P89 Real-world effectiveness of guselkumab in patients with psoriasis with and without concomitant psoriatic arthritis: retrospective data from the British Association of Dermatologists Biologics and Immunomodulators Register

Abstract

Abstract Guselkumab is a monoclonal antibody that inhibits interleukin (IL)-23 signalling by binding to its p19 subunit and is approved to treat adults with moderate-to-severe plaque psoriasis and active psoriatic arthritis (PsA). BADBIR collects UK and Eire real-world observational data and includes patients receiving biologic treatments for psoriasis, with PsA being one of the recorded comorbidities at the time of enrolment. Absolute PASI (aPASI) scores can be used to quantify treatment effectiveness in routine clinical practice, and it has been suggested that an aPASI ≤ 2 represents a relevant disease endpoint to inform treat-to-target psoriasis-management strategies. This retrospective analysis evaluated the 1-year, real-world effectiveness of guselkumab on aPASI response in patients with moderate-to-severe plaque psoriasis and the subset of patients with and without concomitant PsA within BADBIR. Analyses were carried out on data collected up to the September 2021 data cutoff. Data were obtained from patients who had initiated guselkumab treatment and had recorded measurements for aPASI at baseline and 12-month follow-up was analysed. Measures of treatment effect for psoriasis included mean aPASI response, as well as the proportion of patients achieving an aPASI score of ≤ 1, ≤ 2, ≤ 3 and ≤ 5. Incomplete data collection limited the sample size of patients available for analysis. Five patients receiving guselkumab were excluded due to stopping treatment prior to the 12-month cutoff. Stratified by diagnosis, 36 (30.8%) patients had a concomitant diagnosis of PsA vs. 81 (69.2%) who did not. In the overall guselkumab-treated cohort (n = 117), mean (SD) aPASI at baseline and the following 12 months of treatment were 11.85 (8.95) and 2.45 (4.24), respectively. Following 12 months of guselkumab treatment in the cohort of patients with psoriasis (without concomitant PsA), 48 (59.3%) achieved an aPASI ≤ 1, 56 (69.1%) an aPASI ≤ 2, 64 (79.0%) an aPASI ≤ 3 and 69 (85.2%) an aPASI ≤ 5. In the concomitant PsA group, 19 (52.8%) achieved an aPASI score of ≤ 1, 22 (61.1%) achieved an aPASI score of ≤ 2, 28 (77.8%) achieved an aPASI ≤ 3 and 30 (83.3%) achieved an aPASI ≤ 5. Over 50% of guselkumab patients achieved an aPASI ≤ 1 at 12 months, supporting the effectiveness of targeting IL-23 with guselkumab for the treatment of psoriasis over 1 year. These results demonstrate that comparable responses were achieved for the treatment of psoriasis with guselkumab in patients with and without a concomitant PsA diagnosis within a real-world cohort.