Ustekinumab is effective and safe in the long-term treatment of erythrodermic psoriasis : Multicenter study in daily practice
Plana, Clara (Hospital Universitario de la Princesa (Madrid))
Concha-Garzón, María J. (Hospital Universitario de la Princesa (Madrid))
Rocamora, Vicen (Hospital de Manacor (Manacor, Illes Balears))
Baniandrés Rodríguez, Ofelia (Hospital General Universitario Gregorio Marañón)
Feltes, Rosa (Hospital Universitario La Paz (Madrid))
López-Estebaranz, José L. (Hospital Universitario Fundación Alcorcón)
Garcías-Ladaria, Joan (Department of Dermatology. Hospital General de Valencia)
Carrascosa, José Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vilarrasa-Rull, Eva (Institut d'Investigació Biomèdica Sant Pau)
Soria, Caridad (Hospital General Universitario Reina Sofía (Múrcia, Múrcia))
Navajas, Belén (Hospital Universitario de Cruces (Barakaldo, País Basc))
Llamas-Velasco, Mar (Instituto de Investigación Hospital Universitario de la Princesa)
Dauden, Esteban (Instituto de Investigación Hospital Universitario de la Princesa)

Fecha:	2024
Resumen:	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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Biologic therapy ; Daily practice ; Erythrodermic psoriasis ; Ustekinumab
Publicado en:	JEADV Clinical Practice, Vol. 3 Núm. 2 (june 2024) , p. 604-610, ISSN 2768-6566

DOI: 10.1002/jvc2.325

7 p, 890.7 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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