Treatment of recalcitrant psoriatic arthritis with anti-tumor necrosis factor-alpha antibody

J Eur Acad Dermatol Venereol. 2002 Mar;16(2):127-9. doi: 10.1046/j.1468-3083.2002.00391.x.


Currently available treatments for psoriatic arthritis are either not completely effective or toxic in some patients. As tumour necrosis factor (TNF)-alpha is involved in both the joint and skin involvement in psoriatic arthritis, blockade of TNF-alpha seems a reliable way to treat patients with this disease. We report two patients with progressive recalcitrant psoriatic arthritis treated with low-dose methotrexate (7.5 mg, once per week) in combination with intravenous chimeric monoclonal anti-TNF-alpha antibody (infliximab, 3 mg/kg body weight). Both showed a dramatic and rapid response in the reduction of pain, followed by improvement of laboratory and clinical signs of joint inflammation. Skin disease also responds after a short delay. The observation shows that infliximab is effective and well tolerated in patients with recalcitrant progressive psoriatic arthritis. Different kinetics of symptom release during treatment suggest a variable role for TNF-alpha in disease pathways of pain, joint inflammation and skin involvement.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage*
  • Antirheumatic Agents / administration & dosage*
  • Arthritis, Psoriatic / diagnosis*
  • Arthritis, Psoriatic / drug therapy*
  • Arthritis, Psoriatic / immunology
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Humans
  • Infliximab
  • Infusions, Intravenous
  • Male
  • Methotrexate / administration & dosage*
  • Pain Measurement
  • Severity of Illness Index
  • Treatment Outcome


  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Infliximab
  • Methotrexate