Ustekinumab superior to etanercept for treatment of psoriasis

January 01, 0001

Ustekinumab superior to etanercept for treatment of psoriasis

These authors from multiple countries compared two biologic agents, ustekinumab (an interleukin-12 and interleukin-23 blocker) and etanercept (an inhibitor of tumor necrosis factor), for the treatment of psoriasis. They randomly assigned 903 patients with moderate-to-severe psoriasis 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). The primary end point was the proportion of patients with at least 75% improvement in the psoriasis area-and-severity index (PASI) at week 12. Assessors were unaware of the treatment assignments.

They found: “There was at least 75% improvement in the PASI at week 12 in 67.5% of patients who received 45 mg of ustekinumab and 73.8% of patients who received 90 mg, as compared with 56.8% of those who received etanercept. Similarly, 65.1% of patients who received 45 mg of ustekinumab and 70.6% of patients who received 90 mg of ustekinumab had cleared or minimal disease according to the physician's global assessment, as compared with 49.0% of those who received etanercept. Among patients who did not have a response to etanercept, 48.9% had at least 75% improvement in the PASI within 12 weeks after crossover to ustekinumab. One or more adverse events occurred through week 12 in 66.0% of patients who received 45 mg of ustekinumab and 69.2% of patients who received 90 mg of ustekinumab and in 70.0% who received etanercept. 1.9%, 1.2%, and 1.2%, respectively, had serious adverse events. Safety patterns were similar before and after crossover from etanercept to ustekinumab.”

 The authors concluded: “The efficacy of ustekinumab at a dose of 45 or 90 mg was superior to that of high-dose etanercept over a 12-week period in patients with psoriasis.”

Cost will be a consideration in treatment choice for many patients.


For the full abstract, click here.

N Engl J Med 362(2):118-128, 14 January 2010. © 2010 to the Massachusetts Medical Society.
Comparison of Ustekinumab and Etanercept for Moderate-to-Severe Psoriasis. Christopher E.M. Griffiths, Bruce E. Strober, Peter van de Kerkhof, et al. Correspondence to Dr. Griffiths: [email protected]

Category: S. Skin. Keywords: psoriasis, ustekiumab, etanercept, randomized controlled trial
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 26 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care