P92 Efficacy and safety of infliximab biosimilars in the treatment of patients with moderate-to-severe psoriasis

Abstract Increased expression of tumour necrosis factor-a (TNF-a) is related to the pathophysiology of psoriasis. Biosimilar agents of the anti-TNFa infliximab have been approved for treating psoriasis and psoriatic arthritis. There is increasing use and preference for biosimilar agents, because of the higher price of biologic agents and their impending expiration of efficacy for the patient. We report our experience regarding the efficacy and safety of the infliximab biosimilar agents (Inflectra, Zessly, Remsima) in treating patients with moderate-to-severe psoriasis. Data was collected by analysing the medical records of 79 patients with moderate-to-severe psoriasis. All patients switched infliximab with an infliximab biosimilar. Standard doses of 5 mg/kg were given as an intravenous infusion followed by additional 5 mg/kg doses at 2 and 6 weeks after the first infusion, then every 8 weeks. Effectiveness was assessed using the psoriasis area and severity index (PASI) and Dermatology Life Quality Index (DLQI) at Weeks 12, 24, and 52. The mean age was 55 years and the female-to-male ratio was 1:2.5. At baseline the mean PASI score was 19 and DLQI was 12. Twenty patients (25%) had psoriatic arthritis. Fifteen (19%), 22 (28%), 13 (16%), and 78 (99%) patients had failed after cyclosporine, methotrexate, acitretin, and other biologic systemic therapies, respectively. No side effects were reported. Eighty-nine percentage of patients achieved PASI75 (at least 75% improvement from baseline on PASI score) by Week 12 and 65% achieved PASI90 by Week 24. By Week 52, 60% of the patients achieved PASI90 AND 90% achieved DLQI 0/1. All patients with psoriatic arthritis had a significant improvement in their symptoms. According to our study, the infliximab biosimilars demonstrated a favourable efficacy and safety profile. The data provided by our experience contribute to the evidence needed for the clinical evaluation and appropriate incorporation of infliximab biosimilars in the standard treatment of patients with moderate-to-severe psoriasis.1,2