Abstract
Little information is available from real-life studies evaluating the efficacy of guselkumab in moderate-to-severe psoriasis. In this real-life study, we retrospectively examined a database of 52 patients with moderate-to-severe psoriasis treated with guselkumab (100 mg, s.c.) and followed for 1 year. Disease severity and treatment response was assessed by the Psoriasis Area and Severity Index (PASI) at baseline and after 4, 12, 20, 28, 36, 44, and 52 weeks. Predictors of a PASI response were evaluated by univariate and multivariate regression. After 12 months, 84.2% of patients (mean age 51.3 ± 14.1 years) treated with guselkumab achieved a PASI score of <3. Furthermore, PASI score decreased from 20 ± 13.3 at baseline to 4.4 ± 4.7 and 2.7 ± 3.9 at 12 and 20 weeks, and PASI 75, 90, and 100 response was achieved in 84.2%, 78.9%, and 63.2% of patients respectively at 12 months. Stepwise multivariate regression analysis revealed that previous biological treatment and the presence of comorbidities were associated with poorer response between 28–44 weeks, however the presence of obesity per se was not associated with poorer response. Difficult-to-treat areas were also improved as early as 12 weeks following guselkumab. Guselkumab was observed to be effective and safe in patients with moderate-severe chronic psoriasis in a real world-setting.
Highlights
Psoriasis is a chronic inflammatory immune skin disease affecting 2–3% of the world’s population [1]
In post-hoc analyses of the VOYAGE 1 and 2 trials, guselkumab was more effective than adalimumab, that was consistent across different body weight subgroups [16], similar to observations compared to secukinumab from the post-hoc analysis of the ECLIPSE trial [17]
Patient Demographic and Clinical Characteristics. In this real-life retrospective analysis, 52 patients with moderate-to-severe plaque psoriasis were treated with guselkumab and followed over a period of 12 months
Summary
Psoriasis is a chronic inflammatory immune skin disease affecting 2–3% of the world’s population [1]. Biological therapies such as tumor necrosis factor (TNF), interleukin (IL) 12/23, and IL-17 inhibitors have revolutionized the management of moderate-to-severe psoriasis, allowing a high proportion of patients to attain clear skin [2,3,4,5,6,7,8,9]. Guselkumab is an IL-23 inhibitor that binds to the p19 subunit of IL-23 that has been shown to be highly efficacious and well tolerated for the treatment of moderate-to-severe plaque psoriasis [7,8,13,14]. Difficult-to-treat areas, such as the palms and/or soles, improved with guselkumab compared to adalimumab [18]
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