HealthDay News – For patients with psoriasis, ustekinumab has the highest effectiveness over five years of treatment, and adalimumab and ustekinumab more often reach a 75% reduction in Psoriasis Area Severity Index (PASI) compared to baseline (PASI75) than etanercept, according to a study published in the British Journal of Dermatology.

Jeffrey Zweegers, M.D., from the Radboud University Medical Center in Nijmegen, Netherlands, and colleagues compared the effectiveness of three widely used biologics in daily practice psoriasis treatment. Data were extracted from the prospective BioCAPTURE registry for 356 patients with 513 treatment episodes (178 adalimumab, 245 etanercept, and 90 ustekinumab).

The researchers found that after one year, effectiveness for adalimumab, etanercept, and ustekinumab was similar in multilevel linear regression analyses; during five years of treatment, effectiveness was highest for ustekinumab (P = .047; ustekinumab versus etanercept, P = .019). At one year of treatment, the chance of attaining PASI75 was higher with adalimumab and ustekinumab versus etanercept. 

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Patients treated with etanercept more often used a higher than label dose (adalimumab, etanercept, and ustekinumab: 31.5%, 55.1%, and 16.7% after one year; 39.3%, 71.4%, and 24.4% after five years; both P < .001).

“These findings warrant replication from other prospective daily practice cohorts and further research into dose adjustments of biologics in the real world,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Pfizer, Janssen (the manufacturer of ustekinumab), and AbbVie (the manufacturer of etanercept), all of which provided study funding.

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Zweegers J, Groenewoud JM, Van den reek JM, et al. Comparison of the one and 5-years effectiveness of adalimumab, etanercept and ustekinumab in psoriasis patients in daily clinical practice: Results from the prospective BioCAPTURE registry. Br J Dermatol. 2016; doi: 10.1111/bjd.15023