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The recurrence of psoriasis may involve the compensatory T cell activation pathway in the case of blocking CD28-CD80/CD86 with abatacept
.
To determine whether the use of abatacept for costimulatory signal blockade can prevent the recurrence of psoriasis after the discontinuation of Uselnumumab
experimental design:
Treatment of psoriasis with abatacept and usnumab: The Efficacy Study (PAUSE), a parallel-designed, double-blind, placebo-controlled randomized clinical trial conducted at 10 locations in the United States and Canada
.
Participant recruitment started on March 19, 2014 and ended on April 11, 2016
Participant
Those patients who responded to ustekinumab in the 12th week were randomly assigned 1:1 to continue ustekinumab group (ustekinumab group) or switch to abatacept group (abatacept group) )
.
Treatment was stopped at week 39, and participants were followed up until week 88 for recurrence of psoriasis
Clinical intervention:
Participants received subcutaneous injections of Uselnumumab (45 mg per dose for patients ≤100 kg; 90 mg per dose for patients> 100 kg) at week 0 and week 4
.
Participants who were randomly assigned to the abatacept group at week 12 received subcutaneous abatacept at 125 mg per week from week 12 to week 39, and received ustekinumab placebo at week 16 and week 28
Experimental endpoint: The primary endpoint is the proportion of participants with psoriasis recurrence between week 12 and week 88 (loss of initial psoriasis area and severity index improvement ≥50%)
.
Secondary endpoints included time to psoriasis recurrence, proportion of participants with psoriasis recurring between weeks 12 and 40, and adverse events
Results: A total of 108 participants (mean [SD] age, 46.
1 [12.
1] years; 73 [67.
6%] men) received open-label ustekinumab treatment; 91 people were randomized to receive blind treatment
.
Participants in the abatacept group and ustekinumab group had similar relapse rates between weeks 12 and 88 (41 out of 45 people [91.
Conclusion: This parallel-designed, double-blind randomized clinical trial found that abatacept does not prevent psoriasis recurrence that occurs after the withdrawal of uxinuzumab , because it does not completely block the pathogenic psoriasis molecule that causes the recurrence way
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