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Published in: BioDrugs 1/2009

01-02-2009 | Adis Drug Profile

Ustekinumab

Authors: Juliane Weber, Susan J. Keam

Published in: BioDrugs | Issue 1/2009

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Abstract

▴ Ustekinumab is a fully human monoclonal antibody that binds with high specificity and affinity to the cytokines interleukin (IL)-12 and IL-23, thereby suppressing IL-12- and IL-23-mediated inflammation associated with psoriasis.
▴ In two large, phase III trials in patients with moderate to severe plaque psoriasis, significantly more subcutaneous ustekinumab 45 or 90 mg recipients (administered as two injections 4 weeks apart) than placebo recipients achieved a 75% improvement on the Psoriasis Area and Severity Index (PASI 75) score at 12 weeks.
▴ Other efficacy measures, including the physician’s global assessment of clinical response at week 12, also favored ustekinumab over placebo. Psoriatic symptom control was maintained during ustekinumab maintenance therapy (administered once every 12 weeks) for up to 76 weeks.
▴ In a phase II trial in patients with active plaque psoriasis and psoriatic arthritis, signs and symptoms of arthritis and psoriatic symptom control were improved to a greater extent with ustekinumab than with placebo at 12 weeks, based on the proportion of patients achieving a 20% improvement in American College of Rheumatology response criteria (arthritis) or PASI 75 (skin symptoms).
▴ Health-related quality of life, assessed using the Dermatology Life Quality Index and the Health Assessment Questionnaire disability index, was improved to a significantly greater extent with ustekinumab than with placebo at week 12.
▴ Subcutaneous ustekinumab was generally well tolerated in clinical trials, with most treatment-emergent adverse events being of mild severity.
Literature
1.
go back to reference Griffiths CEM, Iaccarino L, Naldi L, et al. Psoriasis and psoriatic arthritis: immunological aspects and therapeutic guidelines. Clin Exp Rheumatol 2006 Jan 28; 24(1 Suppl. 40): S72–8PubMed Griffiths CEM, Iaccarino L, Naldi L, et al. Psoriasis and psoriatic arthritis: immunological aspects and therapeutic guidelines. Clin Exp Rheumatol 2006 Jan 28; 24(1 Suppl. 40): S72–8PubMed
2.
go back to reference Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 2008 May; 58(5): 826–50PubMedCrossRef Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 2008 May; 58(5): 826–50PubMedCrossRef
3.
go back to reference Smith CH, Anstey AV, Barker JNWN, et al. British Association of Dermatologists guidelines for use of biological interventions in psoriasis 2005. Br J Dermatol 2005 Sep; 153(3): 486–97PubMedCrossRef Smith CH, Anstey AV, Barker JNWN, et al. British Association of Dermatologists guidelines for use of biological interventions in psoriasis 2005. Br J Dermatol 2005 Sep; 153(3): 486–97PubMedCrossRef
4.
go back to reference Gottlieb A, Korman NJ, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol 2008 May; 58(5): 851–64PubMedCrossRef Gottlieb A, Korman NJ, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol 2008 May; 58(5): 851–64PubMedCrossRef
5.
go back to reference Boker A, Kimball AB, Rolz-Cruz G. Biologicals in the treatment of psoriasis. Curr Opin Invest Drug 2007; 8(11): 939–46 Boker A, Kimball AB, Rolz-Cruz G. Biologicals in the treatment of psoriasis. Curr Opin Invest Drug 2007; 8(11): 939–46
6.
go back to reference Bartlett BL, Tyring SK. Ustekinumab for chronic plaque psoriasis. Lancet 2008 May 17; 371(9625): 1639–40PubMedCrossRef Bartlett BL, Tyring SK. Ustekinumab for chronic plaque psoriasis. Lancet 2008 May 17; 371(9625): 1639–40PubMedCrossRef
7.
go back to reference Torti DC, Feldman SR. Interleukin-12, interleukin-23, and psoriasis: current prospects. J Am Acad Dermatol 2007 Dec; 57(6): 1059–68PubMedCrossRef Torti DC, Feldman SR. Interleukin-12, interleukin-23, and psoriasis: current prospects. J Am Acad Dermatol 2007 Dec; 57(6): 1059–68PubMedCrossRef
8.
go back to reference Reddy M, Davis C, Wong J, et al. Modulation of CLA, IL-12R, CD40L, and IL-2Ra expression and inhibition of IL-12- and IL-23-induced cytokine secretion by CNTO 1275. Cell Immunol 2007 May; 247(1): 1–11PubMedCrossRef Reddy M, Davis C, Wong J, et al. Modulation of CLA, IL-12R, CD40L, and IL-2Ra expression and inhibition of IL-12- and IL-23-induced cytokine secretion by CNTO 1275. Cell Immunol 2007 May; 247(1): 1–11PubMedCrossRef
9.
go back to reference Leonardi CL, Kimball AB, Papp KA, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1) [published erratum appears in Lancet 2008 May 17; 371 (9625): 1838]. Lancet 2008 May 17; 371(9625): 1665–74PubMedCrossRef Leonardi CL, Kimball AB, Papp KA, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1) [published erratum appears in Lancet 2008 May 17; 371 (9625): 1838]. Lancet 2008 May 17; 371(9625): 1665–74PubMedCrossRef
10.
go back to reference Steinman L. A brief history of TH17, the first major revision in the TH1/TH2 hypothesis of T cell-mediated tissue damage. Nat Med 2007 Feb; 13(2): 139–45PubMedCrossRef Steinman L. A brief history of TH17, the first major revision in the TH1/TH2 hypothesis of T cell-mediated tissue damage. Nat Med 2007 Feb; 13(2): 139–45PubMedCrossRef
11.
go back to reference Kimball AB, Gordon KB, Langley RG, et al. Safety and efficacy of ABT-874, a fully human interleukin 12/23 monoclonal antibody, in the treatment of moderate to severe chronic plaque psoriasis: results of a randomized, placebo-controlled, phase 2 trial. Arch Dermatol 2008 Feb; 144(2): 200–7PubMedCrossRef Kimball AB, Gordon KB, Langley RG, et al. Safety and efficacy of ABT-874, a fully human interleukin 12/23 monoclonal antibody, in the treatment of moderate to severe chronic plaque psoriasis: results of a randomized, placebo-controlled, phase 2 trial. Arch Dermatol 2008 Feb; 144(2): 200–7PubMedCrossRef
12.
go back to reference Cargill M, Schrodi SJ, Chang M, et al. A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. Am J Hum Genet 2007 Feb; 80(2): 273–90PubMedCrossRef Cargill M, Schrodi SJ, Chang M, et al. A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. Am J Hum Genet 2007 Feb; 80(2): 273–90PubMedCrossRef
13.
go back to reference Kauffman CL, Aria N, Toichi E, et al. A phase I study evaluating the safety, pharmacokinetics, and clinical response of a human IL-12 p40 antibody in subjects with plaque psoriasis. J Invest Dermatol 2004 Dec; 123(6): 1037–44PubMedCrossRef Kauffman CL, Aria N, Toichi E, et al. A phase I study evaluating the safety, pharmacokinetics, and clinical response of a human IL-12 p40 antibody in subjects with plaque psoriasis. J Invest Dermatol 2004 Dec; 123(6): 1037–44PubMedCrossRef
14.
go back to reference Toichi E, Torres G, McCormick TS, et al. An anti-IL-12p40 antibody down-regulates type 1 cytokines, chemokines, and IL-12/IL-23 in psoriasis. J Immunol 2006 Oct 1; 177(7): 4917–26PubMed Toichi E, Torres G, McCormick TS, et al. An anti-IL-12p40 antibody down-regulates type 1 cytokines, chemokines, and IL-12/IL-23 in psoriasis. J Immunol 2006 Oct 1; 177(7): 4917–26PubMed
15.
go back to reference Gottlieb AB, Cooper KD, McCormick TS, et al. A phase 1, double-blind, placebo-controlled study evaluating single subcutaneous administrations of a human interleukin-12/23 monoclonal antibody in subjects with plaque psoriasis. Curr Med Res Opin 2007 May; 23(5): 1081–92PubMedCrossRef Gottlieb AB, Cooper KD, McCormick TS, et al. A phase 1, double-blind, placebo-controlled study evaluating single subcutaneous administrations of a human interleukin-12/23 monoclonal antibody in subjects with plaque psoriasis. Curr Med Res Opin 2007 May; 23(5): 1081–92PubMedCrossRef
16.
go back to reference Papp KA, Langley RG, Lebwohl M, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet 2008 May 17; 371(9625): 1675–84PubMedCrossRef Papp KA, Langley RG, Lebwohl M, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet 2008 May 17; 371(9625): 1675–84PubMedCrossRef
17.
go back to reference Zhu Y, Hu C, Lu M, et al. Population pharmacokinetic modeling of ustekinumab, a human monoclonal antibody targeting IL-12/23p40, in patients with moderate to severe plaque psoriasis. J Clin Pharmacol 2009 Feb; 49(2): 162–75PubMedCrossRef Zhu Y, Hu C, Lu M, et al. Population pharmacokinetic modeling of ustekinumab, a human monoclonal antibody targeting IL-12/23p40, in patients with moderate to severe plaque psoriasis. J Clin Pharmacol 2009 Feb; 49(2): 162–75PubMedCrossRef
19.
go back to reference US FDA. Briefing document: ustekinumab [online]. Available from URL: http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4361b1-01-FDA%20.pdf [Accessed 2008 Aug 28] US FDA. Briefing document: ustekinumab [online]. Available from URL: http://​www.​fda.​gov/ohrms/dockets/ac/08/briefing/2008-4361b1-01-FDA%20.pdf [Accessed 2008 Aug 28]
20.
go back to reference Griffiths CEM, Strober B, van der Kerkhof PCM, et al. A phase 3, multicenter, randomized study comparing ustekinumab and etanercept for the treatment of moderate to severe plaque psoriasis [abstract no. FP 1336 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris Griffiths CEM, Strober B, van der Kerkhof PCM, et al. A phase 3, multicenter, randomized study comparing ustekinumab and etanercept for the treatment of moderate to severe plaque psoriasis [abstract no. FP 1336 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris
21.
go back to reference Reich K, Lebwohl M, Schenkel B, et al. Ustekinumab improves work productivity and decreases workdays missed due to psoriasis in patients with moderate to severe psoriasis [abstract no. PSS44]. Value Health 2008 May 30; 11(3): A298CrossRef Reich K, Lebwohl M, Schenkel B, et al. Ustekinumab improves work productivity and decreases workdays missed due to psoriasis in patients with moderate to severe psoriasis [abstract no. PSS44]. Value Health 2008 May 30; 11(3): A298CrossRef
22.
go back to reference Lebwohl M, Schenkel B, Han C, et al. Ustekinumab significantly improves heath-related quality of life in patients with moderate to severe psoriasis [abstract no. FP 1362 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris Lebwohl M, Schenkel B, Han C, et al. Ustekinumab significantly improves heath-related quality of life in patients with moderate to severe psoriasis [abstract no. FP 1362 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris
23.
go back to reference Reich K, Schenkel B, Han C, et al. Ustekinumab reduces work limitations, increases work productivity and decreases workdays missed due to psoriasis in patients with moderate to severe psoriasis [abstract no. FP 1402 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris Reich K, Schenkel B, Han C, et al. Ustekinumab reduces work limitations, increases work productivity and decreases workdays missed due to psoriasis in patients with moderate to severe psoriasis [abstract no. FP 1402 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris
24.
go back to reference Papp K, Kaufmann R, Toth DP, et al. Comparable efficacy and safety of ustekinumab in moderate to severe psoriasis patients treated with systemic therapies and treatment naive patients [abstract no. FP 1388 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris Papp K, Kaufmann R, Toth DP, et al. Comparable efficacy and safety of ustekinumab in moderate to severe psoriasis patients treated with systemic therapies and treatment naive patients [abstract no. FP 1388 plus poster]. 17th Congress of the European Academy of Dermatology and Venereology; 2008 Sep 17–21; Paris
25.
go back to reference Gottlieb A, Menter A, Mendelsohn A, et al. Ustekinumab, a human interleukin 12/ 23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet 2009 Feb 21; 373(9664): 633–40PubMedCrossRef Gottlieb A, Menter A, Mendelsohn A, et al. Ustekinumab, a human interleukin 12/ 23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet 2009 Feb 21; 373(9664): 633–40PubMedCrossRef
Metadata
Title
Ustekinumab
Authors
Juliane Weber
Susan J. Keam
Publication date
01-02-2009
Publisher
Springer International Publishing
Published in
BioDrugs / Issue 1/2009
Print ISSN: 1173-8804
Electronic ISSN: 1179-190X
DOI
https://doi.org/10.2165/00063030-200923010-00006

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