4CPS-145 Long-term ustekinumab efficacy in treatment of adult patients with moderate to severe plaque psoriasis

BackgroundUstekinumab (UST) is a human interleukin-12 and −23 antagonist indicated for treatment of adult patients suffering moderate to severe plaque psoriasis who do not respond, tolerate or have contraindicated other systemic treatments. UST efficacy has been analysed in phase III clinical trials (PHOENIX 1 and 2, TRANSIT, ACCEPT and CADMUS), however there is a lack of experience in long-term use.PurposeThe aim of this study is to assess UST efficacy in clinical practice in patients with moderate to severe plaque psoriasis.Material and methodsObservational and descriptive study in a university hospital. All patients older than 18 years treated with more than one dose of UST were assessed. Data were collected from medical record and pharmacy electronic databases. Efficacy was evaluated with the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and a range of administration. Patients with a mean range administration period higher than 3.5 months were considered optimised. Statistical analysis was performed using SPSS v. 18.0.ResultsFifty-six patients were evaluated, 51.8% females, mean age was 48.6 (18–81) years. 5.4% were treated with the higher dose of 90 mg. 60.7% were naive to biological treatments, in 28.6% UST was used in second-line treatment and in 10.8% in third-line treatment or higher. Only 9.1% used UST in combination with a conventional disease-modifying antirheumatic drug (cDMARD).Mean duration treatment was 40.6 (SD 24.5) months. 14.35% of patients were optimised. Patients achieved a PASI score <3 in 81.5% and <5 in 94.4%. The score of DLQI was <1 in 56.3% and <5 in 94.6% of patients.Patients treated with cDMARD have a higher range administration (3.26 SD 0.17 months) than those treated only with UST (3.06 SD 0.25 months) (F=2.01 p=0.096) although differences are not significant.ConclusionUST is effective in long-term use, for controlling symptomatology as well as quality of life.UST is used in more than half of the cases in a first-line therapy, and mostly in monotherapy.When used concomitantly with a cDMARD, administration periods tend to be longer, although more studies are required to clarify this hypothesis.No conflict of interest