A new study is warning against discontinuing ustekinumab (Stelara) therapy in patients with psoriasis who respond to the treatment.
“Given high rates of relapse [identified in the study], withdrawal of ustekinumab from patients with well-controlled psoriasis cannot be recommended,” the researchers wrote.
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The study investigated relapse in 202 patients, with a total 304 treatment episodes, who were withdrawn from ustekinumab treatment after responding to therapy.
Researchers reported dwindling relapse-free rates over time: 49.3% at 6 months after withdrawal, 12.6% at 12 months, 5.3% at 18 months, 4.7% at 24 months, and just 1.6% at 36 months.
Significant predictors of time to relapse after discontinuing ustekinumab were biologics-naivety, maximum Psoriasis Area and Severity Index improvement on ustekinumab, time to achieve a 50% reduction in the Psoriasis Area and Severity Index after starting ustekinumab, family history of psoriasis, chronic kidney disease, and the use of immunosuppressants while off ustekinumab.
—Jolynn Tumolo
Reference
Chiu HY, Hui RC, Tsai TF, et al. Predictors of time to relapse following ustekinumab withdrawal in patients with psoriasis who had responded to therapy: An eight-year multicenter study [published online January 28, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.01.035
