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      Use of ustekinumab after other biological therapies in moderate-severe psoriasis: Real long-term data Translated title: Uso de ustekinumab tras otras terapias biológicas en psoriasis moderada-grave: Resultados en salud en vida real a largo plazo

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          Abstract

          Abstract Objective: Ustekinumab is used in moderate-severe plaque psoriasis with inadequate response to anti-tumour necrosis factor α drugs. Recent studies support the need to assess real long-term data. The aim of this study was to evaluate the real long-term effectiveness and safety of uste kinumab in moderate-severe plaque psoriasis refractory to 2 anti-tumour necrosis factor α drugs. Method: Retrospective descriptive study from January 2010 to March 2019. The study included patients with moderate-severe plaque psoriasis previously treated with at least 2 anti-tumour necrosis factor α biologic drugs. The effectiveness endpoints were Psoriasis Area and Severity Index 90 and 75 response rates at weeks 24, 48, 72, and 96. Safety was assessed using adverse effects and treatment withdrawal. Results: A total of 36 patients were included (men, 61%). Ustekinumab was used after treatment with 2 anti-tumour necrosis factor α drugs in 88.9% of patients. The biologic drugs most frequently administered prior to ustekinumab were infliximab (94.4%) and etanercept (91.7%). It was ob served that at least 66.7% of patients reached Psoriasis Area and Severity Index 90 at weeks 24, 48, 72, and 96. Adverse effects were recorded in 6 patients. There were no treatment withdrawals. Conclusions: Ustekinumab showed real long-term effectiveness and safety in moderate-severe plaque psoriasis with inadequate response to 2 previous anti-tumour necrosis factor α drugs.

          Translated abstract

          Resumen Objetivo: Ustekinumab se usa en psoriasis en placas moderada-grave con respuesta inadecuada a fármacos antifactor de necrosis tumoral α. Recientes estudios sostienen la escasez de resultados en vida real a largo plazo. El objetivo es evaluar la efectividad y seguridad de larga duración de ustekinumab en psoriasis en placas moderada-severa refractaria a dos fármacos antifactor de necrosis tumoral α. Método: Estudio descriptivo retrospectivo entre enero de 2010 y marzo de 2019. Se incluyeron pacientes con psoriasis en placas moderada-grave tratados previamente con al menos dos agentes biológicos antifactor de ne crosis tumoral α. Las variables de efectividad fueron respuestas Psoriasis Area and Severity Index 90 y 75 a las 24, 48, 72 y 96 semanas. La seguridad fue valorada mediante reacciones adversas y suspensiones de tratamiento. Resultados: Se incluyeron 36 pacientes. El 61% fueron varones. Uste kinumab fue usado tras dos fármacos antifactor de necrosis tumoral α en el 88,9% de los pacientes. Los agentes biológicos previos más frecuentes fueron infliximab (94,4%) y etanercept (91,7%). Se observó que, al menos, el 66,7% de los pacientes alcanzaron Psoriasis Area and Severity Index 90 en las semanas 24, 48, 72 y 96. Se registraron reacciones adversas asociadas a ustekinumab en 6 pacientes. No hubo suspensiones. Conclusiones: Ustekinumab ha demostrado ser efectivo y seguro a largo plazo según resultados de vida real en psoriasis en placas moderada-severa tras respuesta inadecuada a dos fármacos antifactor de necrosis tumoral α.

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          Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials

          Risankizumab is a humanised IgG1 monoclonal antibody that binds to the p19 subunit of interleukin-23, inhibiting this key cytokine and its role in psoriatic inflammation. We aimed to assess the efficacy and safety of risankizumab compared with placebo or ustekinumab in patients with moderate-to-severe chronic plaque psoriasis.
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            Psoriasis - epidemiology and clinical spectrum

            Despite psoriasis being a common skin disease, there are still a number of unanswered questions. One of these is the prevalence of the disease, as there is a lack of specific data, with the majority of studies reporting estimates only. Population based studies are rare and longitudinal observations on changing prevalence rates are lacking. This contrasts with other T-cell mediated autoimmune diseases where the number of those affected is rising. Epidemiological studies revealed that a distinct group of diseases is quite frequently associated with psoriasis, e.g. arthritis, colitis, diabetes and hypertension. In contrast, atopic dermatitis and allergies are less frequently seen compared to normal rates of occurrence. As the psoriatic immune response pattern relates to activated Th-1 cells, psoriasis and atopic dermatitis appear to be mutually exclusive due to the Th-1/Th-2 dichotomy.
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              Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis.

              Interleukin-23 is thought to be critical to the pathogenesis of psoriasis. We compared risankizumab (BI 655066), a humanized IgG1 monoclonal antibody that inhibits interleukin-23 by specifically targeting the p19 subunit and thus prevents interleukin-23 signaling, and ustekinumab, an interleukin-12 and interleukin-23 inhibitor, in patients with moderate-to-severe plaque psoriasis.
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                Author and article information

                Journal
                fh
                Farmacia Hospitalaria
                Farm Hosp.
                Grupo Aula Médica (Toledo, Toledo, Spain )
                1130-6343
                2171-8695
                October 2020
                : 44
                : 5
                : 218-221
                Affiliations
                [1] Lanzarote orgnameHospital Doctor José Molina Orosa orgdiv1Servicio de Farmacia Spain
                [2] Puerto Real orgnameHospital Universitario de Puerto Real orgdiv1Servicio de Farmacia Spain
                Article
                S1130-63432020000500005 S1130-6343(20)04400500005
                10.7399/fh.11420
                226bccc7-2868-4e8f-9810-e6032275e33f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 14 April 2020
                : 09 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 4
                Product

                SciELO Spain

                Categories
                Brief Original

                Resultados,Estudio en mundo real,Cambio de medicamentos,Largo plazo,Ustekinumab,Psoriasis treatment,Retrospective study,Clinical outcome,Real-world study,Drug switching,Long-term care,Estudio retrospectivo,Tratamiento de la psoriasis

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