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Biological Agent Comparison Study: Spotlight on Ustekinumab

 

Researchers recently conducted a head-to-head trial of ustekinumab against other FDA-approved biological agents for the treatment of psoriasis.   Many do not realize that psoriasis is the most prevalent autoimmune disease in the United States, affecting over 7.5 million Americans.  Evidence from this trial can be useful for derm practitioners and pharmacologists in treatment decision-making. 

 

The group ran a systemic search of randomized controlled trials (RCTs) listed on MEDLINE, EMBASE, the Cochrane Library and clinicaltrails.gov.  They searched RCT articles in the period of January 31, 1992 to February 1, 2012 comparing the use of biological agents with placebo or other biological agents for psoriasis patients who were candidates for photo- or systemic therapy.

 

Data was extracted from pertinent studies including the size of the trial, study follow-up period, age of patients, duration and surface area of disease, baseline Psoriasis Area and Severity Index (PASI) and PASI response, and patients’ past treatment with biological agents.

 

In this study, a Bayesian network meta-analysis provided a combination of previous probability distribution with posterior distribution (found in “likelihood function” based on observed data.)  Three regression models were used to estimate the relative efficiency of each biological agent, the most-efficient model being the random-effects model.

 

The meta-analysis compared the efficacy of the anti-IL-12/23 agent ustekinumab with other biological agents in the treatment of psoriasis.

 

Pair-wise Comparison

+ Ustekinumab showed higher odds for 75% PASI reduction when compared with adalimumab, alefacept and etanercept.

+ Ustekinumab was associated with statistically lower odds for PASI reduction when compared with infliximab.

 

Therapeutic Class Comparison

+ Interleukin-12/23 inhibitor showed highest reduction potential compared with placebo

+ Second-highest odds for achieving 75% PASI reduction were tumor necrosis factor inhibitors and the T-cell inhibitor

 

Researchers concluded that ustekinumab may hold higher efficacy rates for the treatment of moderate to severe plaque psoriasis than adalimumab, etanercept and alefacept.  Significant response rates may be higher with infliximab than ustekinumab.  Such results can be helpful for physicians, PAs, pharmacists and payers when making informed treatment decisions for psoriasis. 

 

Source: Arch Dermatol. 2012;148(12):1403-1410

 

[Image by Ellenvd]


Biological Agent Comparison Study: Spotlight on Ustekinumab

 

Researchers recently conducted a head-to-head trial of ustekinumab against other FDA-approved biological agents for the treatment of psoriasis.   Many do not realize that psoriasis is the most prevalent autoimmune disease in the United States, affecting over 7.5 million Americans.  Evidence from this trial can be useful for derm practitioners and pharmacologists in treatment decision-making. 

 

The group ran a systemic search of randomized controlled trials (RCTs) listed on MEDLINE, EMBASE, the Cochrane Library and clinicaltrails.gov.  They searched RCT articles in the period of January 31, 1992 to February 1, 2012 comparing the use of biological agents with placebo or other biological agents for psoriasis patients who were candidates for photo- or systemic therapy.

 

Data was extracted from pertinent studies including the size of the trial, study follow-up period, age of patients, duration and surface area of disease, baseline Psoriasis Area and Severity Index (PASI) and PASI response, and patients’ past treatment with biological agents.

 

In this study, a Bayesian network meta-analysis provided a combination of previous probability distribution with posterior distribution (found in “likelihood function” based on observed data.)  Three regression models were used to estimate the relative efficiency of each biological agent, the most-efficient model being the random-effects model.

 

The meta-analysis compared the efficacy of the anti-IL-12/23 agent ustekinumab with other biological agents in the treatment of psoriasis.

 

Pair-wise Comparison

+ Ustekinumab showed higher odds for 75% PASI reduction when compared with adalimumab, alefacept and etanercept.

+ Ustekinumab was associated with statistically lower odds for PASI reduction when compared with infliximab.

 

Therapeutic Class Comparison

+ Interleukin-12/23 inhibitor showed highest reduction potential compared with placebo

+ Second-highest odds for achieving 75% PASI reduction were tumor necrosis factor inhibitors and the T-cell inhibitor

 

Researchers concluded that ustekinumab may hold higher efficacy rates for the treatment of moderate to severe plaque psoriasis than adalimumab, etanercept and alefacept.  Significant response rates may be higher with infliximab than ustekinumab.  Such results can be helpful for physicians, PAs, pharmacists and payers when making informed treatment decisions for psoriasis. 

 

Source: Arch Dermatol. 2012;148(12):1403-1410

 

[Image by Ellenvd]




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