Positive Psoriasis Response to Guselkumab, Regardless of MetS Status

Guselkumab (GUS) was found to have 5-year efficacy and durability for the treatment of plaque-type psoriasis among patients with and without metabolic syndrome (MetS), according to study results presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29, 2022 in Boston, Massachusetts.

The VOYAGE 1 and VOYAGE 2 studies were randomized, double-blind, placebo- and active-comparator-controlled trial designs which assessed GUS for the treatment of moderate to severe plaque-type psoriasis. In this post-hoc analysis, the effect of baseline MetS was evaluated for outcomes on treatment efficacy through week 264 using the Psoriasis Area and Severity Index (PASI) and Investigator’s Global Assessment (IGA).

MetS was defined as having 3 or more of the following characteristics: BMI of greater than 30 kg/m², triglycerides of 150 mg/dL or higher, high-density lipoprotein cholesterol of lower than 40 mg/dL for men and lower than 50 mg/dL for women, blood pressure 130/85 mmHg or higher, and/or fasting glucose 110 mg/dL or higher.

At baseline, 19.4% of the 1721 included patients fulfilled the criteria for MetS.

Stratified by MetS, numerically fewer patients with baseline MetS achieved PASI score reduction of 90% (77.7% vs 83.4%), PASI score reduction of 100% (48.4% vs 53.9%), IGA cleared or minimal status (76.6% vs 85.2%), or IGA cleared status (50.8% vs 56.1%).

Efficacy was generally stable among all patients between weeks 100 and 252, with or without MetS, it was noted.

Weight and blood pressure fluctuations were not observed through the course of the study.

The investigators did not find any additional safety signals through week 264.

This analysis may have been limited, as it was a post-hoc analysis and the original trials were not specifically designed to assess GUS safety and efficacy among patients with psoriasis and MetS comorbidities.

The study authors concluded that GUS had a high long-term efficacy and durability for the treatment of psoriasis through 5 years, regardless of baseline MetS status.

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

Reference

Merola JF, Thaçi D, Choi O, et al. Guselkumab efficacy and safety through 5 Years among psoriasis patients with and without metabolic syndrome at baseline: Results from VOYAGE 1 and VOYAGE 2. Presented at: the 2022 Annual Meeting; March 25-29, 2022. Abstract/Poster 33055.