The ECLIPSE study found that guselkumab was more effective than secukinumab for the possible long-term management of moderate to severe plaque psoriasis. Findings from this trial were reported in the British Journal of Dermatology.
The head-to-head, phase 3 randomized clinical trial studied the effects of IL-23 inhibitor guselkumab compared with IL-17A inhibitor secukinumab for the treatment of moderate to severe plaque psoriasis during a 56-week period. Specifically, the investigators of this study compared the 2 treatments in regard to the percentage of patients who achieved a ≥90% reduction in the Psoriasis Area and Severity Index (PASI 90) by week 48.
In the study, there was no difference in the 2 treatment arms in terms of baseline characteristics, including demographics, psoriasis duration, and previous therapies. A significantly greater number of patients randomly assigned to guselkumab achieved PASI 90 at week 48 compared with patients randomly assigned to secukinumab (84% vs 70%, respectively; P <.001). There was no difference in the 2 groups in terms of the percentage of patients who achieved a PASI 75 response (85% vs 80%; P =.062).
In addition, patients in the guselkumab group experienced a numerically longer time to achieve the median PASI 50 and PASI 90 (2.7 weeks and 8.2 weeks, respectively) vs patients randomly assigned to secukinumab (2.3 weeks and 7.4 weeks, respectively). Nasopharyngitis was the most common adverse event, reported in 22% of patients treated with guselkumab and 24% of patients treated with secukinumab.
The primary limitation of this study was lack of justification for the testing order as secondary outcomes that favored secukinumab may have been deprioritized, it was noted.
According to the authors who reported on the study, the findings “provides important new information to guide longer-term therapy choices among the newer biologic treatment options for psoriasis.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Wan MT, Takeshita J. Guselkumab vs. secukinumab for the treatment of moderate-to-severe psoriasis: a critical appraisal [published online May 14, 2020]. Br J Dermatol. doi: 10.1111/bjd.19216