Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history
Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated safety and efficacy of combination therapy of infliximab and TGP in treating 13 severe psoriasis patients with liver disorder history.Thirteen patients with severe psoriasis, including 8 men and 5 women, with a mean age of 37.3 ± 12.3 were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean PASI score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5mg/kg and TGP at a dose of 1.8g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 week and 9.6 week, respectively. Conclusion: Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for the patients with liver disorder history.