Background

Data on predictors and time to relapse in psoriasis patients discontinuing therapy in a real world setting are scarce.

Objective

To investigate predictors of relapse after withdrawal of ustekinumab in psoriasis patients.

Method

This study screened 500 psoriasis patients who received ustekinumab (669 treatment episodes (TEs)) between 2011 and 2018. Overall, 202 patients (304 TEs), who had responded to therapy and were withdrawn from ustekinumab treatment, were included.

Results

The cumulative probabilities of relapse-free at 6 months, 12 months, 18 months, 24 months and 36 months of withdrawal from ustekinumab treatment was 49.3%, 12.6%, 5.3%, 4.7% and 1.6%, respectively. Multivariate regression analyses with a generalized estimating equation showed that after adjustments, biologics-naive, the maximum Psoriasis Area and Severity Index (PASI) improvement on ustekinumab, time to achieve PASI-50 after initiation of ustekinumab, family history of psoriasis, chronic kidney disease, and immunosuppressants use while off ustekinumab were significant predictors of time to relapse following ustekinumab discontinuation.

Limitation

Non-randomized allocation of duration of treatment and follow-up.

Conclusion

Given high rates of relapse, withdrawal of ustekinumab from patients with well-controlled psoriasis cannot be recommended.

中文翻译：

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对治疗有反应的银屑病患者停用优特克单抗后复发时间的预测因素：一项为期八年的多中心研究

背景

关于在现实世界环境中停止治疗的银屑病患者的预测因素和复发时间的数据很少。

客观的

调查银屑病患者停用优特克单抗后复发的预测因素。

方法

该研究筛选了 500 名在 2011 年至 2018 年间接受优特克单抗治疗的银屑病患者（669 次治疗发作 (TE)）。总体而言，纳入了 202 名对治疗有反应并退出优特克单抗治疗的患者（304 次 TE）。

结果

停止优特克单抗治疗后 6 个月、12 个月、18 个月、24 个月和 36 个月时无复发的累积概率分别为 49.3%、12.6%、5.3%、4.7% 和 1.6%。使用广义估计方程的多变量回归分析表明，调整后，未使用生物制剂、乌司奴单抗最大银屑病面积和严重程度指数 (PASI) 改善、开始使用乌司奴单抗后达到 PASI-50 的时间、银屑病家族史、慢性肾病和免疫抑制剂在停用优特克单抗时的使用是优特克单抗停药后复发时间的重要预测因子。

局限性

治疗和随访持续时间的非随机分配。

结论

鉴于复发率高，不建议银屑病控制良好的患者停用优特克单抗。