Practical experience of ustekinumab in patients with moderate-to-severe psoriasis who had inadequate therapeutic response to previous tumor necrosis factor blockers

Wang, Tzu-Chang; Chiu, Hsien-Yi; Wang, Ting‐Shun; Tsai, Tsen‐Fang

doi:10.1016/j.dsi.2014.09.005

Cited by 14 publications

(10 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the study cohort, 49 (64.5%) and 33(43.4%) of patients achieved at least PASI50 and 75 responses within 7 months of treatment, respectively, similar to previous findings in clinical practice. [ 16 , 24 ]…”

Section: Resultsmentioning

confidence: 99%

“…Ustekinumab, a human monoclonal antibody against the shared p40 subunit of IL-12 and IL-23, has shown great benefit in the treatment of psoriasis across different ethnic groups and geographical regions [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. However, there is a paucity of data on the immunogenicity of ustekinumab in psoriasis patients, particularly for Asians in clinical setting.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Association between Clinical Response to Ustekinumab and Immunogenicity to Ustekinumab and Prior Adalimumab

et al. 2015

Self Cite

View full text Add to dashboard Cite

BackgroundImmunogenicity due to antidrug antibodies (ADA) to tumor necrosis factor (TNF)-α antagonists is known to decrease treatment response. However, few studies have investigated ADA in ustekinumab, an interleukin-12 and -23 antagonist, in a clinical setting. This study aimed to investigate the immunogenicity of ustekinumab and its clinical consequences in psoriasis.MethodsThis prospective observational study enrolled 76 patients with plaque psoriasis who were treated with ustekinumab for a minimum of 7 months. Blood samples were drawn just prior to scheduled ustekinumab injection during clinic visits. Levels of anti-ustekinumab antibody (AUA) and serum ustekinumab concentration were measured respectively by radioimmunoassays and enzyme-linked immunoassays respectively, and correlated to clinical data and Psoriasis Area and Severity Index (PASI).ResultsAUA was detected in 6.5% of patients after a mean of 13 months of treatment. Patients with positive AUA had significantly lower serum ustekinumab concentrations (0.01 vs. 0.2 mg/L, p<0.001) and lower PASI 50 response than patients without AUA (0% vs. 69%, p = 0.004).The percentage of AUA formation was comparable between patients who had failed previous adalimumab with or without anti-adalimumab antibodies (AAA) (14.3% vs. 12.5%, p = 1.00). However, a higher proportion of switchers without AAA obtaining PASI50 (71.4% vs. 37.5%) and PASI75 response (42.9% vs.12.5%) within 7 months of ustekinumab treatment than with AAA though this difference did not reach statistical significance.ConclusionsOur results suggest that presence of AUA was significantly associated with treatment failure for ustekinumab, though limited by a small sample size. Also, determining the presence of ADA to antecedent TNF-α antagonists may assist in choosing an optimized subsequent treatment modality achieving treatment success.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Association between Clinical Response to Ustekinumab and Immunogenicity to Ustekinumab and Prior Adalimumab

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

“…Based on the Bureau of National Health Insurance reimbursement policy in Taiwan, secukinumab treatment is reimbursed for psoriasis patients who have a Psoriasis Area and Severity Index (PASI) ⩾ 10 and inadequate response, contraindication, or intolerance to at least two of the three conventional systemic agents including methotrexate (⩾15 mg/week), acitretin (0.3-1 mg/kg/day), and cyclosporine (3.5-5 mg/kg/day) in addition to narrow-band ultraviolet B or psoralen ultraviolet A phototherapy at least twice weekly for 3 months. [10][11][12][13][14] Prior to secukinumab treatment, all patients underwent screening for the presence of hepatitis B virus (HBV) surface antigen (HBsAg), hepatitis C virus (HCV) antibody, and latent tuberculosis (TB) by chest X-ray and QuantiFERON ® -TB Gold (QFT-G) (Cellestis, Melbourne, Victoria, Australia). 5,15,16 A 9-month isoniazid prophylaxis was recommended for patients with positive QFT-G results.…”

Section: Study Populationmentioning

confidence: 99%

Effectiveness and safety of secukinumab for psoriasis in real-world practice: analysis of subgroups stratified by prior biologic failure or reimbursement

Ger

Huang

Hui

et al. 2019

Therapeutic Advances in Chronic Disease

Self Cite

View full text Add to dashboard Cite

Background: Little is known about the treatment outcomes of secukinumab in clinical practice, which differ from those in clinical trials. The effectiveness of biologics may differ in psoriasis patients with previous biologics exposure. The objective of this study was to investigate the real-world effectiveness and safety of secukinumab therapy and analyze subgroups stratified by reimbursement or prior biologic failure. Methods: This retrospective multicenter study collected data from a cohort of 118 consecutive patients who received secukinumab treatment between December 2015 and March 2018. Effectiveness was evaluated by degree of improvement in the Psoriasis Area and Severity Index (PASI) scores. Adverse events and reasons for discontinuation were also recorded. Results: The mean PASI improvement rate at weeks 4, 12, 24, and 36 was 63.5%, 77.7%, 78.7%, and 76.0%, respectively. Compared with reimbursed patients, nonreimbursed patients had a significantly lower baseline PASI and a shorter mean disease duration of psoriasis; they were more frequently biologic-naïve, had used less prior traditional antipsoriatic drugs and were more likely to be treated with secukinumab 150 mg. The effectiveness of secukinumab in nonreimbursed patients was superior despite higher discontinuation rates. Compared with patients without prior biologic failure, patients with prior biologic failure had a significantly lower mean PASI improvement at weeks 12, 24, 36, and 48. The decline in response rates to secukinumab tended to be more pronounced for patients who failed ustekinumab than tumor necrosis factor-α inhibitors. Moreover, the number of prior biologic failures was associated with a decreased response rate and increased likelihood of secondary loss of effectiveness of secukinumab therapy. Conclusion: In a real-life clinical setting, the characteristics of nonreimbursed patients receiving secukinumab treatment differed from those of reimbursed patients. The PASI improvement for secukinumab was substantial but lower than that in clinical trials. The number and classes of prior biologic failures impact the treatment response to secukinumab.

show abstract

“…

…”

mentioning

confidence: 99%

Risk of Uveitis Among People With Psoriasis

et al. 2017

View full text Add to dashboard Cite

soriasis is a chronic inflammatory dermatosis that affects 0.1% to 3% of the adult population worldwide and results in a heavy economic burden. [1][2][3][4][5][6] Psoriasis has been associated with various comorbidities, including cardiovascular disease, stroke, diabetes mellitus, renal diseases, and arthritis. 7,8 Various studies reported that 6% to 42% of participants with psoriasis had concomitant psoriatic arthritis, while the percentage was lower among Asian people. 9 Psoriatic arthritis is an inflammatory joint disease that may lead to joint destruction and disability. 9 Uveitis is characterized by inflammation involving the uveal tract and associated ocular structures including the iris, ciliary body, and choroid tissue. 10 When affecting the anterior chamber, uveitis may present with pain and redness of the eye. When affecting the posterior chamber, eye pain and redness may not appear, but compromised visual acuity may occur. 11 Uveitis has been associated with psoriatic arthritis 12 and was more frequent and severe in the presence of human leukocyte antigen B27. 13 By contrast, the relationship between uveitis and psoriasis is still under investigation. 11 There have been a few studies examining the association between uveitis and psoriasis without psoriatic arthritis. A US case series reported that 9 patients with psoriasis without psoriatic arthritis had uveitis. 14 A cross-sectional study of 100 Singaporean patients with psoriasis found that the severity of psoriasis assessed by the Global Assessment score of the Lattice System Physician appeared to be higher among patients with uveitis than those without uveitis, although the difference did not reach statistical significance. 15 However, the Singaporean study did not find an association between uveitis and psoriatic arthritis. 15 A Turkish case-control study among 100 patients IMPORTANCE Uveitis has been associated with psoriatic arthritis, but to our knowledge, the relationship between uveitis and psoriasis is unsettled among researchers. OBJECTIVE To evaluate the risk of incident uveitis among people with psoriasis. DESIGN, SETTING, AND PARTICIPANTS This nationwide, retrospective cohort study conducted in Taiwan from January 1, 2000, to December 31, 2012 included 147 954 people with psoriasis (including 10 107 with concomitant psoriatic arthritis and 137 847 without psoriatic arthritis) and 147 954 nonpsoriatic controls. EXPOSURE Psoriasis. MAIN OUTCOMES AND MEASURES Risk of incident uveitis. RESULTSThe mean (SD) age of the 295 908 study participants was 44.4 (19.8) years, and 41.2% (n = 121 878) were women. We found that the group with severe psoriasis with psoriatic arthritis had the greatest risk of incident uveitis compared with the nonpsoriatic controls (adjusted hazard ratio, 2.40; 95% CI, 1.90-3.02). The group with severe psoriasis without psoriatic arthritis and the group with mild psoriasis with psoriatic arthritis also had an increased risk of incident uveitis (adjusted hazard ratio, 1.42; 95% CI, 1.23-1.64; and 1.42; 95% CI, 1.03-1.96; r...

show abstract

Practical experience of ustekinumab in patients with moderate-to-severe psoriasis who had inadequate therapeutic response to previous tumor necrosis factor blockers

Cited by 14 publications

References 40 publications

The Association between Clinical Response to Ustekinumab and Immunogenicity to Ustekinumab and Prior Adalimumab

The Association between Clinical Response to Ustekinumab and Immunogenicity to Ustekinumab and Prior Adalimumab

Effectiveness and safety of secukinumab for psoriasis in real-world practice: analysis of subgroups stratified by prior biologic failure or reimbursement

Risk of Uveitis Among People With Psoriasis

Contact Info

Product

Resources

About