DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20202656

Evaluation of ustekinumab treatment in psoriasis and the potential effect of metabolic syndrome on treatment response: a single center retrospective study

Ömer Kutlu, Hatice M. Eksioglu

Abstract


Background: Ustekinumab is a biological agent used in the treatment of psoriasis. This study evaluated the treatment response of psoriasis patients who received ustekinumab.

Methods: The study included nine patients with plaque-type psoriasis who received ustekinumab treatment. Clinical response of all patients was evaluated with psoriasis area and severity index (PASI), dermatology life quality index (DLQI), and psoriasis disability index (PDI) at 0, 4, 16 and 28 weeks. The patients were also evaluated for metabolic syndrome and its effect on treatment response.

Results: A total of five male and four female patients with psoriasis vulgaris were included in the study. At the end of 28th weeks, 55% of the patients reached PASI 75 score. The mean PASI scores of the patients at weeks 0, 4, 16, 26 and 28 were 36.98±12.28, 8.86±9.06, 9.52±11.55, 3.55±3.61 and 6.98±6.40, respectively. Although not statistically significant, at the 28th weeks, the mean PASI, DLQI and PDI values of the patients with metabolic syndrome were higher than those without metabolic syndrome (p=0.505, p=0.314, p=0.786, respectively).

Conclusions: Ustekinumab is an effective treatment option for patients with psoriasis who resistant to conventional and biological treatments. In resistant cases to the ustekinumab, the routine treatment interval should be reduced. Psoriasis patients with accompanying metabolic syndrome may have a lower response rate than those without metabolic syndrome to biological agents.


Keywords


PASI score, Quality of life, Ustekinumab, Metabolic syndrome

Full Text:

PDF

References


Smith CH, Anstey AV, Barker JN. British Association of Dermatologists guidelines for use of biological interventions in psoriasis 2005. Br J Dermatol. 2005;153(3):486-97.

Mehlis S, Gordon KB. From laboratory to clinic: rationale for biologic therapy. Dermatol Clin. 2004;22(4):371-7.

Kutlu O, Karaarslan E, Karaosmanoglu N, Eksioglu HM. Evaluation of omalizumab at certain time intervals in patients with chronic spontaneous idiopathic urticaria. Int J Sci Rep. 2019;5(12):351-4.

Dziadecka WD, Grabarek B, Rajs KC, Mrozik SB. The analysis of the therapeutic potential of ustekinumab in psoriasis vulgaris treatment. Dermatol Ther. 2019;28:12843.

Cingoz O. Ustekinumab. MAbs. 2009;1(3):216-21.

Gottlieb AB, Kalb RE, Langley RG, Krueger GG, Jong EM. Safety observations in 12095 patients with psoriasis enrolled in an international registry (PSOLAR): experience with infliximab and other systemic and biologic therapies. J Drugs Dermatol. 2014;13:(12)1441-8.

Papp K, Gottlieb AB, Naldi L. Safety surveillance for ustekinumab and other psoriasis treatments from the psoriasis longitudinal assessment and registry (PSOLAR). J Drugs Dermatol. 2015;14(7):706-14.

Finlay AY, Khan G. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3): 210-6.

Lewis V, Finlay AY. 10 years’ experience of the Dermatology Life Quality Index (DLQI). J Investig Dermatol Symp Proc. 2004;9(2):169-80.

Finlay A, Khan GK, Luscombe DK, Salek MS. Validation of sickness impact profile and psoriasis disability index in psoriasis. British J Dermatology. 1990;123(6):751-6.

Lewis VJ, Finlay AY. Two decades experience of the Psoriasis Disability Index. Dermatology. 2005;210(4):261-8.

Liu L, Li S, Zhao Y, Zhang J, Chen G. Health state utilities and subjective well-being among psoriasis vulgaris patients in mainland China. Qual Life Res. 2018;27(5):1323-33.

Ichiyama S, Ito M, Funasaka Y, Abe M. Assessment of medication adherence and treatment satisfaction in Japanese patients with psoriasis of various severities. J Dermatol. 2018;45(6):727-31.

Jarrett P, Camargo CA, Coomarasamy C, Scragg R. A randomized, double-blind, placebo-controlled trial of the effect of monthly vitamin D supplementation in mild psoriasis. J Dermatolog Treat. 2018;29(4):324-8.

Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):2486.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112(17):2735-52.

Krueger G, Ellis CN. Psoriasis recent advances in understanding its pathogenesis and treatment. J Am Acad Dermatol. 2005;53(1):94-100.

Kutlu O, Metin A. A case of exacerbation of psoriasis after oseltamivir and hydroxychloroquine in a patient with COVID-19: Will cases of psoriasis increase after COVID-19 pandemic. Dermatol Ther. 2020;24(8):4539-47.

Chamian F, Krueger JG. Psoriasis vulgaris: an interplay of T lymphocytes, dendritic cells, and inflammatory cytokines in pathogenesis. Curr Opin Rheumatol. 2004;16(4):331-7.

Shaker OG, Moustafa W, Essmat S, Halim AM, Komy EM. The role of interleukin-12 in the pathogenesis of psoriasis. Clinical Biochem. 2006;39(2):119-25.

Reddy M, Davis C, Wong J, Marsters P. Modulation of CLA, IL-12R, CD40L, and IL-2Rα expression and inhibition of IL-12-and IL-23-induced cytokine secretion by CNTO 1275. Cell Immunol. 2007;247(1):1-11.

Kimball AB, Papp KA, Wasfi Y, Chan D. Long‐term efficacy of ustekinumab in patients with moderate‐to‐severe psoriasis treated for up to 5 years in the PHOENIX 1 study. J Eur Acad Dermatol Venereol. 2013;27(12):1535-45.

Bonifati C, Berardesca E. Clinical outcome measures of psoriasis. Reumatismo. 2007;59(1):64-7.

Chen L, Tsai TF. HLA‐Cw6 and psoriasis. Br J Dermatol. 2018;178(4):562-854.

Chiricozzi A, Krueger JG. IL-17 targeted therapies for psoriasis. Expert Opin Investig Drugs. 2013;22(8):993-1005.

Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S. Interleukin 17A: toward a new understanding of psoriasis pathogenesis. J Am Acad Dermatol. 2014;71(1):141-50.

Boutet MA, Nerviani A, Afflitto G, Pitzalis C. Role of the IL-23/IL-17 axis in psoriasis and psoriatic arthritis: the clinical importance of its divergence in skin and joints. Int J Mol Sci. 2018;19(2):530.

Langley RG, Elewski BE, Lebwohl M, Reich K, Griffiths CE. Secukinumab in plaque psoriasis results of two phase 3 trials. N Eng J Med. 2014;371(4):326-38.

Azfar RS, Gelfand JM. Psoriasis and metabolic disease: epidemiology and pathophysiology. Curr Opin Rhematol. 2008;20(4):416-22.

Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol. 2006;55(5):829-35.

Liakou AI, Zouboulis CC. Links and risks associated with psoriasis and metabolic syndrome. Psoriasis (Auckl). 2015;5:125-8.

Gelfand JM, Yeung H. Metabolic syndrome in patients with psoriatic disease. J Rheumatol Suppl. 2012;89:24-8.