Treatment of recalcitrant erythrodermic psoriasis with ustekinumab

Stinco, Giuseppe; Piccirillo, Angelo; Errichetti, Enzo; Bergamo, Serena; Patrone, Pasquale

doi:10.1684/ejd.2014.2325

Cited by 12 publications

(18 citation statements)

References 9 publications

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“…Such findings would support a possible role of ustekinumab as a valuable therapeutic option for long-lasting control of EP [55]. Moreover, it has also shown efficacy in more resistant cases, since 13 and 10 responsive patients had previously failed one and two other biological agents, respectively [55].…”

Section: Ustekinumabmentioning

confidence: 72%

“…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: 91%

“…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patients, the achieved clinical results were retained during the whole period [51][52][53][54][55]57], and the drug was withdrawn in only two cases due to the onset of severe side effects (see below) [20,56].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]. Moreover, it has also shown efficacy in more resistant cases, since 13 and 10 responsive patients had previously failed one and two other biological agents, respectively [55].…”

Section: Ustekinumabmentioning

confidence: 96%

“…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patients, the achieved clinical results were retained during the whole period [51][52][53][54][55]57], and the drug was withdrawn in only two cases due to the onset of severe side effects (see below) [20,56].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: 99%

“…Ustekinumab is reported to be well tolerated in the treatment of EP [55], and the only two significant adverse events were a case of widespread cutaneous staphylococcal colonization (occurring 9 months after the first administration of the drug) [20] and development of pulmonary miliary tuberculosis (1 week after the second dose of ustekinumab) in a patient with latent tuberculosis infection, despite isoniazid chemoprophylaxis [56]. Regarding the latter event, it is important to keep in mind that the patient had undergone previous and concomitant systemic steroid therapy, which might have made the subject more vulnerable to the development of active tuberculosis.…”

Section: Ustekinumabmentioning

confidence: 99%

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Erythrodermic Psoriasis: Current and Future Role of Biologicals

Stinco

Errichetti

2015

BioDrugs

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Section: Ustekinumabmentioning

confidence: 72%

Section: Ustekinumabmentioning

confidence: 91%

Section: Ustekinumabmentioning

confidence: 96%

Section: Ustekinumabmentioning

confidence: 99%

Section: Ustekinumabmentioning

confidence: 99%

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Erythrodermic Psoriasis: Current and Future Role of Biologicals

Stinco

Errichetti

2015

BioDrugs

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Ustekinumab is effective and safe in the long‐term treatment of erythrodermic psoriasis: Multicenter study in daily practice

Plana,

Concha‐Garzón,

Rocamora

et al. 2024

JEADV Clinical Practice

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BackgroundThe treatment of erythrodermic psoriasis (EP) is challenging. Biological therapies have shown promising results in the long‐term management of this clinical variant, but most of the current available evidence is based on single case reports and short case series.ObjectivesTo determine the effectiveness and safety of ustekinumab (UST) in the treatment of EP under daily practice conditions.MethodsWe conducted a retrospective, observational, nationwide, multicenter cohort study of patients diagnosed with EP treated with UST under daily practice conditions with up to 3 years of follow‐up. Outcomes, such as the psoriasis area and severity index (PASI) and safety, were assessed at months 1, 4, 7, 13, 19, 25, 31 and 37 during treatment. “As observed” and “intention‐to‐treat last observation carried forward (ITT‐LOCF)” analyses were performed.ResultsTwenty‐eight patients were enroled in the study. Baseline mean PASI was 43.1. A sharp decrease in mean PASI was observed during the first 7 months, reaching a plateau that was maintained until the end of the 37‐month follow‐up. At 7 months, 61% and 43% of the patients achieved PASI ≤ 2 and PASI 0, respectively. At 25 months, 48 (39%) (“as observed”/ITT‐LOCF) of the patients achieved complete clearance. At 31 months, PASI 75, PASI 90 and PASI 100 were achieved in 95, 80 and 45 (79%, 64% and 39%) (“as observed”/ITT‐LOCF) of the patients, respectively. Eleven patients required treatment intensification by reducing the interval between doses. Treatment minimisation was performed in four patients. During the follow‐up, nine patients (32%) received systemic combination therapy at some point. Eight patients discontinued treatment mainly due to lack of effectiveness. UST presented a good safety profile. With a follow‐up of 69.25 patient/years, only three patients exhibited serious nondrug‐related adverse events.ConclusionsUstekinumab can be a fast, effective and safe alternative for the long‐term treatment of erythrodermic psoriasis.

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