Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
J Eur Acad Dermatol Venereol. 2017 Jul;31(7):1183-1187. doi: 10.1111/jdv.14200. Epub 2017 Mar 29.
While safety and efficacy of ustekinumab and secukinumab, monoclonal antibodies approved for psoriasis, are described in clinical trials, data on their real-life application are lacking.
We compared the characteristics of patients initiating first-time treatment with secukinumab or ustekinumab.
All Danish patients with moderate-to-severe plaque psoriasis treated with biologics are recorded in the nationwide DERMBIO registry. We compared characteristics of patients starting first-time therapy with ustekinumab and secukinumab, respectively.
We identified a total of 1037 and 142 first-time treatment series with ustekinumab and secukinumab. There was a male predominance in both groups, but patients initiating secukinumab were slightly older and with longer disease duration; in agreement with guidelines for biologic treatment in Denmark where ustekinumab has been first line for all with psoriasis without joint problems since 2012, and secukinumab first line for psoriasis with joint problems since July 2016. A total of (52.9% and 14.5%) patients receiving ustekinumab and secukinumab, respectively, were bio-naïve. The mean dermatology life quality index score was slightly higher for ustekinumab than secukinumab (11.6 vs. 10.0; P = 0.0769); the mean Psoriasis Area and Severity Index score were significantly higher (10.4 vs. 7.3; P < 0.0001) for ustekinumab. Prevalence of joint disease was markedly lover (22.7% vs. 44.4%) among patients receiving ustekinumab.
We found significant differences in characteristics of patients starting therapy with ustekinumab and secukinumab in a real-life clinical setting. These findings may aid clinicians and researchers when interpreting efficacy data derived from clinical trials and biologic registries of patients with psoriasis.
乌司奴单抗和司库奇尤单抗是两种已获批用于治疗银屑病的单克隆抗体，其在临床试验中的安全性和疗效已有相关报道，但关于其真实世界应用的数据尚缺乏。
我们比较了首次接受司库奇尤单抗和乌司奴单抗治疗的患者的特征。
所有在丹麦接受生物制剂治疗的中重度斑块型银屑病患者均被记录在全国性的 DERMBIO 登记处。我们分别比较了首次接受乌司奴单抗和司库奇尤单抗治疗的患者的特征。
我们共确定了 1037 例和 142 例首次使用乌司奴单抗和司库奇尤单抗的治疗系列。两组均以男性为主，但接受司库奇尤单抗治疗的患者年龄稍大，疾病病程较长；这与丹麦生物制剂治疗指南一致，自 2012 年以来，乌司奴单抗一直是所有无关节问题的银屑病患者的一线治疗药物，而司库奇尤单抗则是自 2016 年 7 月以来有关节问题的银屑病患者的一线治疗药物。分别有（52.9%和 14.5%）接受乌司奴单抗和司库奇尤单抗治疗的患者为生物制剂初治患者。乌司奴单抗组的皮肤病生活质量指数评分略高于司库奇尤单抗组（11.6 比 10.0；P = 0.0769）；乌司奴单抗组的银屑病面积和严重程度指数评分明显更高（10.4 比 7.3；P < 0.0001）。接受乌司奴单抗治疗的患者关节病的患病率明显较低（22.7%比 44.4%）。
在真实临床环境中，我们发现首次接受乌司奴单抗和司库奇尤单抗治疗的患者在特征上存在显著差异。这些发现可能有助于临床医生和研究人员在解释来自银屑病患者临床试验和生物制剂登记处的疗效数据时提供参考。
