Infliximab is recommended as an option for treating plaque psoriasis in adults, only when the condition:
is very severe as defined by a total Psoriasis Area Severity Index (PASI) of 20 or more and a Dermatology Life Quality Index (DLQI) of more than 18, and
has not responded to conventional systemic treatments and phototherapy, or these options are contraindicated or not tolerated.
Infliximab treatment should be continued beyond 10 weeks only in people whose psoriasis has shown an adequate response to treatment within 10 weeks. An adequate response is defined as either:
a 75% reduction in the PASI score from when treatment started (PASI 75) or
a 50% reduction in the PASI score (PASI 50) and a 5‑point reduction in the DLQI from when treatment started.
When using the DLQI healthcare professionals should take care to ensure that they take account of a patient's disabilities (such as physical impairments) or linguistic or other communication difficulties, in reaching conclusions on the severity of plaque psoriasis. In such cases healthcare professionals should ensure that their use of the DLQI continues to be a sufficiently accurate measure. The same approach should apply in the context of a decision about whether to continue the use of the drug in accordance with section 1.2.