Faculty Collaboration Database

Long-term efficacy of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years in the PHOENIX 1 study. J Eur Acad Dermatol Venereol 2013 Dec;27(12):1535-45

Date

01/03/2013

Pubmed ID

23279003

DOI

10.1111/jdv.12046

Scopus ID

2-s2.0-84888205088 (requires institutional sign-in at Scopus site)   181 Citations

Abstract

BACKGROUND: Ongoing evaluation of biological agents in patients with moderate-to-severe psoriasis is needed to support their long-term use.

OBJECTIVE: To evaluate long-term efficacy and safety of ustekinumab through 5 years in the PHOENIX 1 study.

METHODS: Patients were randomized to placebo or ustekinumab (45 mg or 90 mg) at Weeks 0, 4 and every-12-weeks thereafter; placebo patients crossed-over to ustekinumab at Week 12. Clinical response through Week 244 was evaluated using the Psoriasis Area and Severity Index (PASI) in the Overall Population (i.e. patients receiving ≥ 1 dose of ustekinumab), Initial Responders (i.e. PASI 75 responders [Weeks 28/40] re-randomized at Week 40 to continue every-12-week maintenance) and Partial Responders (i.e. <PASI 75 responders adjusted to every-8-week maintenance at Weeks 28 or 40). Safety endpoints were evaluated through Week 264 for the Overall Population.

RESULTS: Overall, 68.7% (517/753) of ustekinumab-treated patients completed treatment through Week 244. Initial clinical responses were generally maintained through Week 244 (PASI 75: 63.4% and 72.0%; PASI 90: 39.7% and 49.0%; PASI 100: 21.6% and 26.4%) for patients receiving 45 mg and 90 mg, respectively. Similarly, PASI 75 responses were generally maintained among Initial Responders [79.1% (45 mg) and 80.8% (90 mg)] and Partial Responders [57.6% (45 mg) and 55.1% (90 mg)]. With 3104 patient-years of follow-up, rates of overall adverse events (AEs), serious AEs, serious infections, malignancies and major adverse cardiovascular events were generally consistent over time and comparable between doses.

CONCLUSIONS: Through 5 years of continuous treatment, ustekinumab demonstrated stable clinical response and a safety profile consistent with previous reports.

Author List

Kimball AB, Papp KA, Wasfi Y, Chan D, Bissonnette R, Sofen H, Yeilding N, Li S, Szapary P, Gordon KB, PHOENIX 1 Investigators

Author

Kenneth Brian Gordon MD Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antibodies, Monoclonal, Humanized
Dose-Response Relationship, Drug
Double-Blind Method
Female
Humans
Male
Middle Aged
Placebos
Psoriasis
Treatment Outcome
Ustekinumab