Ustekinumab therapy efficacy in psoriasis patients previously treated with biologic drugs Wojciech Francuzik, Aleksandra Skłodowska Tutor: Prof. Zygmunt Adamski Dermatology Interest Group, Student Scientific Society of Poznan University of Medical Sciences
17
Embed
Ustekinumab therapy efficacy in psoriasis patients previously treated with biologic drugs
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Ustekinumab therapy
efficacy in psoriasis
patients previously treated
with biologic drugs
Wojciech Francuzik,
Aleksandra Skłodowska
Tutor: Prof. Zygmunt Adamski
Dermatology Interest Group,
Student Scientific Society of
Poznan University of Medical Sciences
USTEKINUMAB
Human IgG1 IL-12/23
antibody
Trade name: STELARA
Cytokines IL-12 and IL-23 activate T cells
3
Cytokins
including
IFN-g
TNF-a
Th17
Naïve
T cell
IL-23
DC
Th1
Naïve
T cell
IL-12
DC
Cytokines
including
TNF-a
IL-17
IL-22
1. Gately MK, et al. Annu Rev Immunol. 1998;16:495-521. 2. Wilson NJ, et al. Nat Immunol. 2007;8(9):950-7. 3. Nickoloff BJ, Nestle FO. J Clin Invest. 2004;113(12):1664-75.
Vasodilation, infiltration, plaque formation
Inflammation, increase in WBC
Cytokine IL-12 and IL-23 structure
IL-12
IL-23
p35
p40
p40
Anti-p40 mAb
Material and methods
39 patients
(6 women i 33 men)
Qualification to treatment with
ustekinumab
Lab tests before initiation of
the therapy
Results:
Value
Mean disese duration time (years) 18,69
Mean BSA value (%) 26.7
PASI value (range: 0-72) 12,19
Mean DLQI value (range: 0-30) 9,8
Number of patients previously exposed to
biologic drugs 19 (48,7%)
Comorbid conditions
Condition Patient count
Internal organs diseases 9 (23 %)
Hipertension 8 (20,5 %)
Coronary artery disease 4 (10,3 %)
Diabetes 3 (7,7 %)
Obesity 12 (30,8 %)
Nicotine addiction 10 (25%)
Weight and age of patients
Age Weight
Histogram of PASI values at weeks
0 – 4 – 16 – 52
Reduction of PASI value compared
to initial values (in %)
Number of patients who achieved
therapeutic goals
0
2
4
6
8
10
12
14
16
18
20
PASI 75 PASI 90
after 4 wks
after 16 wks
after 52 wks
Patient
count
Effectiveness of PASI reduction in patients with
psoriatic arthritis
Effectiveness of PASI reduction in patiens
previously exposed to biologic drugs.
Patients who were shifting from another biologic drug
had lower reduction of PASI during first 4 weeks
Adverse events
Event Patient count %
Streptococal infections 2 5 %
M. tuberculosis infection suspected
(QF-TB test positive) 2 5 %
Non- satisfactory response or
worsening 5 12,8%
Safety of ustekinumab treatment
• The therapy was well tolerated.
• Most common adverse events were: erythema
in injection site, headache, fatigue. Infections of