Ustekinumab is effective and safe in the long-term treatment of erythrodermic psoriasis
Background: The 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. Objectives: To determine...
| Autores: | , , , , , , , , , , , , |
|---|---|
| Tipo de documento: | artigo |
| Data de publicação: | 2024 |
| País: | España |
| Recursos: | Universitat Autònoma de Barcelona |
| Repositório: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglês |
| OAI Identifier: | oai:ddd.uab.cat:302167 |
| Acesso em linha: | https://ddd.uab.cat/record/302167 https://dx.doi.org/urn:doi:10.1002/jvc2.325 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Biologic therapy Daily practice Erythrodermic psoriasis Ustekinumab |
| Resumo: | Background: The 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. Objectives: To determine the effectiveness and safety of ustekinumab (UST) in the treatment of EP under daily practice conditions. Methods: We 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. Results: Twenty-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. Conclusions: Ustekinumab can be a fast, effective and safe alternative for the long-term treatment of erythrodermic psoriasis. |
|---|