Guselkumab Effective and Long-Lasting Psoriasis Treatment Across All Skin Tones, suggests study

A new study published in the Journal of American Medical Association showed that Guselkumab was highly effective and durable treatment for psoriasis, providing consistent results across all skin tones, making it an inclusive and reliable therapeutic option for diverse patient populations.

The participants with psoriasis who self-identify as belonging to a race or ethnic group other than White, spanning the whole skin-tone spectrum, were included in Cohort A of the VISIBLE research. Thus, this research assessed the effectiveness, quality of life, and adverse event outcomes of guselkumab, 100 mg, administered for up to 48 weeks to people with moderate to severe psoriasis and skin of color.

This clinical study from 39 locations in the US and Canada included persons with moderate to severe psoriasis (body surface area [BSA] ≥10%; Psoriasis Area and Severity Index [PASI] ≥12; Investigator's Global Assessment [IGA] ≥3). The randomized individuals (3:1) were given 100 mg of guselkumab at weeks 0 and 4, then every 8 weeks, or a placebo with a crossover to guselkumab at weeks 16 and 20, followed by every 8 weeks. The coprimary end goals were an IGA score of 0 or 1 (IGA 0/1) and a PASI improvement of 90% or greater (PASI 90) by week 16 (guselkumab versus placebo).

In a study with 103 individuals (77 guselkumab and 26 placebo), 91.3% completed 48 weeks. The average age was 44.1 years, and 71.8% were men. In week 16, guselkumab substantially improved outcomes: IGA 0/1 in 74.0% vs 0%, PASI 90 in 57.1% vs 3.8%, IGA 0 in 32.5% vs 0%, and PASI 100 in 29.9% vs 0% (all P < .001).

With guselkumab, quality of life and symptom ratings improved dramatically. At week 48, effectiveness was maintained, with >94% mean PASI and BSA improvement; more than half got full clearance. A ≥4-point decrease in itch score was seen in 66.7% vs. 16.7% (P< .001). Infections were the most prevalent adverse event, primarily minor respiratory tract infections.

Overall, the findings provide strong clinical evidence that guselkumab is extremely successful in the treatment of moderate to severe plaque psoriasis in people of color, including all objectively determined skin tones. At week 48, more than 70% of guselkumab-randomized subjects attained both IGA 0/1 and PASI 90, more than half showed no indications of psoriasis (IGA 0), and the mean BSA and PASI improvements were larger than 94%.

Reference:

Alexis, A., McMichael, A., Soung, J., Choi, O., Alkousakis, T., Alonso-Llamazares, J., Shahriari, M., Rodriguez, A. O., Bhutani, T., Chan, D., Rowland, K., Sauder, M., Hong, H. C.-H., Yadav, G., Yeung, J., Jeyarajah, J., Ma, T., Gao, L.-L., Park-Wyllie, L., … VISIBLE Trial Investigators. (2025). Guselkumab for moderate to severe psoriasis across all skin tones: Cohort A of the VISIBLE randomized clinical trial: Cohort A of the VISIBLE randomized clinical trial. JAMA Dermatology (Chicago, Ill.). https://doi.org/10.1001/jamadermatol.2025.1836