Efficacy and safety of ustekinumab in the treatment of moderate to severe plaque psoriasis in Singapore

• Published in: Singapore medical journal Vol. 64; no. 7; pp. 434 - 438
• Main Authors: Chan, Wai, Wong, Yisheng, Oon, Hazel, Theng, Colin, Chong, Wei-Sheng
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2023; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Drug therapy; Interleukins; Medical research; Medicine, Experimental; Monoclonal antibodies; Original; Psoriasis; Asia; China; Singapore; Biologic; psoriasis; ustekinumab
• ISSN: 0037-5675; 2737-5935
• DOI: 10.11622/smedj.2022029

Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: Ustekinumab is safe and efficacious in the treatment of patients with moderate to severe plaque psoriasis in a multiethnic Asian population.