In-Office Ustekinumab for Psoriasis Associated With Higher Drug Survival

syringe and a couple vials
syringe and a couple vials
The first study to compare the real-world survival of a single biologic administered in-office with the same agent administered at home suggests that in-office ustekinumab administration may result in superior drug survival.

In-office administration of ustekinumab, an interleukin-12/23 inhibitor, is associated with a longer drug survival time than at-home, self-administered ustekinumab in patients with psoriasis, study research published in the Journal of the American Academy of Dermatologists suggests.

The study was a retrospective chart review of 225 patients with psoriasis who received in-office ustekinumab a single institution. Patients received ustekinumab either 90 mg (52% in both in-office and self-administered groups) or 45 mg (48% in both in-office and self-administered groups). Compared with patients who self-administered ustekinumab, patients who received the drug in-office were older (mean age, 49.3 years vs 52.8 years, respectively; P =.033) and more likely to be biologic-naïve (33% vs 58%, respectively; P <.0001).

On average, the drug quartile survival time was significantly longer for in-office ustekinumab compared with self-administered ustekinumab (56 months [95% CI, 34 to (data not provided) +] vs 39 months [95% CI, 14-55], respectively; P =.034). There was no difference between the in-office and self-administered groups with regard to rates of primary failure (21.4% vs 31.7%, respectively) and adverse events leading to discontinuation (4.8% vs 4.8%, respectively). Just 1% of all patients reported discontinuation of ustekinumab due to an adverse event (injection-site reactions).

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Study limitations were the single-institution data source, as well as the retrospective nature of the analysis.

“These results may be extrapolated to conclude that in-office administration of other infrequently-dosed biologics may optimize compliance,” the researchers wrote. They also suggest that “in-office administration may help to reduce unnecessary psoriasis-related healthcare spending,” possibly due to the slightly lower rate of primary failure.


Muzumdar S, Waldman R, Wu R, Kelsey A. In-office administration associated with increased drug survival of ustekinumab for chronic plaque psoriasis when compared with self-administration: a single institution retrospective chart review [published online October 25, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.10.041