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A cohort study of guselkumab in the treatment of psoriasis refractory to previous biologic therapies: effectiveness, safety and adherence

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Abstract

Background Guselkumab is indicated for moderate-to-severe plaque psoriasis. Data from real-life clinical practice regarding its use are scarce, especially concerning patients who relapse after previous biologic therapies. Aim This study aimed to evaluate the effectiveness, safety, and adherence to guselkumab in psoriasis refractory to biologic therapies. Method This real-life, retrospective study included patients who initiated guselkumab between February 2019 and October 2020. The main objective was to assess effectiveness, expressed as the psoriasis area and severity index (PASI) ≤5, ≤2 and 0, at the first follow-up medical visit. As secondary effectiveness outcomes, we assessed the body surface area (BSA) and dermatology life quality index (DLQI). We also evaluated adverse events and adherence (using the medication possession ratio [MPR]). Results The study included 35 patients who had previously received a median of two biologic drugs. The median basal PASI score (IQR) was 11 (7.3-15.9), decreasing to 0 (0-1.4) at first follow-up medical visit. At this point, 32 patients (94.1%) reached PASI ≤5, 28 (82.4%) PASI ≤2 and 19 (55.9%) PASI 0. We also found statistically significant improvements in PASI, BSA and DLQI at first follow-up (p<0.001). Three patients developed adverse events. Most patients (N=29, 85.3%) had an MPR ≥90%. The MPR was not associated with PASI score at first follow-up. Conclusion Our study supports evidence that guselkumab is an effective and safe drug in psoriasis refractory to biologic therapies. Adherence to treatment is not related to effectiveness, suggesting that, in some cases, the interval between doses could be increased.

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Acknowledgements

This work was supported by the Instituto de Salud Carlos III (JR20/00008 for Pau Riera).

The authors thank Carolyn Newey for English language editing.

Funding

This work did not receive any specific support from funding agencies.

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Author notes

  1. David Medina-Catalán and Pau Riera contributed equally to this work.

Authors and Affiliations

  1. Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain

    David Medina-Catalán, Pau Riera, Neus Pagès-Puigdemont & Montserrat Masip

  2. U705, ISCIII Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain

    Pau Riera

  3. Dermatology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain

    Anna López-Ferrer, Eva Vilarrasa & Lluís Puig

Authors
  1. David Medina-Catalán
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  2. Pau Riera
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Correspondence to Neus Pagès-Puigdemont.

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Conflicts of interest

D. Medina-Catalán does not declare any conflict of interests.

P. Riera reports grants from Ferrer and Sanofi outside the submitted work.

N. Pagès-Puigdemont has perceived consultancy/speaker’s honoraria and grants/research from Abbvie, Amgen, Boehringer Ingelheim, Celgene, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi and UCB.

M. Masip has perceived consultancy/speaker’s honoraria and grants/research from Abbvie, Amgen, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB.

E. Vilarrasa has perceived consultancy/speaker’s honoraria from and/or participated in clinical trials sponsored by Abbvie, Almirall, Amgen, Bayer, Boehringer Ingelheim, Celgene, Gebro, Isdin, Janssen, Leo-Pharma, Lilly, Merck-Serono, MSD, Novartis, Pfizer, Roche, Sandoz, Sanofi, and UCB. Not related to the submitted work.

A. López-Ferrer reports personal fees for participation as an advisory board member, consultant and/or speaker, and grants/research support for participation in clinical trials with AbbVie, Almirall, Amgen, Celgene, Janssen, LEO Pharma, MSD, Eli Lilly, Novartis and UCB Pharma. Not related to the submitted work.

L. Puig has perceived consultancy/speaker’s honoraria from and/or participated in clinical trials sponsored by Abbvie, Almirall, Amgen, Baxalta, Biogen, Boehringer Ingelheim, Celgene, Gebro, Janssen, JS BIOCAD, Leo-Pharma, Lilly, Merck-Serono, MSD, Mylan, Novartis, Pfizer, Regeneron, Roche, Sandoz, Samsung-Bioepis, Sanofi, and UCB.

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Medina-Catalán, D., Riera, P., Pagès-Puigdemont, N. et al. A cohort study of guselkumab in the treatment of psoriasis refractory to previous biologic therapies: effectiveness, safety and adherence. Int J Clin Pharm 44, 725–730 (2022). https://doi.org/10.1007/s11096-022-01400-z

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