Psoriasis: Golimumab

  • Indications: moderate to severe psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis. Note: golimumab does not have indication for psoriasis 
  • Dosing: 50 mg every 4 wk subcutaneously
  • Efficacy for psoriatic arthritis: ACR 20 in 51% at wk 14
  • Efficacy for psoriasis: PASI-75 in 40% at wk 14
  • Toxicities:
    • Occasional injection-site reactions
    • Rare reports of serious infections and nonmelanoma along with systemic malignancies
    • Although there are rare reports of drug-induced reversible side effects including lupus without central nervous system or renal complications, cytopenias, multiple sclerosis, and exacerbation along with new-onset congestive heart failure with other 3 TNF inhibitors, there have been no reports of these reactions with golimumab to date. However, golimumab is TNF inhibitor and it should be used cautiously.
  • Baseline monitoring:
    • PPD is required
    • LFT and CBC
  • Ongoing monitoring:
    • Yearly PPD and consider periodic CBC and LFT treatment
    • Consider yearly PPD, and periodic CBC and LFT
  • Pregnancy category B
Strength of recommendation: A   Level of evidence: I

Navigate section 6 of the psoriasis guideline: Case-based review

Citation note

Menter A, Korman NJ, Elmets CA,Feldman SR, Gelfand JM, Gordon KB, Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011 Jul;65(1):137-74. 

View the AAD guidelines disclaimer.