Guselkumab an Option for Previously Treated Severe Plaque Psoriasis

Plaque psoriasis
Plaque psoriasis
Real-world data from patients with plaque psoriasis treated with guselkumab, who had previously been administered biologic agents is presented.

Treatment with guselkumab, a cytokine IL-23 inhibitory agent, was safe and effective for managing moderate to severe plaque psoriasis in patients who had previously received other biologic therapy, according to study findings published in the Journal of the European Academy of Dermatology and Venereology.

The study was a retrospective analysis of real-world data of 50 patients with moderate to severe plaque psoriasis who were treated with guselkumab at a single center in Denmark between 2018 and 2019. All patients had previously received a biologic therapy prbefore guselkumab, but these therapies failed to show benefit or caused adverse events causing discontinuation. Before initiation of guselkumab, the overall median Psoriasis Area and Severity Index (PASI) score was low for most patients.

Overall, the mean time on guselkumab was 80.6 weeks (95% CI, 68.1-93.0). At 3 months, approximately 63.6% of patients experienced 50% or greater reduction in PASI (PASI 50), and 36.4% of patients had 90% or greater reduction in PASI (PASI 90). Up to 31.4% and 68.6% had PASI scores <1 (PASI <1) and <3 (PASI <3), respectively, at 3 months with guselkumab.

The majority of the 19 patients who stopped treatment with guselkumab during the observation period did so due to lack of efficacy. Treatment with guselkumab was considered generally safe in the overall population. A total of 2 patients reported increased joint pain, and 1 patient experienced an increase in PASI after starting guselkumab.

Limitations of this study were its retrospective nature, the small sample size, as well as the lack of a control group.

Given the limitations of this study, the investigators conclude that additional “research with long-term observation focusing of real-world efficacy and safety issues that may emerge are warranted.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Schwensen JFB, Nielsen VW, Nissen CV, Sand C, Gniadecki R, Thomsen SF. Effectiveness and safety of guselkumab in 50 patients with moderate to severe plaque psoriasis who had previously been treated with other biologics: a retrospective real-world evidence study. Published online December 18, 2020. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.17092