High-Resolution HLA Typing Identifies a New "Super Responder" Subgroup of HLA-C*06:02–Positive Psoriatic Patients

TAKE-HOME MESSAGE

• A retrospective analysis of 164 patients with moderate to severe plaque psoriasis who were typed for the HLA-C locus and their responses to ustekinumab for drug survival and clinical efficacy was performed. Patients with the HLA-C*06:02 allele had a significantly higher PASI response at 2 years compared with patients who did not have the allele. Patients with the allele also had a 2-year ustekinumab retention rate of 81% compared with a rate of 54% in patients without the allele (P=.002).

• HLA-C*06:02 is a marker of early and long-term response to ustekinumab. Thus, this study demonstrated the burgeoning field of personalized medicine and its potential role in treating dermatologic diseases such as psoriasis.

– Margaret Hammond, MD

Written by

 

 

Robert T Brodell MD, FAAD 

Written by

 

 

Eliot N Mostow MD, MPH

This article is perhaps a bit esoteric, and, perhaps, its findings not readily applicable to the routine care of psoriasis patients, but it is a wonderful "proof of concept" article. This suggests that, someday very soon, dermatologists will be tailoring their treatment of psoriasis to individual patients (personalized medicine). Of course, a combination of clinical factors will always need to be considered in addition to genetic factors.

Abstract

Psoriasis is a chronic autoimmune skin disease affecting 2–3% of people worldwide.1 While tumour necrosis factor and interleukin (IL)-12/23 and IL-17 inhibitors have revolutionized the management of moderate-to-severe psoriasis, many patients still remain untreated, do not respond or experience treatment-related toxicities.

Psoriatic patients carrying the HLA-C*06:02 allele have improved response to ustekinumab compared to those without, and aside from HLA-C*06:02, psoriasis is associated with HLA-C*12:03, HLA-C*07:01, HLA-C*07:02 and HLAC* 07:04.

Journal of the European Academy of Dermatology and Venereology: JEADV

High-Resolution HLA Typing Identifies a New 'Super Responder' Subgroup of HLA-C*06:02-Positive Psoriatic Patients: HLA-C*06:02/HLA-C*04, in Response to Ustekinumab

J Eur Acad Dermatol Venereol 2019 May 08;[EPub Ahead of Print], M Talamonti, S D'Adamio, T Galluccio, M Andreani, R Pastorino, CG Egan, L Bianchi, M Galluzzo 

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.