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Treating Psoriasis

In a study involving more than 900 patients, researchers found that ustekinumab was more effective than etanercept in treating moderate to severe psoriasis. Researchers randomly assigned patients to receive subcutaneous injections of either 45 or 90 mg of ustekinumab (at weeks 0 and 4) or high-dose etanercept (50 mg twice weekly for 12 weeks). At the end of the 12-week treatment period, they found the following percentages of patients showed at least a 75% improvement in the psoriasis area-and-severity index (PASI):

73.8% of those who received 90 mg of ustekinumab

67.5% of those who received 45 mg of ustekinumab

56.8% of those who received etanercept

The researchers also found the following percentages of patients had cleared or minimal disease by physician assessment:

70.6% of those who received 90 mg of ustekinumab
65.1% of those who received 45 mg of ustekinumab
49.0% of those who received etanercept

Among patients who had no response to etanercept, 48.9% showed at least 75% improvement in the PASI within 12 weeks after crossing over to ustekinumab.
Both etanercept and ustekinumab are biologic agents. Etanercept inhibits tumor necrosis factor alpha. Ustekinumab blocks interleukin-12 and interleukin-23. Ustekinumab is approved in Canada and Europe and under review in the United States. (N Eng J Med, 362:118-128, 2010)

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