BACKGROUND: Palmoplantar psoriasis is a variant of psoriasis resistant to many forms of treatment. METHODS:Twenty subjects with moderate-to-severe psoriasis of the palms and soles, 50% with pustules at baseline, were treated with ustekinumab at weeks 0, 4, and 16. All subjects had previously failed topical corticosteroids. Dosing was 45 mg subcutaneously for subjects weighing <100 kg and 90 mg for subjects weighing ≥100 kg. The primary endpoint was the percent of subjects achieving clinical clearance at week 16, defined as Palm-Sole Physician's Global Assessment ≤1. The study received Tufts Medical Center IRB approval. RESULTS: After 16 weeks of treatment, 35% (7/20) of subjects achieved clinical clearance. Sixty percent (12/20) improved two or more points on the Palm-Sole Physician's Global Assessment scale. Sixty-seven percent (6/9) of those receiving the 90 mg ustekinumab dose achieved clinical clearance compared with nine percent (1/11) receiving 45 mg (p = 0.02). At 24 weeks, mean values showed 56% improvement in Dermatology Life Quality Index, and 34% improvement in pain Visual Analogue Scale score (all p < 0.05). LIMITATIONS: Assessment tools for palmoplantar psoriasis are not yet validated. Five subjects withdrew or were lost to follow-up. CONCLUSION: This study demonstrates that ustekinumab dosed at 90 mg is effective in controlling signs and symptoms of palmoplantar psoriasis.
RCT Entities:
BACKGROUND:Palmoplantar psoriasis is a variant of psoriasis resistant to many forms of treatment. METHODS: Twenty subjects with moderate-to-severe psoriasis of the palms and soles, 50% with pustules at baseline, were treated with ustekinumab at weeks 0, 4, and 16. All subjects had previously failed topical corticosteroids. Dosing was 45 mg subcutaneously for subjects weighing <100 kg and 90 mg for subjects weighing ≥100 kg. The primary endpoint was the percent of subjects achieving clinical clearance at week 16, defined as Palm-Sole Physician's Global Assessment ≤1. The study received Tufts Medical Center IRB approval. RESULTS: After 16 weeks of treatment, 35% (7/20) of subjects achieved clinical clearance. Sixty percent (12/20) improved two or more points on the Palm-Sole Physician's Global Assessment scale. Sixty-seven percent (6/9) of those receiving the 90 mg ustekinumab dose achieved clinical clearance compared with nine percent (1/11) receiving 45 mg (p = 0.02). At 24 weeks, mean values showed 56% improvement in Dermatology Life Quality Index, and 34% improvement in pain Visual Analogue Scale score (all p < 0.05). LIMITATIONS: Assessment tools for palmoplantar psoriasis are not yet validated. Five subjects withdrew or were lost to follow-up. CONCLUSION: This study demonstrates that ustekinumab dosed at 90 mg is effective in controlling signs and symptoms of palmoplantar psoriasis.
Authors: Y Poulin; J J Crowley; R G Langley; K Unnebrink; O M Goldblum; W C Valdecantos Journal: J Eur Acad Dermatol Venereol Date: 2013-06-22 Impact factor: 6.166
Authors: Carmine Pinto; Francesca Di Fabio; Gerardo Rosati; Ivan R Lolli; Enzo M Ruggeri; Libero Ciuffreda; Daris Ferrari; Giovanni Lo Re; Giovanni Rosti; Paolo Tralongo; Raimondo Ferrara; Oscar Alabiso; Silvana Chiara; Giovanni P Ianniello; Antonio Frassoldati; Domenico Bilancia; Giovanna A Campanella; Carlo Signorelli; Patrizia Racca; Elena Benincasa; Maria Elena Stroppolo; Francesco Di Costanzo Journal: Cancer Med Date: 2016-10-17 Impact factor: 4.452