A high level of health-related quality of life (HRQOL) in patients with moderate to severe psoriasis who have achieved complete or almost complete skin clearance was consistently sustained for 5 years with guselkumab treatment, 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.
Investigators evaluated the association between reaching 100% improvement in the Psoriasis Area and Severity Index (PASI 100) and achieving optimal HRQOL (Dermatology Life Quality Index [DLQI] = 0 or 1) during the open-label treatment period of the 5-year phase 3 VOYAGE 1 and 2 trials. Additional analyses were performed in participants who had near optimal improvement in PASI.
Patients were randomly assigned to guselkumab, adalimumab, or placebo in VOYAGE 1 (N = 837) and VOYAGE 2 (N = 992). They received guselkumab 100 mg about every 8 weeks in the open-label extensions. Based on pooled data from the 2 trials, participants with a baseline DLQI greater than 1 were included in the analysis.
The percentage of patients who achieved a DLQI=0 or 1 was determined by PASI response category (PASI 100 and PASI 90 to <100) for 7 time-points from weeks 100 to 252. Missing DLQI data were counted as not achieving a DLQI = 0 or 1.
The VOYAGE 1 and 2 participants had an overall mean (SD) PASI score of 21.8 (8.9) at baseline, which indicates moderate to severe psoriasis, as well as a DLQI of 14.5 (7.2), which demonstrates, investigators noted, a very large influence of skin disease on HRQOL.
At week 100, 1522 patients with a baseline DLQI greater than 1 were included in the analysis. The percentage of patients who achieved a DLQI=0 or 1 for both PASI response categories was mostly consistent from weeks 100 through 252. DLQI improvements were greater in patients who achieved PASI 100 (range, 87.1%-91.5%), compared with those who achieved PASI 90 to less than 100 (range, 61.8%-67.1%).
“Most notably, [more than] 87% of patients achieving clear skin obtained optimal HRQOL,” stated the study authors. “These data highlight the long-term HRQOL benefits of achieving clear or almost clear skin in patients with moderate to severe psoriasis treated with guselkumab.”
Griffiths CEM, Strauss M, Liu Y-H, et al. Sustained improvement in health-related quality of life by PASI response in patients with moderate to severe psoriasis treated with guselkumab through 5 years in the VOYAGE 1 and 2 trials. Presented at: the 2022 European Academy of Dermatology and Venerology (EADV) Congress Annual Meeting: September 7-10, 2022. Abstract/Poster