Abstract
Infliximab is one of the most effective treatments available for severe psoriasis. It has been used successfully to treat severe plaque psoriasis, pustular psoriasis and erythrodermic psoriasis, and is one of the most rapidly effective treatments available. Relative contraindications include severe infliximab hypersensitivity, severe heart failure and significant infections including tuberculosis, malignancies and demyelinating diseases. Baseline screening must include testing for tuberculosis (TB) and most advise routine chemistry screen and complete blood count (CBC). The drug is administered by intravenous (IV) infusion. The development of infusion reactions may necessitate treatment with acetaminophen, diphenhydramine and epinephrine. Pre-treatment with acetaminophen and diphenhydramine can prevent infusion reactions.
Follow-up monitoring should include screening for tuberculosis, chemistry screens with liver function tests, CBC and monitoring for infection or malignancy. Side effects include reactivation of tuberculosis, exacerbation of heart failure, reactivation of hepatitis B, hepatotoxicity, exacerbation of demyelinating diseases, the development of lupus-like syndromes and infusion reactions.
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