Ustekinumab treatment for moderate to severe psoriasis. Eight-year real-world follow-up of 61 cases in a tertiary level hospital

Background: Efficacy and safety profiles of ustekinumab have been proved in numerous clinical trials. However, relevant variations with daily practice have been shown and few studies value the long-term response maintenance. Objective: To evaluate the efficacy of long-term ustekinumab therapy in patients with moderate-to-severe plaque-type psoriasis in a real-world setting. Methods: Observational retrospective follow-up study including, patients receiving ustekinumab at least 3 months in our department. Efficacy was expressed as percentage of patients achieving Psoriasis area and severity index (PASI) 50, PASI75, and PASI90 and maintaining PASI <= 5, <= 3, and 0 every 3 months during the first year of treatment, and every 12 months to the end of follow-up or to withdrawal from the study. Results: Sixty-one patients. Fifty patients had previously been treated with other biologic therapies. The percentage of patients maintaining PASI90 was 72.1, 78.3, 70.0, 83.3, 96.2, 91.7, and 100.0%, and PASI value maintained 0 in 68.9, 73.9, 67.50, 80.6, 96.2, 91.7, and 100.0% at 3, 12, 24, 36, 60, 84, and 96 months. Ustekinumab was discontinued in 26.2% of patients. No patients were withdrawn because of adverse events. Conclusions: This real world-setting study shows maintenance of long-term efficacy and safety of ustekinumab treatment in moderate-severe plaque psoriasis in daily practice through 8 years.