1
|
Chiu HY, Hui RCY, Tsai TF, Chen YC, Chang Liao NF, Chen PH, Lai PJ, Wang TS, Huang YH. Predictors of time to relapse following ustekinumab withdrawal in patients with psoriasis who had responded to therapy: An 8-year multicenter study. J Am Acad Dermatol 2023; 88:71-78. [PMID: 30703455 DOI: 10.1016/j.jaad.2019.01.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/13/2019] [Accepted: 01/19/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Data on predictors and time to relapse in patients with psoriasis who discontinue therapy in a real-world setting are scarce. OBJECTIVE To investigate predictors of relapse after withdrawal of ustekinumab in patients with psoriasis. METHOD This study screened 500 patients with psoriasis who received ustekinumab (669 treatment episodes) between 2011 and 2018. Overall, 202 patients (accounting for 304 treatment episodes) who had responded to therapy and were withdrawn from ustekinumab treatment were included. RESULTS The cumulative probabilities of being relapse-free at 6, 12, 18, 24, and 36 months after withdrawal from ustekinumab treatment were 49.3%, 12.6%, 5.3%, 4.7%, and 1.6%, respectively. Multivariate regression analyses with a generalized estimating equation showed that after adjustments, biologic-naive status, maximum improvement in Psoriasis Area and Severity Index during ustekinumab treatment, time to achieve a 50% improvement in baseline Psoriasis Area and Severity Index score after initiation of ustekinumab, family history of psoriasis, chronic kidney disease, and immunosuppressant use while not taking ustekinumab were significant predictors of time to relapse following discontinuation of ustekinumab. LIMITATION Nonrandomized allocation of duration of treatment and follow-up. CONCLUSION Given the high rates of relapse, withdrawal of ustekinumab from patients with well-controlled psoriasis cannot be recommended.
Collapse
Affiliation(s)
- Hsien-Yi Chiu
- Department of Dermatology and Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Rosaline Chung-Yee Hui
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology and Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
| | | | - Po-Hua Chen
- Department of Dermatology and Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan
| | - Po-Ju Lai
- Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Dermatology, Chung Shan Medical University, Taichung, Taiwan
| | - Ting-Shun Wang
- Department of Dermatology and Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Dermatology, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Taiwan.
| |
Collapse
|
2
|
Dodero-Anillo JM, Lozano-Cuadra IC, Rios-Sanchez E, Pedrosa-Martinez MJ, Ruiz-Carrascosa JC, Galan-Gutierrez M, Armario-Hita JC. Optimising the Therapeutic Interval for Biologics in Patients with Psoriasis. Life (Basel) 2022; 12:2075. [PMID: 36556440 PMCID: PMC9787329 DOI: 10.3390/life12122075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/25/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In our clinical experience, more than half of patients do not present a complete response to biologic drugs, or drug loses its efficacy over time. Plasma determinations of drug and anti-drug antibodies levels are an objective tool for optimisation in these patients; however, established therapeutic ranges are not suitable, so the objective of this study was to study these patients and optimise their healthcare. We have made a retrospective, observational study, using data of plasma levels of drugs and anti-drugs antibodies of infliximab, adalimumab or Etanercept, we summarise all data and make a study of sensitivity, specificity, positive and negative predictive value on current therapeutic ranges. We have found a statistically significant association between subtherapeutic levels and therapeutic failure in psoriasis treated with infliximab and adalimumab. New ranges were found with higher sensitivity than the established ones, we propose 2-10 µg/mL therapeutic range for infliximab, 3-11 µg/mL for adalimumab, and 1-7 µg/mL for etanercept. In conclusion, levels of drug and anti-drug antibodies are a decisive tool for predicting therapeutic response. The current therapeutic ranges may have minimum values that are excessively high, owing to which lowering them significantly increases the sensitivity of the test in all cases, and negative predictive value in the case of etanercept. Further prospective studies are needed to prove the usefulness of these new ranges.
Collapse
|
3
|
Huang YH, Tang CH, Goh CH, Chang CL, Qiu H, Yang YW, Saadoun C, Chang CL, Liu Y. Persistence and Adherence to Biologics in Patients with Psoriasis in Taiwan: A New Biologics User Cohort Study. Front Pharmacol 2022; 13:880985. [PMID: 35656306 PMCID: PMC9152324 DOI: 10.3389/fphar.2022.880985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Biologics are used to treat moderate-to-severe psoriasis, and persistence to biologics may reflect clinical effectiveness. Limited information describing how biologics are used in patients with moderate-to-severe psoriasis in Asian countries is available. We conducted a population-based, retrospective, new user cohort study using the National Health Insurance Research Database (NHIRD) in Taiwan to assess treatment persistence and adherence to biologics. Methods: Adults with a diagnosis of psoriasis between 01 January 2015 and 31 December 2017 were identified in the NHIRD (ICD-9-CM 696.1; ICD-10 L40.0). New users were patients who initiated treatment with etanercept, adalimumab, ustekinumab or secukinumab between 01 January 2015 and 31 December 2017. All eligible patients were followed until 31 December 2018, death or disenrollment. Kaplan-Meier analysis was conducted to estimate persistence of treatment for index biologics. A Cox-proportional hazard regression model was used to compare risks of biologic discontinuation between biologic groups. Adjustments for potential confounding factors (age, gender and Charlson comorbidity index score) were made in the Cox model. Results: There were 1,397 new biologic users with psoriasis during the study period. The ratio men:women was approximately 4:1. Mean age of patients ranged from 44.6 to 47.7 years across exposure groups. The 1-year/2-years persistence rates were 94.2%/84.9% for ustekinumab, 96.2%/not calculated (due to too few patients at year 2) for secukinumab, 66.0%/29.9% for etanercept, and 59.8%/40.3% for adalimumab. The risk of discontinuation was significantly lower in patients initiating ustekinumab compared with adalimumab (hazard ratio adjusted for age, sex and co-morbidities 0.289, 95%CI 0.247-0.339, p < 0.0001). Drug survival was significantly higher for ustekinumab compared with adalimumab and etanercept (log-rank test p < 0.0001). The proportions of patients with 1-year/2-years medication possession ratios of ≥80% were 95.3%/92.0% for ustekinumab, 98.1%/not calculated for secukinumab, 89.4%/83.1% for etanercept, and 70.8%/59.4% for adalimumab. Limitations: Clinical improvement and response to treatment data were not available. Conclusion: There was relatively high persistence amongst biologic users with psoriasis in Taiwan. There is a trend towards greater persistence of ustekinumab compared to other biologics, the magnitude of which depends on the treatment gap used for its calculation. This study provides real-world evidence that may facilitate optimal treatment choice.
Collapse
Affiliation(s)
- Yu-Huei Huang
- Chang Gung Memorial Hospital, Linkou, Division of Dermatology, and School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Choo Hua Goh
- Epidemiology, Office of the Chief Medical Officer, Johnson & Johnson, Singapore, Singapore
| | - Chia-Li Chang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Hong Qiu
- Epidemiology, Office of the Chief Medical Officer, Johnson & Johnson, Titusville, NJ, United States
| | - Ya-Wen Yang
- Immunology, Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, United States
| | - Carine Saadoun
- Regional Medical Affairs, Janssen Asia-Pacific, Singapore
| | | | - Yanfang Liu
- Epidemiology, Office of the Chief Medical Officer, Johnson & Johnson, Singapore, Singapore
| |
Collapse
|
4
|
Ger TY, Huang YH, Hui RCY, Tsai TF, Chiu HY. Effectiveness and safety of secukinumab for psoriasis in real-world practice: analysis of subgroups stratified by prior biologic failure or reimbursement. Ther Adv Chronic Dis 2019; 10:2040622319843756. [PMID: 31024679 PMCID: PMC6472156 DOI: 10.1177/2040622319843756] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Little is known about the treatment outcomes of secukinumab in clinical
practice, which differ from those in clinical trials. The effectiveness of
biologics may differ in psoriasis patients with previous biologics exposure.
The objective of this study was to investigate the real-world effectiveness
and safety of secukinumab therapy and analyze subgroups stratified by
reimbursement or prior biologic failure. Methods: This retrospective multicenter study collected data from a cohort of 118
consecutive patients who received secukinumab treatment between December
2015 and March 2018. Effectiveness was evaluated by degree of improvement in
the Psoriasis Area and Severity Index (PASI) scores. Adverse events and
reasons for discontinuation were also recorded. Results: The mean PASI improvement rate at weeks 4, 12, 24, and 36 was 63.5%, 77.7%,
78.7%, and 76.0%, respectively. Compared with reimbursed patients,
nonreimbursed patients had a significantly lower baseline PASI and a shorter
mean disease duration of psoriasis; they were more frequently
biologic-naïve, had used less prior traditional antipsoriatic drugs and were
more likely to be treated with secukinumab 150 mg. The effectiveness of
secukinumab in nonreimbursed patients was superior despite higher
discontinuation rates. Compared with patients without prior biologic
failure, patients with prior biologic failure had a significantly lower mean
PASI improvement at weeks 12, 24, 36, and 48. The decline in response rates
to secukinumab tended to be more pronounced for patients who failed
ustekinumab than tumor necrosis factor-α inhibitors. Moreover, the number of
prior biologic failures was associated with a decreased response rate and
increased likelihood of secondary loss of effectiveness of secukinumab
therapy. Conclusion: In a real-life clinical setting, the characteristics of nonreimbursed
patients receiving secukinumab treatment differed from those of reimbursed
patients. The PASI improvement for secukinumab was substantial but lower
than that in clinical trials. The number and classes of prior biologic
failures impact the treatment response to secukinumab.
Collapse
Affiliation(s)
- Tzong-Yun Ger
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, No.5, Fuxing Street, Guishan Dist., Taoyuan City 333
| | | | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital, Taipei
| | - Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, NO.25, Lane 442, Section 1, Jingguo Road, Hsinchu City 300
| |
Collapse
|
5
|
Chiu HY, Wang TS, Chen PH, Hsu SH, Tsai YC, Tsai TF. Psoriasis in Taiwan: From epidemiology to new treatments. DERMATOL SIN 2018. [DOI: 10.1016/j.dsi.2018.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
6
|
Su P, Pan JY. Paradoxical flare of psoriasis, psoriatic spondyloarthritis, and psoriatic uveitis after switching from infliximab to secukinumab. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2016.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
7
|
Yu S, Tu HP, Yu CL, Lee CH, Hong CH. Is psoriasis an independent risk factor of renal disease? A nationwide retrospective cohort study from 1996 to 2010. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2017.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
8
|
Tu HP, Yu CL, Lan CCE, Yu S. Prevalence of schizophrenia in patients with psoriasis: a nationwide study. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2016.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
9
|
Wang TS, Chan CC, Chiu HY, Tsai TF. Secukinumab in psoriasis patients with prior ustekinumab treatment: Results of a single-center experience. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2016.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
10
|
Chiu HY, Hsieh CF, Chiang YT, Huang WF, Tsai TF. The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study. PLoS One 2016; 11:e0160041. [PMID: 27467265 PMCID: PMC4965214 DOI: 10.1371/journal.pone.0160041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/12/2016] [Indexed: 12/13/2022] Open
Abstract
Background Psoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis. Methods Using the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis. Results The incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments. Conclusions Psoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP.
Collapse
Affiliation(s)
- Hsien-Yi Chiu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Feng Hsieh
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Ting Chiang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Weng-Foung Huang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
11
|
Chiu HY, Lo PC, Huang WF, Tsai YW, Tsai TF. Increased risk of aortic aneurysm (AA) in relation to the severity of psoriasis: A national population-based matched-cohort study. J Am Acad Dermatol 2016; 75:747-754. [PMID: 27473449 DOI: 10.1016/j.jaad.2016.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/06/2016] [Accepted: 06/01/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Inflammation of systemic and vascular tissues besides the skin in psoriasis is associated with cardiovascular morbidity and mortality. OBJECTIVE We sought to investigate whether or not patients with psoriasis have an increased risk of aortic aneurysm (AA). METHODS This population-based cohort study identified 34,301 patients with psoriasis in the Taiwan National Health Insurance Research Database during 2004 to 2006, who were matched for age and sex with 137,204 control subjects without psoriasis from the Taiwan Longitudinal Health Insurance Database 2000. Each individual was individually followed up for 5 years to identify those who subsequently developed AA. RESULTS After adjusting for medical history and medication use, patients with psoriasis were at increased overall risk of AA (adjusted hazard ratio [HR] 1.80; 95% confidence interval 1.25-2.61). The risk for AA increased with the severity of psoriasis. The adjusted HRs were higher for male than female patients (adjusted HR 1.84 vs 1.56), and for patients younger than 50 years versus older patients (adjusted HR 2.81 vs 1.64). LIMITATIONS There is a lack of information regarding patients' Psoriasis Area and Severity Index score, daily tobacco use, or alcohol consumption. CONCLUSION Patients with psoriasis are predisposed to developing AA: this risk increases with psoriasis severity and is independent of established cardiovascular risk factors.
Collapse
Affiliation(s)
- Hsien-Yi Chiu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Ching Lo
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Weng-Foung Huang
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Wen Tsai
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| |
Collapse
|
12
|
Chiu HY, Chu TW, Cheng YP, Tsai TF. The Association between Clinical Response to Ustekinumab and Immunogenicity to Ustekinumab and Prior Adalimumab. PLoS One 2015; 10:e0142930. [PMID: 26566272 PMCID: PMC4643875 DOI: 10.1371/journal.pone.0142930] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/28/2015] [Indexed: 12/21/2022] Open
Abstract
Background Immunogenicity due to antidrug antibodies (ADA) to tumor necrosis factor (TNF)-α antagonists is known to decrease treatment response. However, few studies have investigated ADA in ustekinumab, an interleukin-12 and -23 antagonist, in a clinical setting. This study aimed to investigate the immunogenicity of ustekinumab and its clinical consequences in psoriasis. Methods This prospective observational study enrolled 76 patients with plaque psoriasis who were treated with ustekinumab for a minimum of 7 months. Blood samples were drawn just prior to scheduled ustekinumab injection during clinic visits. Levels of anti-ustekinumab antibody (AUA) and serum ustekinumab concentration were measured respectively by radioimmunoassays and enzyme-linked immunoassays respectively, and correlated to clinical data and Psoriasis Area and Severity Index (PASI). Results AUA was detected in 6.5% of patients after a mean of 13 months of treatment. Patients with positive AUA had significantly lower serum ustekinumab concentrations (0.01 vs. 0.2 mg/L, p<0.001) and lower PASI 50 response than patients without AUA (0% vs. 69%, p = 0.004).The percentage of AUA formation was comparable between patients who had failed previous adalimumab with or without anti-adalimumab antibodies (AAA) (14.3% vs. 12.5%, p = 1.00). However, a higher proportion of switchers without AAA obtaining PASI50 (71.4% vs. 37.5%) and PASI75 response (42.9% vs.12.5%) within 7 months of ustekinumab treatment than with AAA though this difference did not reach statistical significance. Conclusions Our results suggest that presence of AUA was significantly associated with treatment failure for ustekinumab, though limited by a small sample size. Also, determining the presence of ADA to antecedent TNF-α antagonists may assist in choosing an optimized subsequent treatment modality achieving treatment success.
Collapse
Affiliation(s)
- Hsien-Yi Chiu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Thomas Waitao Chu
- Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yu-Pin Cheng
- Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail:
| |
Collapse
|