Janssen Biotech’s Stelara (ustekinumab) remains an effective treatment for severe psoriasis long after other therapies have lost their punch, a study shows.
The research, “Biologic drug survival in Israeli psoriasis patients,” was published in the Journal of the American Academy of Dermatology.
Psoriasis is a complex autoimmune disease that can be difficult to treat. Although several therapies are licensed for it, they can lose their effectiveness over time. This could be due to the body producing antibodies against the treatments, eventually neutralizing them.
Israeli researchers decided to see how long various biologic treatments for severe psoriasis were effective, and whether they could predict which therapies would be effective for which patients.
Lev Pavlovsky and his colleagues studied 907 patients, 60% men and 40% women, with a mean age of 46.3 years. Pavlovsky, MD, PhD, is with the Department of Dermatology at Beilinson Hospital’s Rabin Medical Center.
Patients received AbbVie’s Humira (adalimumab), Janssen’s Remicade (infliximab), Amgen’s Enbrel (etanercept) and Stelara. Information about the patients’ treatments came from Clalit Health Services, the largest public HMO in Israel.
Overall, patients received 1,575 treatments. Stelara had the highest treatment survival rate — 40.8 months. Humira’s survival rate was 26.4 months, Enbrel’s 26.35 months, and Remicade’s 23.9 months.
“Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and duration of previous systemic treatments were negative predictors,” the researchers said in a news release. Another therapy, Methotrexate, reduces the clearance of Humira, Remicade and other treatments, increasing their survival rate, the team wrote.
“In comparison to previous reports, it seems that biologic drug survival rates in our [Clalit Health Services] patients are relatively low,” researchers wrote. “This difference may be attributed partially to the Israeli guidelines for treatment of psoriasis.”
“We have shown that biologics efficacy in real-life clinical practice decreases over time,” the researchers concluded. “We observed that [ustekinumab] had higher retention [survival] rates in comparison with other investigated biologics, although most of its use was as a third-line [therapy] in patients with severe psoriasis.”
Stelara is an option when psoriasis fails to respond to treatments applied on the skin. The antibody decreases the inflammation that triggers psoriasis by binding together the proteins IL-12 and IL-23.
The U.S. Food and Drug Administration approved Stelara for psoriasis in 2009 and for those 18 and older with active psoriatic arthritis in 2013.