Combination Therapy of Biologics With Traditional Agents in Psoriasis

Lyn C. Guenther, MD, FRCPC


Skin Therapy Letter. 2011;16(6) 

In This Article

Combination With Infliximab (Remicade®)

Warren et al. used methotrexate in one patient and cyclosporine in two patients at transition to infliximab therapy in order to prevent a flare.[29] Dalaker and Bonesrønning treated 17 patients with infliximab 3 mg/kg + methotrexate 7.5–15 mg/wk, one with infliximab 5 mg/kg + methotrexate, and five patients with infliximab 5 mg/kg + azathioprine 50 mg/day.[30] At week 14, 69.6% achieved PASI 75 and 39.1% PASI 90. Two patients on methotrexate + infliximab stopped treatment because of loss of response, one after 14 months and one after 3 years.


The National Institute for Health and Clinical Excellence (NICE) guidelines recommend concurrent use of methotrexate with infliximab to enhance efficacy, reduce the development of antibodies to infliximab, and in cases where it is need, to associated arthritis.31 Co-administration of methotrexate with infliximab may result in higher infliximab serum levels.[31]


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