title: Ustekinumab dosing, persistence, and discontinuation patterns in patients with moderate-to-severe psoriasis.
abstract: OBJECTIVE
  Ustekinumab is the most recently approved biologic for the treatment of moderate-to-severe psoriasis. Real-world dosing patterns of ustekinumab are yet to be fully characterized.
  
  
  METHODS
  A retrospective, observational study was conducted using MarketScan Commercial and Medicare databases. A cohort of psoriasis patients treated with ustekinumab between 25 September 2009 and 31 October 2010 was evaluated. Main outcomes included ustekinumab dosing and treatment patterns. Kaplan-Meier estimates were calculated to adjust for the censoring of data. Subgroup analysis was conducted for biologic-experienced patients and biologic-naïve patients.
  
  
  RESULTS
  One thousand ustekinumab patients were included, of whom 60% were biologic-experienced. The average age was 49.0 and 53.9% were male. 63.3% of patients initiated ustekinumab with a 45 mg dose and 34.5% initiated with a 90 mg dose. Mean (median) days from initial dose to second dose was 31.1 (28.0). During maintenance therapy, dose intervals spanned from 80.6 to 81.2 (84.0) days. About 81.4% of patients were persistent during the variable-length follow-up period.
  
  
  CONCLUSIONS
  The majority of patients received the 45 mg ustekinumab dose. The mean dosing intervals were consistent with the US prescribing guidelines. Biologic-naïve and biologic-experienced patients had similar dosing patterns. Ustekinumab treatment achieved a persistency rate as high as 81.4% over an average of 186.5 (SD 114.2) days of follow-up.
authors.affiliation: Truven Health Analytics , Cambridge, MA , USA and.
authors.forename: Zhun
authors.initials: Z
authors.lastname: Cao
authors.forename: Chureen
authors.initials: C
authors.lastname: Carter
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Wilson
authors.forename: Brad
authors.initials: B
authors.lastname: Schenkel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D000069549:Ustekinumab / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000069549:Ustekinumab
keywords: Discontinuation; dosing; persistence; ustekinumab