Ustekinumab for severe treatment-resistant psoriasis: a 24-week pilot study in Hong Kong Chinese

Introduction: Ustekinumab, an interleukins 12 and 23 antagonist, is shown to be an effective treatment in patients with moderate to severe psoriasis. However, little is known about its efficacy or safety of in Chinese patients with recalcitrant psoriatic disease. Method: Five patients with treatment-resistant psoriasis (mean baseline PASI 22.8) receiving ustekinumab (week 0, 4 and 16) were followed up for 24 weeks. Results: All patients (100%, 5/5) attained PASI 50 and two (40%, 2/5) patients attained PASI 75 at week 12 after initialed the two doses at week 0 and week 4. Minor relapse in PASI score before the third dose at week 16 was noted in 4 patients (80%, 4/5). The clinical response could be maintained at week 24 after the third dose at week 16. No major adverse event was noted. Conclusion: Ustekinumab may be a useful treatment alternative for patients with severe recalcitrant psoriasis. Long term study with larger patient cohort is needed to establish its long term efficacy and side effects.