The Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT): results of radiographic analyses after 1 year

• Published in: Annals of the rheumatic diseases 2006-08, Vol.65 (8), p.1038-1043
• Main Authors: Kavanaugh, A, Antoni, C E, Gladman, D, Wassenberg, S, Zhou, B, Beutler, A, Keenan, G, Burmester, G, Furst, D E, Weisman, M H, Kalden, J R, Smolen, J, van der Heijde, D
• Format: Article
• Language: English
• Subjects: Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Psoriatic - diagnostic imaging; Arthritis, Psoriatic - drug therapy; C-reactive protein; Chi-Square Distribution; CRP; DIP; disease modifying antirheumatic drug; Disease Progression; distal interphalangeal; DMARD; Double-Blind Method; Drug Therapy, Combination; erythrocyte sedimentation rate; ESR; Extended Report; Follow-Up Studies; Foot Joints - diagnostic imaging; Glucocorticoids - therapeutic use; Hand Joints - diagnostic imaging; Humans; IFX; IMPACT; Inflammation; Infliximab; Infliximab Multinational Psoriatic Arthritis Controlled Trial; joint space narrowing; JSN; methotrexate; MTX; PBO; placebo; Proteins; PsA; Psoriasis; psoriatic arthritis; Radiography; rheumatoid arthritis; SDD; smallest detectable difference; structural damage; TNF inhibitors; TNFα; Treatment Outcome; Tumor necrosis factor-TNF; tumour necrosis factor alpha; tumour necrosis factor α; van der Heijde-Sharp score; vdH-S score
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2005.045658

Objective: Infliximab is effective in improving signs and symptoms of joint/skin involvement, functional status, and quality of life in patients with psoriatic arthritis (PsA). Using IMPACT trial data, we assessed the effect of infliximab (IFX) on structural damage in PsA. Methods: Patients with active PsA were randomly assigned to receive placebo (PBO/IFX) or infliximab 5 mg/kg (IFX/IFX) at weeks 0, 2, 6, and 14, with the primary endpoint at week 16. The PBO group received infliximab loading doses at weeks 16, 18, and 22. Thereafter, all patients received infliximab 5 mg/kg every 8 weeks through week 50. Hand/feet radiographs were obtained at weeks 0 and 50. Total radiographic scores were determined using the PsA modified van der Heijde-Sharp (vdH-S) score. Projected annual rate of progression was calculated by dividing x ray score by disease duration (years). Results: As reported previously, 65% of infliximab treated patients versus 10% of PBO treated patients achieved an ACR20 response at week 16 (p