rubbert A, Poswig A, et al. Treatment of psoriatic arthritis with etanercept [letter]. J Am Acad Dermatol 2001; 44: 1052PubMedGoogle Scholar
  67. 67.
    Aboulafia DM, Bundow D, Wilske K, et al. Etanercept for the treatment of human immunodeficiency virus-associated psoriatic arthritis. Mayo Clin Proc 2000; 75: 1093–8PubMedGoogle Scholar
  68. 68.
    Kruithof E, Van den Bosch F, Baeten D, et al. Repeated infusions of infliximab, a chimeric anti-TNFα monoclonal antibody, in patients with active spondyloarthropathy: one year follow up. Ann Rheum Dis 2002; 61: 207–12PubMedGoogle Scholar
  69. 69.
    Ogilvie AL, Antoni C, Dechant C, et al. Treatment of psoriatic arthritis with antitumour necrosis factor-alpha antibody clears skin lesions of psoriasis resistant to treatment with methotrexate. Br J Dermatol 2001 Mar; 144(3): 587–9PubMedGoogle Scholar
  70. 70.
    Oh CJ, Das KM, Gottlieb AB. Treatment with anti-tumor necrosis factor alpha (TNF-alpha) monoclonal antibody dramatically decreases the clinical activity of psoriasis lesions. J Am Acad Dermatol 2000 May; 42(5 Pt 1): 829–30PubMedGoogle Scholar
  71. 71.
    Kirby B, Marsland AM, Carmichael AJ, et al. Successful treatment of severe recalcitrant psoriasis with combination infliximab and methotrexate. Clin Exp Dermatol 2001 Jan; 26(1): 27–9PubMedGoogle Scholar
  72. 72.
    Chaudhari U, Romano P, Mulcahy LD, et al. Efficacy and safety of infliximab monotherapy for plaque-type psoriasis: a randomised trial. Lancet 2001 Jun 9; 357(9271): 1842–7PubMedGoogle Scholar
  73. 73.
    O’Quinn RP, Miller JL. The effectiveness of tumor necrosis factor alpha antibody (infliximab) in treating recalcitrant psoriasis: a report of 2 cases. Arch Dermatol 2002 May; 138(5): 644–8PubMedGoogle Scholar
  74. 74.
    Schopf RE, Aust H, Knop J. Treatment of psoriasis with the chimeric monoclonal antibody against tumor necrosis factor alpha, infliximab. J Am Acad Dermatol 2002 Jun; 46(6): 886–91PubMedGoogle Scholar
  75. 75.
    Salvarani C, Cantini F, Olivieri I, et al. Efficacy of infliximab in resistant psoriatic arthritis. Arthritis Care Res 2003. In pressGoogle Scholar
  76. 76.
    Olivieri I, Padula A, Ciancio G, et al. Successful treatment of SAPHO syndrome with infliximab: report of two cases. Ann Rheum Dis 2002; 61: 375–6PubMedGoogle Scholar
  77. 77.
    Weber JCP. Epidemiology of adverse reactions to nonsteroidal antiinflammatory drugs. In: Rainsford KD, Velo GP, editors. Advances in Inflammation Research. Vol 6. New York: Raven Press, 1984: 1–7Google Scholar
  78. 78.
    Keane J, Gershon S, Wise RP, et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 2001 Oct 11; 345(15): 1098–104PubMedGoogle Scholar
  79. 79.
    Keane J, Gershon SK, Braun M. Tuberculosis and treatment with infliximab [letter]. N Engl J Med 2002; 346(8): 625–6Google Scholar
  80. 80.
    Riminton S, Pearce N, Basten A. Tuberculosis and treatment with infliximab [letter]. N Engl J Med 2002; 346(8): 625Google Scholar
  81. 81.
    Lim WS, Powell RJ, Johnston ID. Tuberculosis and treatment with infliximab. N Engl J Med 2002; 346(8): 623–6PubMedGoogle Scholar
  82. 82.
    Bean GA, Rosch DR, Briscoe H, et al. Structural deficiences in granuloma formation in TNF gene-targeted mice underlie the heightened susceptibility to aerosol mycobacterium tuberculosis infection. J Immunol 1999; 162: 3504–11PubMedGoogle Scholar
  83. 83.
    Myers A, Clark J, Foster H. Tuberculosis and treatment with infliximab [letter]. N Engl J Med 2002; 346(8): 625Google Scholar
  84. 84.
    Westendorp RG, Langermans JA, Huizinga TW, et al. Genetic influence on cytokine production and fatal meningococcal disease. Lancet 1997 Jan 18; 349(9046): 170–3PubMedGoogle Scholar
  85. 85.
    Ritz MA, Jost R. Severe pneumococcal pneumonia following treatment with infliximab for Crohn’s disease [letter]. Inflamm Bowel Dis 2001 Nov; 7(4): 327PubMedGoogle Scholar
  86. 86.
    Smith D, Letendre S. Viral pneumonia as a serious complication of etanercept therapy [letter]. Ann Intern Med 2002 Jan 15; 136(2): 174PubMedGoogle Scholar
  87. 87.
    Marotte H, Charrin JE, Miossec P. Infliximab-induced aseptic meningitis [letter]. Lancet 2001 Nov 24; 358(9295): 1784PubMedGoogle Scholar
  88. 88.
    Baghai M, Osmon DR, Wolk DM, et al. Fatal sepsis in a patient with rheumatoid arthritis treated with etanercept. Mayo Clin Proc 2001 Jun; 76(6): 653–6PubMedGoogle Scholar
  89. 89.
    Zhang Z, Correa H, Bégué RE. Tuberculosis and treatment with infliximab [letter]. N Engl J Med 2002; 346(8): 624Google Scholar
  90. 90.
    Warns A, Bjorneklett A, Gaustad P. Invasive pulmonary aspergillosis associated with infliximab therapy. N Engl J Med 2001 Apr 5; 344(14): 1099–100Google Scholar
  91. 91.
    Phillips K, Husni ME, Karlson EW, et al. Experience with etanercept in an academic medical center: are infection rates increased? Arthritis Rheum 2002 Feb; 47(1): 17–21PubMedGoogle Scholar
  92. 92.
    De Rosa FG, Bonora S, Di Perri G. Tuberculosis and treatment with infliximab [letter]. N Engl J Med 2002; 346(8): 624Google Scholar
  93. 93.
    Moreland LW, Cohen SB, Baumgartner SW, et al. Longterm safety and efficacy of etanercept in patients with rheumatoid arthritis. J Rheumatol 2001; 28:1238–44PubMedGoogle Scholar
  94. 94.
    Kavanaugh A, Keenan G, DeWoody K, et al. Long-term follow-up of patients treated with Remicade (Infliximab) in clinical trials [abstract]. Arthritis Rheum 2001; 46: S173Google Scholar
  95. 95.
    Smith KJ, Skelton HG. Rapid onset of cutaneous squamous cell carcinoma in patients with rheumatoid arthritis after starting tumor necrosis factor alpha receptor IgG1-Fc fusion complex therapy. J Am Acad Dermatol 2001 Dec; 45(6): 953–6PubMedGoogle Scholar
  96. 96.
    Mohan N, Edwards ET, Cupps TR, et al. Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 2001 Dec; 44(12): 2862–9PubMedGoogle Scholar
  97. 97.
    van Oosten BW, Barkhof F, Truyen L, et al. Increased MRI activity and immune activation in two multiple sclerosis patients treated with the monoclonal anti-tumor necrosis factor antibody cA2. Neurology 1996 Dec; 47(6): 1531–4Google Scholar
  98. 98.
    Robinson WH, Genovese MC, Moreland LW. Demyelinating and neurologic events reported in association with TNF-α antagonism: by what mechanisms could TNF-α antagonism improve RA but exacerbate multiple sclerosis? Arthritis Rheum 2001; 44: 1977–83PubMedGoogle Scholar
  99. 99.
    Data on file, CentocorGoogle Scholar
  100. 100.
    FDA website,
  101. 101.
    Bloom BJ. Development of diabetes mellitus during etanercept therapy in a child with systemic-onset juvenile rheumatoid arthritis. Arthritis Rheum 2000 Nov; 43(11): 2606–8PubMedGoogle Scholar
  102. 102.
    Galaria NA, Werth VP, Schumacher HR. Leukocytoclastic vasculitis due to etanercept. J Rheumatol 2000 Aug; 27(8): 2041–4PubMedGoogle Scholar
  103. 103.
    McCain ME, Quinet RJ, Davis WE. Etanercept and infliximab associated with cutaneous vasculitis. Rheumatology (Oxford) 2002 Jan; 41(1): 116–7Google Scholar
  104. 104.
    Shakoor N, Michalska M, Harris CA, et al. Drug-induced systemic lupus erythematosus associated with etanercept therapy. Lancet 2002 Feb 16; 359( 9306): 579–80PubMedGoogle Scholar
  105. 105.
    Shergy WJ, Isern RA, Cooley DA, et al. Open label study to assess infliximab safety and timing of onset of clinical benefit among patients with RA. J Rheumatol 2002; 29: 667–77PubMedGoogle Scholar
  106. 106.
    Baert F, Noman M, Vermeire S, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn’s disease. N Engl J Med 2003; 348(7): 601–8PubMedGoogle Scholar
  107. 107.
    Ellis CN, Krueger GG. Alefacept Clinical Study Group. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med 2001 Jul 26; 345(4): 248–55PubMedGoogle Scholar
  108. 108.
    Dinant HJ, van Kuijk AWR, Goedkoop AY, et al. Alefacept (LFA3-IgGl fusion protein LFA3TIP) reduces synovial inflammatory infiltrate and improves outcome in psoriatic arthritis. Arthritis Rheum 2001; 42 Suppl.: S91Google Scholar
  109. 109.
    Gottlieb AB, Krueger JG, Wittkowski K, et al. Psoriasis as a model for T-cell-mediated disease: immunobiologic and clinical effects of treatment with multiple doses of efalizumab, an anti-CD11a antibody. Arch Dermatol 2002 May; 138(5): 591–600PubMedGoogle Scholar
  110. 110.
    Krueger JG, Walters IB, Miyazawa M, et al. Successful in vivo blockade of CD25 (high-affinity interleukin 2 receptor) on T cells by administration of humanized anti-Tac antibody to patients with psoriasis. J Am Acad Dermatol 2000 Sep; 43(3): 448–58PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2003

Authors and Affiliations

  1. 1.Rheumazentrum RuhrgebietHerneGermany
  2. 2.Medical Department I, RheumatologyUniversity Hospital Benjamin FranklinBerlinGermany

Personalised recommendations