Comparison of Ustekinumab and Etanercept for Moderate-to-Severe Psoriasis

In this 12-week randomized trial comparing two biologic agents known to be effective for psoriasis, ustekinumab (an interleukin-12 and interleukin-23 blocker) was more effective than etanercept (an inhibitor of tumor necrosis factor α). Adverse events associated with the two treatments were similar, but the trial was not large enough and follow-up was not long enough to assess uncommon adverse events. In this 12-week randomized trial comparing two biologic agents known to be effective for psoriasis, ustekinumab (an interleukin-12 and interleukin-23 blocker) was more effective than etanercept (an inhibitor of tumor necrosis factor α). Psoriasis is a chronic, inflammatory skin disease affecting approximately 2% of the world's population. 1 , 2 Therapeutic agents used for the management of psoriasis commonly target the underlying inflammation. Immunosuppressive agents such as methotrexate and cyclosporine have proved effective in the treatment of psoriasis. 3 Biologic agents that selectively block steps in the inflammatory cascade have provided additional therapies for psoriasis and have led to a better understanding of its immunologic and pathophysiological basis. 4 – 9 Proinflammatory cytokines such as tumor necrosis factor α (TNF-α) play a central role in the inflammation underlying psoriasis. Agents that selectively block TNF-α have proved highly effective . . .