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Ustekinumab Deemed Superior to Etanercept for Psoriasis

Study finds drug associated with greater improvements in psoriasis area-and-severity index

WEDNESDAY, Jan. 13 (HealthDay News) -- In patients with moderate-to-severe psoriasis, treatment with ustekinumab at a dose of 45 or 90 mg is more effective than treatment with high-dose etanercept, according to a study in the Jan. 14 New England Journal of Medicine.

Christopher E.M. Griffiths, M.D., of the University of Manchester in the United Kingdom, and colleagues randomly assigned 903 patients to receive subcutaneous injections of either 45 or 90 mg of ustekinumab (at weeks zero and four) or high-dose etanercept (50 mg twice weekly for 12 weeks).

At 12 weeks, the researchers found that achievement of the primary end point -- at least a 75 percent improvement in the psoriasis area-and-severity index -- was more common in the 45 mg and 90 mg ustekinumab groups (67.5 and 73.8 percent, respectively) than in the etanercept group (56.8 percent). They also found that achievement of cleared or minimal disease was more common in both ustekinumab groups (65.1 and 70.6 percent, respectively) than in the etanercept group (49 percent).

"Our findings are generally consistent with those of previous studies," the authors conclude. "The high level of efficacy of ustekinumab treatment that we observed was achieved with only two injections during the 12-week period, as compared with twice-weekly injections of etanercept, which may be important for improved treatment compliance. Furthermore, the results of this study could have implications for determining the optimal approach to the treatment of psoriasis and, in particular, the need for therapeutic strategies targeting Th1 cells, Th17 cells, or both to provide optimal benefit and safety."

This study was supported by Centocor Research and Development; several authors reported financial relationships with the company.

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