The effect of combination treatment with Ustekinumab and topical agents in Korean patients with moderate-to-severe psoriasis: A retrospective study of 30 patients through 5 years of follow up

Background: Psoriasis is a chronic inflammatory skin disorder affecting approximately 1~3% of the general population. Ustekinumab is a recently developed human monoclonal antibody for psoriasis that binds to the p40 subunit shared by the interleukins IL-12 and IL-23. Objective: The purpose of this study was to evaluate the effect of combination treatment with ustekinumab and topical agents in 30 Korean patients with psoriasis regarding different clinical parameters. Methods: We retrospectively searched to identify patients with moderate-to-severe plaque-type psoriasis who had initiated treatment with ustekinumab between January 2012 and January 2016. Among them, our study was conducted in 30 patients with psoriasis who were treated with ustekinumab and topical agents for at least 16 weeks by analyzing their clinical charts and photographs. Results: Overall, 16.7%, 93.3%, and 96.2% patients achieved PASI 75 response rates at weeks 4, 16, and 40, respectively. Furthermore, fifteen patients achieved 90% improvement in their PASI score at 100 weeks and five patients maintained their PASI score at 160 weeks. The efficacy of treatment with ustekinumab was different in sub-group analysis. Non-smokers enjoyed a higher therapeutic effect than did smokers. In addition, the therapeutic effect of ustekinumab was lower in the groups with psoriatic arthritis and nail psoriasis. However, it was not statistically significant. None of the patients experienced serious adverse events requiring the interruption of treatment. Conclusion: Combination treatment with ustekinumab and topical agents provides effective treatment results for Korean patients with psoriasis. (Korean J Dermatol 2017;55(3):171~177).