Fatigue and Psoriasis Severity Scores Linked, Improve With Guselkumab Therapy

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The relationship between fatigue and psoriasis severity, and the effect of treatment with guselkumab on fatigue, is investigated.

The following article is a part of conference coverage from the 2022 American Academy of Dermatology Annual Meeting , held live from March 25 through March 29 in Boston, Massachusetts. The team at Dermatology Advisor will be reporting on the latest news and research conducted by leading experts in dermatology. Check back for more from the 2022 AAD Annual Meeting .


Guselkumab treatment for psoriasis was found to improve fatigue, which was correlated with psoriasis severity, according to study results presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29 in Boston, Massachusetts.

The VOYAGE-2 study was a randomized, double-blind, placebo- and active-comparator-controlled trial conducted from 2014 to 2016. Patients (N=992) with moderate to severe plaque-type psoriasis were randomly assigned in a 2:1:1 ratio to receive 100 mg guselkumab at baseline and week 4 then every 8weeks (n=496), placebo at baseline and 4 and 12 weeks then 100 mg guselkumab at weeks 16 and 20 (n=248), or 80 mg adalimumab at baseline and 40 mg adalimumab at week 1 followed by every 2 weeks (n=248) through week 23. At baseline and weeks 16 and 24, patients were assessed for fatigue using the 36-item Short Form survey (SF-36) vitality score and psoriasis severity using the Psoriasis Area and Severity Index (PASI). An improvement of 5 or more points on the SF-36 was defined as a clinically relevant improvement in fatigue.

Stratified by baseline PASI scores, patients with low (12-<20), intermediate (20-<30), and high (≥30) PASI scores had mean SF-36 vitality scores of 48.7, 48.3, and 45.2 points, respectively. Baseline PASI and SF-36 scores were negatively correlated (r, -0.13938; P <.001).

At week 16, placebo recipients reported a 1.1-point increase in SF-36 vitality scores compared with a 3.9-point increase among adalimumab recipients (P <.001) and 5.6-point increase among guselkumab recipients (P <.001).

At week 24, patients who had crossed over from placebo to guselkumab had a 4.6-point increase, adalimumab recipients had a 3.9-point increase, and guselkumab recipients a 5.8-point increase (P =.0148 vs adalimumab).

Stratified by PASI score improvement, at week 24 the SF-36 vitality scores had increased by 1.5 points among the patients with little PASI improvement (<75%), 4.7-points among those with intermediate improvement (75%-<90%), and 6.1-points among the greatest PASI score (³90%) improvement cohort. At study conclusion, improvements to SF-36 and PASI scores were positively correlated (r, 0.17387; P <.001).

This study may have been limited, as it was a post-hoc analysis of clinical trial data that was not specifically designed to evaluate fatigue.

“Fatigue is underestimated in [patients with] psoriasis,” the investigators wrote. These data indicated to them that fatigue and psoriasis severity were correlated, and that fatigue was more greatly improved by guselkumab therapy than placebo or adalimumab.

Disclosure: Several authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.


Strober B, Liu Y-h, Yang Y-W, et al. Correlation of Fatigue Severity and Psoriasis Severity, and the Treatment Effect of Guselkumab: A Detailed Analysis of SF-36 Vitality Scores From the VOYAGE 2 Study. Presented at: the 2022 Annual Meeting; March 25-29, 2022. Abstract/Poster 33064.

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