Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis
Introduction: Ustekinumab is a monoclonal antibody directed against the p40 subunit common to both IL-12 and IL-23 cytokines. Although the evidence of ustekinumab efficacy and safety in clinical trials is extensively recognized, data on its use in clinical practice is limited. Our objective is to re...
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doaj-82c5c712cb1a4d908dfc43ee5d0913852020-11-25T01:15:22ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582019-03-0132321421810.20344/amp.107284867Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe PsoriasisInês Raposo0Andreia Bettencourt1Luiz Leite2Manuela Selores3Tiago Torres4Department of Dermatology. Centro Hospitalar do Porto. Porto.Immunogenetics laboratory. Instituto Ciências Biomédicas Abel Salazar. University of Porto. Porto.Clínica Laser de Belém. Lisboa.Department of Dermatology. Centro Hospitalar do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. University of Porto. Porto. Dermatology Research Unit. Centro Hospitalar do Porto. Porto.Department of Dermatology. Centro Hospitalar do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. University of Porto. Porto. Dermatology Research Unit. Centro Hospitalar do Porto. Porto.Introduction: Ustekinumab is a monoclonal antibody directed against the p40 subunit common to both IL-12 and IL-23 cytokines. Although the evidence of ustekinumab efficacy and safety in clinical trials is extensively recognized, data on its use in clinical practice is limited. Our objective is to report on the real-life experience of two Portuguese dermatology departments with ustekinumab in patients with moderate to severe psoriasis, and to identify the clinical characteristics associated with a weaker clinical response. Material and Methods: Clinical, demographic, and therapeutic response data was retrospectively collected in 116 patients with moderate to severe psoriasis treated with ustekinumab between November 2009 and December 2015. Results: A PASI75 therapeutic response was observed in 67.2%, 85.3%, 89.6% and 88.7% of patients at weeks 4, 12, 24 and 52, respectively. Ustekinumab was discontinued in seven patients (three due to primary failure, three due to secondary treatment failure, and one due to adverse events). Neither cardiovascular events nor cases of reactivation of previous infections (tuberculosis, hepatitis B) were observed during follow-up. In nine patients methotrexate was used as adjuvant therapy, and fourteen patients required ustekinumab dosage optimization. No side effects were observed in the two latter groups. The therapeutic response was higher in patients naïve to biologic therapies as compared to non-naïve patients. Discussion and Conclusion: A trend towards lower clinical response was observed in patients weighing between 90-100 kg, and dosage optimization in this group of patients may be of value prior to considering biologic switch.https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10728Biological Products/therapeutic usePsoriasis/drug therapyUstekinumab/therapeutic use |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Inês Raposo Andreia Bettencourt Luiz Leite Manuela Selores Tiago Torres |
spellingShingle |
Inês Raposo Andreia Bettencourt Luiz Leite Manuela Selores Tiago Torres Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis Acta Médica Portuguesa Biological Products/therapeutic use Psoriasis/drug therapy Ustekinumab/therapeutic use |
author_facet |
Inês Raposo Andreia Bettencourt Luiz Leite Manuela Selores Tiago Torres |
author_sort |
Inês Raposo |
title |
Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis |
title_short |
Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis |
title_full |
Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis |
title_fullStr |
Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis |
title_full_unstemmed |
Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe Psoriasis |
title_sort |
ustekinumab in real-life practice: experience in 116 patients with moderate-to-severe psoriasis |
publisher |
Ordem dos Médicos |
series |
Acta Médica Portuguesa |
issn |
0870-399X 1646-0758 |
publishDate |
2019-03-01 |
description |
Introduction: Ustekinumab is a monoclonal antibody directed against the p40 subunit common to both IL-12 and IL-23 cytokines. Although the evidence of ustekinumab efficacy and safety in clinical trials is extensively recognized, data on its use in clinical practice is limited. Our objective is to report on the real-life experience of two Portuguese dermatology departments with ustekinumab in patients with moderate to severe psoriasis, and to identify the clinical characteristics associated with a weaker clinical response.
Material and Methods: Clinical, demographic, and therapeutic response data was retrospectively collected in 116 patients with moderate to severe psoriasis treated with ustekinumab between November 2009 and December 2015.
Results: A PASI75 therapeutic response was observed in 67.2%, 85.3%, 89.6% and 88.7% of patients at weeks 4, 12, 24 and 52, respectively. Ustekinumab was discontinued in seven patients (three due to primary failure, three due to secondary treatment failure, and one due to adverse events). Neither cardiovascular events nor cases of reactivation of previous infections (tuberculosis, hepatitis B) were observed during follow-up. In nine patients methotrexate was used as adjuvant therapy, and fourteen patients required ustekinumab dosage optimization. No side effects were observed in the two latter groups. The therapeutic response was higher in patients naïve to biologic therapies as compared to non-naïve patients.
Discussion and Conclusion: A trend towards lower clinical response was observed in patients weighing between 90-100 kg, and dosage optimization in this group of patients may be of value prior to considering biologic switch. |
topic |
Biological Products/therapeutic use Psoriasis/drug therapy Ustekinumab/therapeutic use |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10728 |
work_keys_str_mv |
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