Tremfya shows ‘special site’ psoriasis efficacy
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Key takeaways:
- Low body surface area psoriasis in sensitive or highly visible areas is often prescribed only topical medications.
- Tremfya significantly cleared psoriasis in the scalp, face, intertriginous and genital areas.
A study found patients with psoriasis in sensitive or difficult-to-treat areas experienced success with Tremfya, according to a press release.
The multicenter, randomized, double-blind, placebo-controlled, phase 3b SPECTREM trial studied the safety and efficacy of Tremfya (guselkumab, Johnson & Johnson), a dual acting interleukin-23 inhibitor, in patients with low body surface area moderate psoriasis with involvement of “special sites,” defined as sensitive or highly visible areas such as the scalp, face, skin folds and genitals.
“For these people, the impact of the disease on their daily lives can be significant, but still they aren’t typically provided systemic treatment, leaving them largely undertreated,” Linda Stein Gold, MD, director of dermatology clinical research at Henry Ford Health and SPECTREM investigator, told Healio.
“The reason for this is that psoriasis treatment decisions have historically been driven by body surface area coverage of the disease rather than symptom burden,” Stein Gold added. “This means people with psoriasis lesions in special sites that cover a smaller total area of their body are often prescribed topical treatments and are not considered as candidates for advanced therapies. In turn, many remain unable to successfully manage the symptoms of their disease.”
Patients were randomly assigned to receive Tremfya 100 mg injections at weeks 0 and 4, followed by every 8 weeks, or placebo at weeks 0 and 4, followed by a crossover to Tremfya at week 16 and then every 8 weeks.
At week 16, a scalp IGA response of 0 or 1 was observed in 75% of patients in the treatment group compared with 14.5% of the placebo group. In facial, intertriginous and genital areas, 87.8%, 86.5% and 78% of the study groups achieved IGA response of 0/1 compared with 28.6%, 28.8% and 37.5% of the placebo group, respectively.
Complete clearance was achieved by 60.3% in the scalp, 75.7% in the face, 76.6% in intertriginous areas and 72.7% of genital areas. This compared with 9.3%, 23.9%, 24.2% and 32.7% of the placebo group.
In addition, a PASI 90 response was recorded in 52.9% of those treated with Tremfya compared with 6.2% of those treated with placebo, and 80.6% of the treatment group experienced an improvement of more than 80% in both body surface area and PASI, compared with 6.1% and 13.7% of the placebo group.
Quality of life improvements, as measured by the DLQI questionnaire, also improved, with 48.9% of those in the Tremfya group and 3.5% of those in the placebo group achieving a DLQI score of 0/1. Further, 62.7% of the Tremfya group achieving a 4-point or greater improvement in Psoriasis Symptoms and Signs Diary itch compared with 12.5% of the placebo group.
“The SPECTREM study results, which showed high levels of skin clearance and improved quality of life impact with Tremfya among adult patients with low body surface area moderate psoriasis with special site involvement who had failed topical treatment, could represent a new approach to care for these patients who have historically been overlooked and not treated with advanced therapies like biologics,” Stein Gold said.