The rates of relapse are high following withdrawal of ustekinumab from psoriasis patients who responded to treatment, according to a study published in the January issue of the Journal of the American Academy of Dermatology .

Hsein-Yi Chiu, M.D., Ph.D., from the National Taiwan University Hospital Hsin-Chu Branch, and colleagues examined predictors of relapse after ustekinumab withdrawal in patients with psoriasis. A total of 500 patients with psoriasis who received ustekinumab (669 treatment episodes) between 2011 and 2018 were screened; 202 patients with 304 treatment episodes who responded to therapy and were withdrawn from ustekinumab were included.

The researchers found that after withdrawal from ustekinumab therapy, the cumulative probabilities of being relapse-free at six, 12, 18, 24, and 36 months were 49.3, 12.6, 5.3, 4.7, and 1.6 percent, respectively. After adjustments, significant predictors of time to relapse following discontinuation of ustekinumab included biologic-naive status, maximum improvement in the Psoriasis Area and Severity Index during ustekinumab treatment, time to achieve a 50 percent 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.

"Although a subset of patients with distinct characteristics relapsed more slowly after discontinuation of ustekinumab treatment, current evidence supports continuous treatment with biologics," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Janssen, which manufactures ustekinumab.

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