The comparison of effectiveness of therapy with ustekinumab and etanercept in psoriatic patients during 48 weeks’ observation

Inhibitors of the tumour necrosis factor (TNF) – adalimumab, etanercept and 12/23 (IL-12/23) interleukin inhibitor – ustekinumab are used in the therapy of psoriasis vulgaris and psoriatic arthritis. These inhibitors suppress signal pathways activated by the cytokines, for which the said medicines were designed [1]. Etanercept is an example of a fusion protein which bonds to the soluble form of TNF. In turn, ustekinumab shows ability to bind to subunit p40 (IL12B), common for IL-12 and IL-23. The efficacy of therapies with the use of the anti-cytokine medicines can be achieved following a 12-week long pharmacotherapy [2]. Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and Body Surface Area (BSA) scales are used to evaluate the efficacy. Application of the three indexes, which enable to assess, either objectively or subjectively, the intensity of symptoms and therapy efficacy, makes it possible to eliminate the possible interpretation errors of each scale separately. Moreover, thanks to the three said scales it is possible to get a holistic view of the patients’ disease and monitor how the applied therapy affects the quality of their lives [3]. The aim of our study was to compare the efficacy of therapies with the use of etanercept and ustekinumab during a 48-week long observation of psoriatic patients, on the basis of the recommended scales of disease advancement. We also made an attempt to determine whether during the molecularly targeted therapy, a loss of adequate response to treatment (drug resistance) can occur, how fast it can be detected and which of the indexes may describe the case the most accurately.
The sample group was composed of 10 persons, including 7 people with diagnosed psoriasis vulgaris treated with ustekinumab and 3 people with diagnosed psoriatic arthritis treated with etanercept, who had the therapeutic effects analysed 5 times during the whole observation period. The efficacy was assessed with the use of PASI, BSA and DLQI scales in patients treated with ustekinumab on week 0-4-16-28-40, which resulted from the exact dosage regime. In turn, in case of patients treated with etanercept, the observation was made basing on the PASI, BSA and DLQI values every 12 weeks (week 0-12-24-36-48).
The statistical analysis (p < 0.05) was performed with the use of Statistica 12 (Krakow, Poland). The values of PASI, BSA and DLQI indexes in a given week was described with the use of a median (Me),...


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