Subject(s)
Anemia, Hemolytic, Autoimmune/chemically induced , Antineoplastic Agents/adverse effects , Bridged Bicyclo Compounds, Heterocyclic/adverse effects , Sulfonamides/adverse effects , Adenine/analogs & derivatives , Aged , Anemia, Hemolytic, Autoimmune/drug therapy , Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bridged Bicyclo Compounds, Heterocyclic/therapeutic use , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Male , Methylprednisolone/therapeutic use , Piperidines , Prednisone/administration & dosage , Pyrazoles/administration & dosage , Pyrimidines/administration & dosage , Recurrence , Rituximab/administration & dosage , Salvage Therapy/adverse effects , Sulfonamides/therapeutic use , Vincristine/administration & dosageABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Antibodies, Monoclonal/adverse effects , Anticholesteremic Agents/adverse effects , Everolimus/adverse effects , Immunosuppressive Agents/adverse effects , Kidney Transplantation , Pneumonia/therapy , Hyperlipidemias/chemically induced , Pneumonia/etiologySubject(s)
Antibodies, Monoclonal/adverse effects , Anticholesteremic Agents/adverse effects , Everolimus/adverse effects , Immunosuppressive Agents/adverse effects , Kidney Transplantation , Pneumonia/therapy , Antibodies, Monoclonal, Humanized , Humans , Hyperlipidemias/chemically induced , Male , Middle Aged , Pneumonia/etiologyABSTRACT
BACKGROUND/AIMS: Ustekinumab (UST) is a fully human immunoglobulin G1 monoclonal antibody approved for treating moderate to severe psoriasis and, more recently, psoriatic arthritis (PsA) as well. However, information regarding its clinical usefulness in a real-world setting is scarce. We aimed to evaluate the effectiveness and safety of UST in a real-world clinical setting. METHODS: This single-center observational study included PsA outpatients (n = 50) treated with UST from March 2015 to March 2017. Only patients who used at least 3 doses of UST were analyzed. The percentage of patients who achieved a minimal disease activity (MDA) response was collected. The impact of the disease was also evaluated according to the recently developed Psoriatic Arthritis Impact of Disease (PsAID) questionnaire. A binary logistic regression multivariate model was performed to look for variables predicting MDA. RESULTS: Twenty-seven patients (54%) reached an MDA state. Mean PsAID in MDA group was 3.5 ± 2.9 versus 6.8 ± 5.1 in non-MDA patients (p < 0.001). Among the patients who achieved MDA, 19 (70.4%) had a patient-acceptable symptom state according to the PsAID, whereas only 5 (21.7%) of the 23 patients who did not reach an MDA achieved a patient-acceptable symptom state (p < 0.001). Higher basal Psoriasis Area and Severity Index decreased the odds of achieving MDA (odds ratio [OR], 0.80; 95% CI, 0.65-0.99; p = 0.038), whereas a longer use of UST (OR, 1.52; 95% CI, 1.13-2.06; p = 0.015) and a previous failure to 1 anti-tumor necrosis factor α (OR, 18; 95% CI, 2.52-128.63; p = 0.004) increased this odds. We found no major safety problems. CONCLUSIONS: Ustekinumab was effective and safe in this PsA population. Minimal disease activity and PsAID may be useful tools in the evaluation of PsA therapeutic interventions in routine clinical practice.