Investigator-initiated, open-label trial of ustekinumab for the treatment of moderate-to-severe palmoplantar psoriasis. (June 2013)

• Record Type: Journal Article
• Authors: Au, Shiu-Chung; Goldminz, Ari M.; Kim, Noori; Dumont, Nicole; Michelon, Melissa; Volf, Eva; Hession, Meghan; Lizzul, Paul F.; Andrews, Israel D.; Kerensky, Todd; Wang, Andrew; Yaniv, Shimrat; Gottlieb, Alice B.
• Is Part Of: Journal of dermatological treatment. Volume 24:Number 3(2013:Jun.)
• Page Start: 179
• Page End: 187
• Publication Date: 2013-06
• Subjects: Skin -- Diseases -- Treatment -- Periodicals; Skin Diseases -- drug therapy -- Periodicals; Skin Diseases -- therapy -- Periodicals; 616.5
• DOI: 10.3109/09546634.2012.672710
• Languages: English
• ISSNs: 0954-6634

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background: </italic>Palmoplantar psoriasis is a variant of psoriasis resistant to many forms of treatment. <italic>Methods: </italic>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. <italic>Results</italic>: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 (<italic>p</italic> = 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 <italic>p</italic> < 0.05). <italic>Limitations: </italic>Assessment tools for palmoplantar psoriasis are not yet validated. Five subjects withdrew or were lost to follow-up. <italic>Conclusion: </italic>This study demonstrates that ustekinumab dosed at 90 mg is effective in controlling signs and symptoms of palmoplantar psoriasis.</p> </abstract>