Goselkumab therapy beneficial for patients with moderate to severe plaque psoriasis

The researchers demonstrated benefits showing improvement in overall quality of life.

Guselkumab is a fully human monoclonal antibody.

RCTs of patients with moderate-to-severe psoriasis have shown improvements in disease severity. More precisely, it improves Patient-reported outcome measures (PROMs). It targets the p19 subunit of the cytokine interleukin-23.

Previous real-world studies have shown the guselkumab effectiveness in short durations of therapy, small patient populations, and few outcomes. No such studies are focussing on patients in the USA and Canada. There needs to be more data on real-world effectiveness.

April W. Armstrong and colleagues from the University of Southern California and Harvard Medical School, USA, did a study to evaluate 9-12 months of continuous guselkumab use among such patients in the USA and Canada.

In 2017, FDA and Health Canada approved guselkumab for managing adult patients with moderate-to-severe plaque psoriasis, indicated for systemic therapy or phototherapy.

The study prospectively analyzed real-world data from 113 patients enrolled in the CorEvitas Psoriasis Registry with a history of moderate-to-severe psoriasis. These patients received Guselkumab for 9–12 months in the USA and Canada.

The study summary includes the following:

• The eligible patients had Investigator’s Global Assessment (IGA) score ≥ three and body surface area (BSA) ≥ 10%.
• The patients initiated guselkumab at a registry (index) visit.
• The follow-up visit was after 9–12 months of therapy.
• Data were retrieved at baseline, and outcomes were assessed at index and follow-up.
• The researchers calculated response rates and mean changes.
• There were 113 patients with a mean age of 49.7 years and a mean psoriasis duration of 17.5 years.
• 65.5% of patients were biologic experienced.
• The mean IGA score, Psoriasis Area Severity Index (PASI) score and 13.6, and Dermatology Life Quality Index (DLQI) score at baseline was 3.3, 13.6 and 9.6, respectively.
• 2IGA 0/1, PASI 90, and DLQI 0/1 were achieved by 62.2%, 56.8%, and 54.7% of patients at follow-up.
• There was a significant improvement in disease activity scores and PROMs, including the EuroQoL Visual Analogue Scale, Work Productivity and Activity Impairment, skin pain, itch, Patient Global Assessment, and fatigue.

This real-world study showed that patients with moderate-to-severe psoriasis who received 9–12 months of persistent guselkumab therapy experienced improvements in disease severity and PROMs.

To conclude, the researchers said that, “Our study’s findings show that guselkumab-treated patients experienced significant improvements from baseline in psoriasis activity, the ability to work, overall HRQoL, symptom burden, and daily functioning.

The study’s strength includes prospective design, a larger patient population, and a longer treatment duration.

Further reading:

Armstrong, A.W., Fitzgerald, T., McLean, R.R. et al. Real-World Effectiveness of 9–12 Months of Guselkumab Therapy among Patients with Moderate-to-Severe Plaque Psoriasis in the CorEvitas Psoriasis Registry. Dermatol Ther (Heidelb) (2022). https://doi.org/10.1007/s13555-022-00879-8