Repeated switching between ustekinumab biosimilar and reference gave matching drug levels and response

The edition in brief

A randomised double-blind trial in 453 people with plaque psoriasis found that switching three times between the ustekinumab biosimilar ABP 654 and the reference product gave drug exposure similar to continuing the reference product (geometric mean ratios 0.93 for AUCtau and 0.95 for Cmax, both within the 0.8 to 1.25 margin), with similar efficacy, antidrug antibodies and adverse events. A registry-linked cohort of 21,503 kidney transplant recipients in Australia and New Zealand found skin cancer mortality 11.1 times that of the general population, 34.5 times for keratinocyte cancer and 4.5 times for melanoma, highest in high-UV regions. A network meta-analysis of eight studies (4,319 patients) found that all psoriasis biologic classes improved depression and anxiety symptoms against placebo in the short term, with sparse networks and uncertain drug rankings. A retrospective cohort of 2,464 women found that biologic-exposed pregnancies with psoriasis did not have more adverse pregnancy outcomes than unexposed psoriasis controls (24.1% vs 30.0%). The pearl restates sun protection and skin checks as established practice for transplant recipients.