Sustained efficacy of ustekinumab in refractory erythrodermic psoriasis after failure of antitumor necrosis factor therapies

Castiñeiras, Iria; Fernández-Díaz, L.; Juárez, Yolanda Isabel García; Lueiro, Mercedes

doi:10.1111/j.1346-8138.2011.01499.x

Cited by 18 publications

(24 citation statements)

References 5 publications

(5 reference statements)

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“…As previously reported [8, 9], we observed a striking and rapid response to ustekinumab in the treatment of EP. To our knowledge, this is the first report on the long-term treatment of EP using ustekinumab without any increase in dosage [10], demonstrating its ability to control and prevent the occurrence of erythrodermic flare with an excellent safety profile and a satisfactory compliance.…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab Treatment of Erythrodermic Psoriasis Occurring after Physical Stress: A Report of Two Cases

et al. 2013

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Erythrodermic psoriasis (EP) is a severe form of psoriasis precipitated by numerous factors, including physical stress, infections, and drugs. The disease represents a therapeutic challenge, and little is known about its response to ustekinumab. Though the efficacy of ustekinumab has been extensively studied in chronic plaque psoriasis, no trials have been carried out in EP. We report the case of 2 patients, 1 male and 1 female, who showed EP despite being treated with etanercept and methotrexate for chronic plaque psoriasis, respectively. The patients were treated with ustekinumab at a dosage of 45 mg s.c. They showed a significant improvement in their Psoriasis Area and Severity Index score after only 4 weeks of ustekinumab therapy, and further improvements were observed throughout the treatment. In our experience, ustekinumab has been proven safe and effective, without increasing the dosage, in controlling and preventing the occurrence of erythrodermic flares. Ustekinumab therapy may therefore be considered a valid therapeutic option for the treatment of EP, even in cases where other biological agents have failed.

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Section: Discussionmentioning

confidence: 99%

Ustekinumab Treatment of Erythrodermic Psoriasis Occurring after Physical Stress: A Report of Two Cases

et al. 2013

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“…Significant clinical improvement is generally seen quite quickly, with 50 % and 87.5 % of responders (patients reaching at least PASI 50) achieving PASI 50 at weeks 4 and 12, respectively (findings based on cases where such data were described; n = 16) [20,51,52,[54][55][56]. The average followup duration was 11.6 months (range 3-29); in most patients, the achieved clinical results were retained during the whole period [51][52][53][54][55]57], and the drug was withdrawn in only two cases due to the onset of severe side effects (see below) [20,56]. Such findings would support a possible role of ustekinumab as a valuable therapeutic option for long-lasting control of EP [55].…”

Section: Ustekinumabmentioning

confidence: 88%

“…The use of ustekinumab in the treatment of EP is supported by several small case series and single case reports for a total of 21 patients, with 18 (85.7 %) and 15 (71.4 %) cases reaching PASI 50 and PASI 75, respectively [20,[51][52][53][54][55][56][57]. Importantly, two of the three non-responders were multi-resistant cases that had previously been unsuccessfully treated with three anti-TNFa agents [20].…”

Section: Ustekinumabmentioning

confidence: 90%

Erythrodermic Psoriasis: Current and Future Role of Biologicals

Stinco

Errichetti

2015

BioDrugs

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“…No significant side effect has been reported. Ustekinumab is a human monoclonal antibody against interleukin-12 and -23, which has been licensed for the treatment of moderate to severe plaque psoriasis [7].…”

mentioning

confidence: 99%

“…Recently, it has also been used to treat sub-erythrodermic psoriasis [8] and EP [2,4,7,9,10], especially in cases resistant to traditional and/or anti-TNF-␣ therapies (table 1 shows information on erythrodermic patients). Although safety data concerning the use of ustekinumab in EP are limited by the small number of cases published, significant side effects seem infrequent, since only one case of widespread cutaneous staphylococcal colonization has been reported in the literature [4].…”

mentioning

confidence: 99%