Ustekinumab for the treatment of psoriasis.
Author(s): Laws PM, Warren RB.
Affiliation(s): Dermatological Sciences, Salford Royal Hospital, The University of Manchester,
Manchester Academic Health Science Centre, Manchester, M6 8HD, UK.
Publication date & source: 2011, Expert Rev Clin Immunol. , 7(2):155-64
Management of psoriasis over the last decade has changed significantly with the
introduction of biological therapies. Ustekinumab is a first-in-class biological
agent, inhibiting the action of IL-12 and IL-23, and has provided further
evidence for the role of Th1 and Th17 lymphocytes in the pathogenesis of
psoriasis. Efficacy has been clearly demonstrated in three Phase III clinical
trials. Week 12 Psoriasis Area and Severity Index (PASI) 75 was observed in
66.4-75.7% of patients with PASI 90 achieved in 36.7-50.9%. This marked clinical
response is also reflected in a significant improvement in quality of life. The
most recent Phase III clinical trial has demonstrated the superior efficacy of
ustekinumab (regardless of dosing regimen) compared with high-dose etanercept at
week 12. Long-term efficacy has been demonstrated over 148 weeks with 64-76% of
patients maintaining PASI 75. The role of ustekinumab in the treatment of
psoriatic arthritis has shown some benefit in Phase II clinical trials. Phase III
clinical trials are pending and will provide further guidance on management of
concurrent disease. The currently available safety data are on the whole
reassuring, although ongoing vigilance remains central to the detection of rare
or late sequelae.
|