Guselkumab in moderate-to-severe plaque psoriasis: Effectiveness in real clinical practice

Ana Peláez, María de las Aguas Robustillo, Pilar Santos


Introduction: Psoriasis is a chronic immune‐mediated inflammatory skin disease that affects nearly 1–2% of the population worldwide. Biologic treatment of moderate-to-severe psoriasis has changed the disease management paradigm, allowing for better disease control.

Methods: A retrospective observational study including patients with moderate-to-severe psoriasis who were treated for at least 36 weeks with guselkumab. Efficacy was evaluated by estimating the proportion of patients achieving PASI 75, PASI 90 and PASI 100 responses at weeks 16, 24 and 36. The Student t-test for paired samples was used to determine the significant difference in outcome of patients between PASI at baseline and PASI response at weeks 16, 24 and 36.

Results: 22 patients were included, 14 women (63.6%), with mean age of 48.7±15.5. Guselkumab treatment decreased mean PASI from 10.3±6 at baseline to 2.4±2 (p=0.003), 1.3±1.8 (p=0.001) and 0.3±0.6 (p=0.001) at 16, 24 and 36 weeks, respectively.

Discussion: The first anti-IL23 drug family to join the therapeutic arsenal is guselkumab. The efficacy obtained is higher than that observed in phase III studies for PASI 90 and 100 at week 36. There are some studies that have evaluated the short-term effectiveness of guselkumab in real clinical practice; however, this drug has only recently been marketed, limiting the possibility of as yet longer treatment periods.

Conclusions: Guselkumab shows great results in the management of psoriasis in adults. Medium- and long-term real clinical practice will be essential, with a larger sample size and longer follow-up period.

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