National Skin Centre, Singapore.
The Skin Specialist & Laser Clinic, Mount Alvernia Medical Centre, Singapore.
Singapore Med J. 2023 Jul;64(7):434-438. doi: 10.11622/smedj.2022029.
Ustekinumab is a human monoclonal antibody that binds to the p40 subunit of both interleukin (IL)-12 and IL-23, and it is approved for the treatment of moderate to severe plaque psoriasis. In this study, we assessed the efficacy and safety of patients receiving ustekinumab for psoriasis.
This retrospective study included all adults with chronic plaque psoriasis who were prescribed ustekinumab in a tertiary dermatologic centre between December 2009 and December 2015. Efficacy end points included a proportion of patients achieving at least 50% and 75% improvement from baseline psoriasis area and severity index (PASI) and body surface area (BSA) at Weeks 4 and 16.
A total of 99 patients were prescribed ustekinumab; 69% of these were Chinese, followed by 15% Indians and 9% Malays. 31 patients had documented PASI scores and 55 patients had documented BSA improvements. In patients with recorded PASI scores, 29 (93.5%) of 31 patients achieved PASI 50, and 21 (67.7%) of 31 achieved PASI 75 at week 16. In patients with recorded BSA, 43 (78.2%) of 55 had at least 50% BSA improvement, and 31 (56.4%) of 55 achieved 75% BSA improvement at 16 weeks. Regarding safety, no patient experienced tuberculosis reactivation. A total of 11 (11%) of 99 patients had latent tuberculosis infection and were treated with prophylactic isoniazid. No patient experienced serious adverse events. No cardiovascular events, cutaneous malignancies or deaths were reported over six years.
Ustekinumab is safe and efficacious in the treatment of patients with moderate to severe plaque psoriasis in a multiethnic Asian population.
乌司奴单抗是一种人源化单克隆抗体，可与白细胞介素（IL）-12 和 IL-23 的 p40 亚基结合，用于治疗中重度斑块状银屑病。在这项研究中，我们评估了接受乌司奴单抗治疗的银屑病患者的疗效和安全性。
本回顾性研究纳入了 2009 年 12 月至 2015 年 12 月期间在一家三级皮肤科中心接受乌司奴单抗治疗的所有慢性斑块状银屑病成人患者。疗效终点包括第 4 周和第 16 周时至少有 50%和 75%的患者从基线银屑病面积和严重程度指数（PASI）和体表面积（BSA）改善的患者比例。
共为 99 例患者开具了乌司奴单抗处方；其中 69%为中国人，其次是 15%的印度人和 9%的马来西亚人。31 例患者有记录的 PASI 评分，55 例患者有记录的 BSA 改善情况。在有记录 PASI 评分的患者中，31 例患者中有 29 例（93.5%）达到 PASI 50，31 例患者中有 21 例（67.7%）达到 PASI 75。在有记录 BSA 的患者中，55 例患者中有 43 例（78.2%）至少有 50%的 BSA 改善，55 例患者中有 31 例（56.4%）达到 BSA 改善 75%。关于安全性，没有患者出现结核再激活。共有 11 例（11%）99 例患者患有潜伏性结核感染，并用异烟肼预防性治疗。没有患者发生严重不良事件。在六年多的时间里，没有报告心血管事件、皮肤恶性肿瘤或死亡。
乌司奴单抗在治疗多种族亚洲人群中中重度斑块状银屑病患者时安全有效。
