Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,
Dermatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy,
Dermatology. 2019;235(3):213-218. doi: 10.1159/000497274. Epub 2019 Mar 29.
Switching between biologics is commonly performed for the management of plaque psoriasis. However, no evidence about switching from secukinumab to ustekinumab has been reported.
This retrospective observational multicenter study aimed to describe efficacy and safety of ustekinumab in secukinumab nonresponder patients.
A total of 21 patients unresponsive to secukinumab were treated with ustekinumab for a mean period of 53.3 weeks. Ustekinumab was effective in reducing disease severity, with significant improvements of both psoriasis area severity index (PASI) and dermatology quality of life index (DLQI) scores. PASI score improvements of 31.8, 44, 77.8, 80.3, 80.5, and 89.6%, at week 4, 12, 24, 36, 48, and above 60 weeks, respectively, were detected (p < 0.05), achieving PASI 50, 75, and > 90 responses in 93.8, 87.5, and 50% of patients at week 48. Four patients withdrew from ustekinumab treatment because of inefficacy, and failure of multiple biologic agents (> 2) seemed to affect ustekinumab drug survival. No serious adverse events (AEs) were reported while 38.1% of patients experienced mild AEs.
Ustekinumab was safe and effective in treating patients unresponsive to secukinumab.
为了治疗斑块状银屑病，经常需要在生物制剂之间进行转换。然而，目前尚无关于从司库奇尤单抗转换为乌司奴单抗的证据。
本回顾性观察性多中心研究旨在描述乌司奴单抗在司库奇尤单抗无应答患者中的疗效和安全性。
共有 21 例对司库奇尤单抗无应答的患者接受乌司奴单抗治疗，平均治疗时间为 53.3 周。乌司奴单抗可有效降低疾病严重程度，银屑病面积严重指数（PASI）和皮肤病生活质量指数（DLQI）评分均有显著改善。在第 4、12、24、36、48 和 60 周时，PASI 评分分别改善了 31.8%、44%、77.8%、80.3%、80.5%和 89.6%（p<0.05），分别有 93.8%、87.5%和 50%的患者在第 48 周时达到 PASI 50、75 和>90 的应答。4 例患者因疗效不佳而退出乌司奴单抗治疗，而多种生物制剂（>2 种）失败似乎影响了乌司奴单抗的药物生存。未报告严重不良事件（AE），但有 38.1%的患者发生了轻度 AE。
乌司奴单抗治疗对司库奇尤单抗无应答的患者安全且有效。
