For patients with moderate to severe psoriasis, 2 years of continuous treatment with the interleukin-23 blocker guselkumab resulted in high levels of efficacy, and switching from adalimumab to guselkumab at 1 year resulted in improved efficacy, according to a study published in the Journal of Drugs in Dermatology.
Due to the importance of sustained-response treatments for chronic conditions like psoriasis, the current study sought to evaluate the efficacy of continuous guselkumab treatment through 2 years of the phase 3 VOYAGE 1 trial. At baseline, participants were randomly assigned into placebo (n=174), guselkumab (n=329), or adalimumab (n=334) groups. Placebo patients switched to guselkumab at week 16, and adalimumab patients switched to guselkumab at week 52, at which time all patients received open-label treatment with guselkumab through week 100. Efficacy of treatment was assessed using the Psoriasis Area and Severity Index (PASI) and the Investigator’s Global Assessment (IGA). Data were analyzed using nonresponder imputation so that patients with missing data were characterized as nonresponders through week 48, and patients meeting the treatment failure rules were counted as nonresponders from week 52 to 100.
Clinical responses were maintained based on all 3 analyses through week 100. The percentage of patients achieving PASI 75 was 94.8%; 82.1% achieved PASI 90; 49.0% achieved PASI 100; 82.4% achieved IGA 0/1; 53.8% achieved IGA 0. At week 100, these results were similar for the adalimumab to guselkumab and placebo to guselkumab groups based on As Observed analyses but were 5% to 10% lower when analyzed with more conservative NRI rules applied.
Study investigators concluded, “Guselkumab provides a robust treatment option, with durable maintenance of response over time, for patients with psoriasis who wish to maintain clear skin.”
Griffiths CEM, Papp KA, Kimball AB, et al. Long-term efficacy of guselkumab for the treatment of moderate-to-severe psoriasis: results from the phase 3 VOYAGE 1 Trial through two years. J Drugs Dermatol. 2018;1;17(8):826-832.