Guselkumab Demonstrates Long-Term Efficacy in Scalp, Nail Psoriasis

Investigators assess the long-term efficacy of guselkumab for the treatment of scalp and nail psoriasis.

Guselkumab yielded complete skin clearance in patients with scalp or nail psoriasis through 5 years, regardless of baseline severity of scalp or nail psoriasis, according to results from a study presented at the 2022 Annual Meeting of the European Academy of Dermatology and Venerology (EADV) Congress, held from September 7 to 10, 2022 in Milano, Italy.

Researchers conducted a post hoc analysis of pooled data from VOYAGE 1 ( Identifier: NCT02207231) and VOYAGE 2 ( Identifier: NCT02207244). In VOYAGE 1 (N=837) and VOYAGE 2 (N=992), adults with moderate to severe plaque psoriasis were randomly assigned to receive guselkumab, or adalimumab or placebo. During the open-label extensions of these studies, all patients took guselkumab 100 mg approximately every 8 weeks. In both trials, the last dose of guselkumab was received at week 252. Among the cohort, the mean age was 43.6 years; 71.1% were men.

The team analyzed pooled efficacy data for all guselkumab-treated patients, which included: patients initially randomly assigned to guselkumab, patients who switched from placebo to guselkumab, and patients who switched from ADA to guselkumab. Of the guselkumab-treated patients evaluable at week 100, 1316 had scalp psoriasis (ss-IGA ≥2 at baseline) and 814 had fingernail psoriasis (f-PGA ≥2 at baseline), and all of these patients were included in the analysis.

Complete skin clearance responses among guselkumab-treated patients with baseline scalp or nail involvement were similar to the responses observed in the overall population of guselkumab-treated patients from VOYAGE 1 and VOYAGE 2, the researchers noted.  

“Generally, from week 100 through week 252, approximately 35% to 40% of [guselkumab-treated] patients with scalp or nail psoriasis at baseline reported no symptoms of psoriasis (Psoriasis Symptoms and Signs Diary [PSSD] symptom score=0) and approximately 25% to 30% reported no signs of psoriasis (PSSD sign score=0),” according to the researchers. “Clear skin responses were consistently maintained through 5 years in [guselkumab-treated] patients with baseline scalp or nail psoriasis, regardless of the severity of scalp or nail psoriasis at baseline.”

This study was limited as all patients received only guselkumab during the open-label extension of VOYAGE 1 and VOYAGE 2.

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Puig L, Foley P, Miller M, et al. Long-term efficacy of guselkumab in patients by baseline nail or scalp psoriasis: results from VOYAGE 1 and 2 through 5 years. Presented at: the 2022 European Academy of Dermatology and Venerology (EADV) Congress Annual Meeting: September 7-10, 2022. Abstract/Poster 1578.