Scientific presentation for International Congress of Young Medical Scientists

1. Ustekinumab therapy
efficacy in psoriasis
patients previously treated
with biologic drugs
Wojciech Francuzik,
Aleksandra Skłodowska
Tutor: Prof. Zygmunt Adamski
Dermatology Interest Group,
Student Scientific Society of
Poznan University of Medical Sciences

2. USTEKINUMAB
Human IgG1 IL-12/23
antibody
Trade name: STELARA

3. Cytokines IL-12 and IL-23 activateT cells
3
Cytokins
including
IFN-g
TNF-a
Th17
Naïve
T cell
IL-23
DC
Th1
Naïve
T cell
IL-12
DC
Cytokines
including
TNF-a
IL-17
IL-22
1. Gately MK, et al. Annu Rev Immunol. 1998;16:495-521. 2. Wilson NJ, et al. Nat Immunol. 2007;8(9):950-7. 3. Nickoloff BJ, Nestle FO. J Clin Invest. 2004;113(12):1664-75.
Vasodilation, infiltration, plaque formation
Inflammation, increase in WBC

4. Cytokine IL-12 and IL-23 structure
IL-12
IL-23
p35
p40
p40
Anti-p40 mAb

5. Material and methods
39 patients
(6 women i 33 men)
Qualification to treatment with
ustekinumab
Lab tests before initiation of
the therapy

6. Results:
Value
Mean disese duration time (years) 18,69
Mean BSA value (%) 26.7
PASI value (range: 0-72) 12,19
Mean DLQI value (range: 0-30) 9,8
Number of patients previously exposed to
biologic drugs
19 (48,7%)

7. Comorbid conditions
Condition Patient count
Internal organs diseases 9 (23 %)
Hipertension 8 (20,5 %)
Coronary artery disease 4 (10,3 %)
Diabetes 3 (7,7 %)
Obesity 12 (30,8 %)
Nicotine addiction 10 (25%)

8. Weight and age of patients
Age Weight

9. Histogram of PASI values at weeks
0 – 4 – 16 – 52

10. Reduction of PASI value compared
to initial values (in %)

11. Number of patients who achieved
therapeutic goals
0
2
4
6
8
10
12
14
16
18
20
PASI 75 PASI 90
after 4 wks
after 16 wks
after 52 wks
Patientcount

12. Effectiveness of PASI reduction in patients with
psoriatic arthritis

13. Effectiveness of PASI reduction in patiens
previously exposed to biologic drugs.

14. Patients who were shifting from another biologic drug
had lower reduction of PASI during first 4 weeks

15. Adverse events
Event Patient count %
Streptococal infections
2 5 %
M. tuberculosis infection suspected
(QF-TB test positive) 2 5 %
Non- satisfactory response or
worsening 5 12,8%

16. Safety of ustekinumab treatment
• The therapy was well tolerated.
• Most common adverse events were: erythema
in injection site, headache, fatigue. Infections of
upper respiratory tract were most frequently
observed.
• No serious adverse events were noted.

17. Tips to therapeutic success:
• Patients should always undergo
qualification protocol
• Discontinue drug when no benefit is seen
only after 16-32 weeks.
• Do not be afraid of using when shifting
from different biologic agents
• Use of classical psoriasis drugs (MTX) is
often times beneficial and may be adequate
in tough cases.