Guselkumab More Effective Than Adalimumab for Reduction of Psoriasis Symptoms

According to a recent study published in the Journal of the European Academy of Dermatology and Venereology, patients with moderate to severe psoriasis reported greater reduction in signs and symptoms of psoriasis when treated with guselkumab as compared with adalimumab or placebo.

Guselkumab is a monoclonal antibody that binds to the p19 subunit of interleukin 23. This interaction inhibits the downstream signaling required for differentiation and survival of helper T cells.

Investigators analyzed data from the first year of VOYAGE 1, an ongoing, phase 3, double-blind, controlled trial of patients with moderate to severe psoriasis.

Patients (age ≥18 years) were included in the study if they had moderate to severe plaque psoriasis for ≥6 months and were eligible for systemic therapy or phototherapy. Patients were randomly assigned in a 2:1:2 ratio to 1 of 3 groups: guselkumab 100 mg every 8 weeks, placebo to guselkumab 100 mg every 8 weeks, or adalimumab 40 mg every 2 weeks.

A validated patient-reported outcome measure, Psoriasis Symptoms and Signs Diary (PSSD), was used to assess signs and symptoms of psoriasis every 24 hours. Time points of 16, 24, and 48 weeks were selected for measurement of proportions of patients with clinically meaningful improvements as defined by predetermined criteria, as well as symptom- and sign-free scores of 0.

The clinical sample used for this study comprised 652 patients. At week 16, a higher proportion of patients in the guselkumab group evidenced clinically meaningful improvements in their PSSD summary scores compared with in the placebo group (P <.001), as well as symptom- and sign-free scores of 0 (P <.001). At weeks 24 and 48, the proportion of patients with clinically meaningful improvements in PSSD summary scores and symptom-free and sign-free scores of 0 was significantly greater in the guselkumab group vs the adalimumab group (P =.002 and P <.001, respectively).

“Our results from the VOYAGE 1 trial demonstrate that, based on self-reported 24-hour recall using the PSSD, patient-reported perceptions of broad improvements in symptoms and signs over time was high and correlates with the high efficacy of guselkumab,” the authors commented. “[T]hese results may assist clinicians in making treatment decisions for patients with psoriasis.”

Disclosures: Funding for the study was provided by Janssen Research & Development, LLC. Several authors declare affiliations with the pharmaceutical industry.

Reference

Papp KA, Blauvelt A, Kimball AB, et al. Patient-reported signs and symptoms of moderate-to-severe psoriasis treated with guselkumab or adalimumab: results from the randomized VOYAGE 1 trial. [published online March 6, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.14910