Psoriasis

Real-World Study: Guselkumab May Be Effective for Moderate-to-Severe Plaque Psoriasis

Avatar photoBrandon May
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Chronic plaque psoriasis is a condition in which epithelial cells are over produced and form a well-defined site. The redness is often covered with silvery scales of skin. The cause of this type of psoriasis is unknown, but some inheritance factor has been reported, as has a connection with stress disorders. Treatment is normally by palliative creams based on coal tar, although some acute cases are treated with drugs.
Chronic plaque psoriasis is a condition in which epithelial cells are over produced and form a well-defined site. The redness is often covered with silvery scales of skin. The cause of this type of psoriasis is unknown, but some inheritance factor has been reported, as has a connection with stress disorders. Treatment is normally by palliative creams based on coal tar, although some acute cases are treated with drugs.
Real-world data from patients with plaque psoriasis treated with guselkumab, who had previously been administered biologic agents is presented.

A real-world study suggests guselkumab is highly effective and safe when used as a treatment for patients with moderate-to-severe plaque psoriasis (PsO) who have received other biologic therapies. Findings from this study were published in the Journal of the European Academy of Dermatology and Venereology.

The study included electronic medical record data for 50 patients with moderate to severe plaque PsO who had started guselkumab at a hospital in Denmark from 2018 to 2019. All patients had previously received 1 or more biologic treatments but did not benefit from treatment or had an adverse event related to treatment. .

Overall, the mean time on guselkumab was 80.6 weeks. At 3 months following initiation of guselkumab, approximately 63.6% of patients experienced a 50% or greater reduction in PASI, and 36.4% of patients experienced a 90% or greater reduction in PASI from baseline. This reduction was in compliance with the physician’s global assessment of efficacy, which was observed in 62% of patients at any given time. Approximately 68.6% and 31.4% of patients also had PASI scores of less than 1 and less than 3, respectively, at 3 months.

Treatment with guselkumab in this real-world patient population was generally safe. A total of 19 patients stopped guselkumab during the observation period, with most discontinuations caused by lack of efficacy. There was an increase in joint pain in 2 patients, and 1 patient experienced a rapid increase in PASI score after starting guselkumab.

Limitations of this study included its retrospective nature, the small sample of patients, and the lack of a control arm.

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The investigators concluded that additional “research with long-term observation focusing [on] real-world efficacy and safety issues that may emerge are warranted.”

Reference

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: aguselku retrospective real-world evidence study. Published online December 18, 2020. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.17092

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