A systematic review on the efficacy and safety of Infliximab in patients with psoriasis

Figures & data

Figure 1. The basic selection steps of publications.

Table 1. Methodology quality assessment-jadad scale

The methods to generate the sequence of randomization.
2 points:	The method to generate the sequence of randomization was described and it was appropriate (table of random numbers, computer generated, etc.)
1 point:	The method of generate the sequence of randomization was stated but not in detail.
0 point:	The method to generate the sequence of randomization was described and it was inappropriate (patients were allocated alternatively, or according to date of birth, hospital number, etc.)
Double blinding
2 points:	The method of double blinding was described and it was appropriate (identical placebo, active placebo, dummy, etc.)
1 point:	The research was described as double blind but the method was not in detail.
0 point:	The research was described as double blind but the method of blinding was inappropriate.
Withdrawal or dropouts
1 point:	The number and the reason for withdrawal in each group were stated in detail.
0 point:	No statement on withdrawals and dropouts.

Table 2. Baseline data of included researches

Research	Methods	Allocation concealment	Participants	Interventions	Outcome measures	Jadad scale
Alan Menter^11	Random Double-blinded	Mentioned A	313 patients in infliximab 3 mg/kg, 314 patients in infliximab 5 mg/kg,208 patients in placebo	10 weeks infliximab 3 or 5 mg/kg and placebo	PASI 75 efficiency	4
Hidesshi Torii^12	Random Double-blinded	Mentioned A	35 patients in infliximab 5 mg/kg, 19 patients in placebo	10 weeks infliximab 5 mg/kg and placebo	PASI 75 efficiency	4
J.Barker^13	Open-label, active-controlled, Random	Mentioned B	653 patients in infliximab 5 mg/kg,, 215 patients in methotrexate	10 weeks infliximab 5 mg/kg and placebo	PASI 75 efficiency	2
Kristian Reich^14	Random Double-blinded	A	301 patients in infliximab 5 mg/kg, 77 patients in placebo	10 weeks infliximab 5 mg/kg and placebo	PASI 75 efficiency	4
S.R.Feldman^15	Random Double-blinded	A	99 patients in infliximab 3 mg/kg, 99 patients in infliximab 5 mg/kg, 51 patients in placebo	10 weeks infliximab 3 or 5 mg/kg and placebo	PASI 75 efficiency	4
U Chaudhari^16	Random	B	11 patients in infliximab 5 mg/kg, 11 patients in placebo	10 weeks infliximab 5 mg/kg and placebo	PASI 75 efficiency	2
YANG.Hai-zhen^17	Random Double-blinded	A	84 patients in infliximab 5 mg/kg, 45 patients in placebo	10 weeks infliximab 5 mg/kg and placebo	PASI 75 efficiency	4
A Karanaugh^18	Random Double-blinded	A	100 patients in infliximab 5 mg/kg, 100 patients in placebo	24 weeks infliximab 5 mg/kg and placebo	ACR 20 efficiency	4
Antoni C^19	Random Double-blinded	A	100 patients in infliximab 5 mg/kg, 100 patients in placebo	14 weeks infliximab 5 mg/kg and placebo	ACR 20 efficiency	4
Asta Baranauskaite^20	Open-label, Random	B	51 patients in infliximab+ methotrexate 5 mg/kg, 48 patients in methotrexate	16 weeks infliximab 5 mg/kg and placebo	ACR 20 efficiency	2
Christian E. Antoni^21	Random Double-blinded	A	52 patients in infliximab 5 mg/kg, 52 patients in placebo	16 weeks infliximab 5 mg/kg and placebo	ACR 20 efficiency	4
LAURAC COATES^22	Random Double-blinded	A	31 patients in infliximab 5 mg/kg, 32 patients in placebo	16 weeks infliximab 5 mg/kg and placebo	ACR 20 efficiency	4
R.Bissonnette^23	Random Double-blinded	A	12 patients in infliximab 5 mg/kg, 12 patients in placebo	14 weeks infliximab 5 mg/kg and placebo	m-PPPASI efficiency	4

Figure 2. The meta-analysis result of infliximab (5 mg/kg) group in treatment of psoriasis vulgaris in efficacy.

Figure 3. The meta-analysis result of infliximab (3 mg/kg) group in treatment of psoriasis vulgaris in efficacy.

Table 3. The meta-analysis result (grouped by the dose of infliximab)

			Heterogeneity Test			Total effective rate
Outcome	Number of reference	N	χ^2	p	Model	OR	95%CI	Z	p
Inf5mg/kg	7	1497	49.76	0.00001	Fixed	13.55	(11.14,16.48)	26.05	<0.0001
Inf3mg/kg	2	412	1.81	0.18	Fixed	85.45	(39.13,186.58)	11.16	<0.0001

Figure 4. The meta-analysis result of infliximab (5 mg/kg) group in treatment of psoriasis arthritis (PsA) in efficacy.

Table 4. The incidence rates of adverse events during infliximab treatment

Adverse events	No. of patients with adverse events	Incidence rates (total 1816 patients from 9 articles)
Pain	128	7.05%
Headache	48	2.64%
Nausea	11	0.61%
Diarrhea	10	0.55%
Vomiting	2	0.11%
Infusion reactions	195	10.74%
Abnormal liver function tests	53	2.92%
Development of antinuclear antibodies	20	1.10%
Nasopharyngitis	43	2.37%
Malaise	32	1.76%
Leucopenia	2	0.11%
Pruritus	42	2.31%
Musculoskeletal pain	2	0.11%
Allergic reaction	6	0.33%
Lymphoproliferative disorders and Development of malignancies	1	0.06%

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