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Ustekinumab: A Potential New Treatment for Ankylosing Spondylitis

Posted on: 1/28/08

A new biologic medication, Ustekinumab, is in its final steps of study and development. Its maker, Centocor, Inc., has announced that applications for its approval in the use in treating adult patients with chronic moderate to severe plaque psoriasis have been submitted to the FDA.

In phase 3 trials in the treatment of psoriatic arthritis, the drug was shown to be very effective and the improvement in patients was so significant that Dr. Alice B. Gottlieb was prompted to comment, "You do not see this with any of the anti-[tumor necrosis factor] agents." Dr. Gottlieb reported the data at the annual meeting of the American College of Rheumatology.

Psoriatic arthritis is in the same family of diseases as, and is related to, ankylosing spondylitis. Both are considered spondyloarthropathies. So, could this new biologic medication have potential in treating ankylosing spondylitis?

The TASC study - of which the Spondylitis Association of America has played a significant role, especially in the areas of recruitment and coordination - had a recent breakthrough in discovering two new genes that appear to contribute to the susceptibility of AS. One of these genes is IL23R.

Ustekinumab targets IL12p40, which, according to Dr. Matthew Brown, "makes up half of IL12 and also half of IL23. So this treatment blocks both IL12 and IL23."

Thus, could this drug effectively treat AS? "This makes it an excellent potential therapy for AS," says Dr. Brown.

Although a biologic agent, Ustekinumab is not a TNF-a blocker, and is in a different class of medications. It targets a different region of the genome - a region the TASC study has now shown could contribute to the genetic roots of AS.

References:

Spondylitis Association of America Participates in Study That Uncovers Two Genes Related to Disabling Form of Arthritis

Report: Responses to Ustekinumab in PsA Significant and Sustained

Press Release on Ustekinumab




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