Guselkumab ranks high in psoriasis clearance among psoriatic arthritis treatments
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WAILEA, Hawaii — Guselkumab showed better efficacy in psoriasis skin clearance than most psoriatic arthritis treatments, according to a meta-analysis presented at Maui Derm for Dermatologists.
“We can use this data to discuss with our patients the comparative effectiveness of a variety of treatments that are approved for psoriatic arthritis (PsA) to help us with clinical decision-making about next steps, either when a patient is beginning advanced therapy treatments, use of biologics or targeted synthetic [disease-modifying antirheumatic drugs (DMARDs)] for psoriatic arthritis, or when making a choice between treatments to switch to if previous treatment is yielding an inadequate response for safety issues,” Philip J. Mease, MD, a clinical professor at the University of Washington School of Medicine and director of rheumatology research at the Swedish Medical Center in Seattle, told Healio.
This systemic literature review included 33 randomized controlled trials, with 31 trials being placebo-controlled up to 24 weeks and two trials being head-to-head studies. They evaluated 15 PsA therapies.
Treatment responses were compared with a variety of metrics, including American College of Rheumatology (ACR) response, Psoriasis Area and Severity Index response, modified van der Heijde-Sharp (vdH-S) score and serious adverse events.
Results were then analyzed and the treatments were ranked for each metric.
Guselkumab every 8 weeks (Q8W) ranked second for PASI 90 response, while guselkumab every 4 weeks (Q4W) ranked first among 23 treatments. The results for PASI 75 and PASI 100 were similar.
For the ACR 20 response among 23 treatments, guselkumab ranked 14th for the Q8W dose and 12th for the Q4W dose. ACR 50 and ACR 70 responses were similar.
Among 18 treatments, guselkumab Q8W ranked eighth and guselkumab Q4W ranked third for vdH-S response.
Serious adverse events were comparable across most treatments.
“What this is showing us is that guselkumab has comparable results in the musculoskeletal domain — as reflected in the ACR 20 response as well as the radiographic evidence for structural damage progression inhibition — as the majority of other approved treatments for psoriatic arthritis,” Mease said. “And it shows superior results for improvement of psoriasis, which is a clinically important domain in psoriatic arthritis.”