Pustular psoriasis development after initial ustekinumab administration in chronic plaque psoriasis

Gregoriou, Stamatis; Kazakos, Charalambos; Christofidou, Eleftheria; Kontochristopoulos, George; Vakis, George; Rigopoulos, Dimitrios

doi:10.1684/ejd.2011.1164

Cited by 40 publications

(22 citation statements)

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“…Regarding AEs in our study, two patients experienced paradoxical palmoplantar psoriasis. Paradoxical psoriasis is an AE mostly associated with tumour necrosis factor antagonists, and it frequently manifests as palmoplantar pustulosis or palmoplantar plaque psoriasis . Three other patients stopped secukinumab because of arthralgia, candidiasis and eczema, respectively.…”

Section: Discussionmentioning

confidence: 99%

Long‐term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance

et al. 2019

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Summary Background There are limited data regarding the long‐term continuation with biological therapy for patients with psoriasis. In particular, the reasons for secukinumab discontinuation have not been thoroughly investigated. Aim To better ascertain the real‐life continuation of secukinumab in psoriasis, we conducted a retrospective study to evaluate the incidence, causes and factors of secukinumab discontinuation in patients with psoriasis. Methods All patients treated with secukinumab for psoriasis in the Department of Dermatology (Toulouse University and Larrey Hospital, Toulouse, France), between September 2011 and June 2017, were enrolled in the study. Results Of the 91 patients in the study, 22 (24.2%) discontinued secukinumab. In 14 (15%) patients, the discontinuation was due to loss of efficacy. Two patients stopped treatment because they planned a pregnancy and five patients stopped because of adverse events. A longer disease duration (P = 0.01) and presence of palmoplantar psoriasis (P = 0.01) seem to be predictive factors for treatment failure. Patients reaching 90 or 100% improvement in Psoriasis Area and Severity Index (PASI90 and PASI100, respectively) at weeks 12–16 had a lower risk of long‐term treatment discontinuation compared with patients who had less complete clearance (P = 0.04). Conclusion Long‐term persistence of secukinumab appears to be good, as only 24.2% (n = 22) of the patients in this study discontinued secukinumab over the follow‐up period. Loss of efficacy prompted discontinuation in about 14% of patients by the 2‐year follow‐up. Persistence appears to be lower in patients with palmoplantar psoriasis and in patients previously exposed to many systemic treatments. Optimal therapeutic response at 12–16 weeks as defined by reaching PASI90–100 seems to be predictive of long‐term treatment persistence.

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Section: Discussionmentioning

confidence: 99%

Long‐term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance

et al. 2019

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“…115,152,153 On the other hand, three previous studies have independently shown the exacerbation or new occurrence of pustular psoriasis in association with the administration of ustekinumab. [154][155][156] Due to insufficient evidence, it is proper to use ustekinumab in patients with GPP only when they are resistant to other treatment modalities.…”

Section: Cq16 Are Biologics Other Than Tnf-a Inhibitors Effective Fomentioning

confidence: 99%

Japanese guidelines for the management and treatment of generalized pustular psoriasis: The new pathogenesis and treatment of GPP

Fujita

Terada

Hayama

et al. 2018

The Journal of Dermatology

198

456

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Generalized pustular psoriasis (GPP) is a rare disease characterized by recurrent fever and systemic flushing accompanied by extensive sterile pustules. The committee of the guidelines was founded as a collaborative project between the Japanese Dermatological Association and the Study Group for Rare Intractable Skin Diseases under the Ministry of Health, Labour, and Welfare Research Project on Overcoming Intractable Diseases. The aim of the guidelines was to provide current information to aid in the treatment of patients with GPP in Japan. Its contents include the diagnostic and severity classification criteria for GPP, its pathogenesis, and recommendations for the treatment of GPP. Since there are few clinical trial data with high levels of evidence for this rare disease, recommendations by the committee are described in the present guidelines.

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“…Der Wechsel auf einen anderen TNF-Blocker führte bei maximal 25 % der Patienten zu einer Abheilung, sodass bei der paradoxen psoriasiformen Dermatitis von einem Klasseneffekt von TNF-Antagonisten ausgegangen wird [77]. Das Auftreten pustulöser psoriasiformer Hautläsionen wurde aber auch unter Ustekinumab beschrieben [78][79][80]. …”

Section: Introductionunclassified

Pustulöse Psoriasis

et al. 2016

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A number of pustular skin diseases share clinical, pathogenetic, and epidemiological aspects with plaque-type psoriasis, and their classification as a separate clinical entity or as a subtype of psoriasis remains controversial, which is also reflected in the multitude of their names. They include generalized pustular psoriasis with its subtypes, acrodermatitis continua suppurativa (Hallopeau), acute pustulosis palmopantaris, palmoplantar pustular psoriasis, and pustular variants of a mostly TNF-blocker triggered paradoxical psoriasiform dermatitis. In this article, the epidemiology, clinical picture, pathogenesis, genetics, and therapy of these pustular skin diseases are described.

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Pustular psoriasis development after initial ustekinumab administration in chronic plaque psoriasis

Cited by 40 publications

References 0 publications

Long‐term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance

Long‐term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance

Japanese guidelines for the management and treatment of generalized pustular psoriasis: The new pathogenesis and treatment of GPP

Pustulöse Psoriasis

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