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Bonifati C, Lembo S, Richetta AG, Romanelli M, Satolli F, Corazza M, Atzori L, Lasagni C, Potenza C, Savoia P, Bardazzi F, Di Lernia VG, Bianchi L, Fabbrocini G, Giofrè C, Zichichi L, Guarneri C, Pallotta S, Fargnoli MC, Loconsole F, Offidani A, Burlando M, Piaserico S, Peris K, Papini M, Carrera CG, Costanzo A, Prignano F, Bongiorno R, Dapavo P, Stingeni L, Donini M, Micali G, Rongioletti F, Stinco G, Gramiccia T, Cantini G, Argenziano G. Effectiveness of guselkumab in patients with facial and/or genital psoriasis: Interim analysis results at Week 12 from the GULLIVER study. J Eur Acad Dermatol Venereol 2024. [PMID: 38924150 DOI: 10.1111/jdv.20187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Facial (FP) and genital psoriasis (GP) significantly affect patients' quality of life. Despite the advances in treatments, limited data on efficacy and safety are available on these difficult-to-treat areas. Guselkumab is an interleukin (IL)-23 inhibitor which has been proven effective in treating patients with moderate-to-severe plaque psoriasis. OBJECTIVES The aim of this interim analysis was to report the efficacy and safety of guselkumab in the treatment of patients with FP and/or GP. MATERIALS AND METHODS GULLIVER is a 52-week Italian observational study to evaluate the effectiveness and safety of guselkumab in a real-life setting in patients with FP and/or GP. Adult patients with facial and/or genital moderate-to-severe psoriasis (sPGA score ≥ 3) were included. The primary endpoint of this analysis was the percentage of patients achieving a facial or genital sPGA score of 0 (clear) or 1 (almost clear), at Week 12. The change in the score of the facial or genital sPGA components in patients with a score ≥3 for each sPGA component was assessed. PASI score in patients with a baseline PASI above or below 10 was evaluated. RESULTS Overall, 351 patients were included in the study; 83.3% of FP and 76.5% of GP patients achieved the primary endpoint. Similar response rates were observed for the facial or genital sPGA components in patients with a baseline facial or genital sPGA score ≥3 in each component. Among patients with a baseline PASI score >10, mean PASI score improved from 19.0 (SD 8.3) to 2.2 (SD 4.8). Forty-four AEs were observed in 32 patients; two mild and transient AEs (fatigue and nausea) were considered treatment related. No SAEs were observed. CONCLUSIONS Guselkumab, showing to be effective and safe in treating FP and GP, may be a valid therapeutic option for patients with psoriasis localized in these difficult-to-treat areas.
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Affiliation(s)
- C Bonifati
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - S Lembo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - A G Richetta
- Unit of Dermatology, Department of Internal and Anesthetic and Cardiovascular Sciences, Sapienza University of Roma, Rome, Italy
| | - M Romanelli
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - F Satolli
- Dermatology Unit (General and Specialist Medical Department), AO - University of Parma, Parma, Italy
| | - M Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - L Atzori
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - C Lasagni
- Dermatology, Department of Specialized Medicine, AOU Policlinico di Modena, Modena, Italy
| | - C Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Roma, Rome, Italy
| | - P Savoia
- Department of Health Science & IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Università del Piemonte Orientale, Novara, Italy
| | - F Bardazzi
- Unit of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - V G Di Lernia
- Dermatology Unit, Arcispedale S. Maria Nuova, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - L Bianchi
- Dermatology Unit, Fondazione Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - G Fabbrocini
- Dermatology, University "Federico II" Naples, Naples, Italy
| | - C Giofrè
- U.O.C of Dermatology, A.O. Papardo, Messina, Italy
| | - L Zichichi
- Unit of Dermatology, San Antonio Abate Hospital, Trapani, Italy
| | - C Guarneri
- Section of Dermatology, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - S Pallotta
- Dermatology Department, IDI-IRCCS, Fondazione Luigi M. Monti, Rome, Italy
| | - M C Fargnoli
- Department of Biotechnological and Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Loconsole
- Department of Dermatology, University of Bari, Bari, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - M Burlando
- DiSSal, Dermatology Clinic, San Martino Policlinic Hospital-Istituto di Ricovero e Cura a Carattere Scientifico, University of Genova, Genova, Italy
| | - S Piaserico
- Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - K Peris
- Department of Translational Medicine and Surgery, IRCCS A. Gemelli, Sacred Heart Catholic University, Rome, Italy
| | - M Papini
- Department of Medicine and Surgery, Dermatologic Clinic of Terni, University of Perugia, Perugia, Italy
| | - C G Carrera
- Dermatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital Rozzano (MI), Rozzano (MI), Italy
| | - F Prignano
- Section of Dermatology, Department of Dermatological Science, University of Florence, Florence, Italy
| | - R Bongiorno
- Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - P Dapavo
- ASO City of Health and Science, University Dermatological Clinic, Torino, Italy
| | - L Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - M Donini
- Operative Unit of Dermatology, ULSS 3 Serenissima, Venezia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Rongioletti
- Section of Dermatology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - G Stinco
- Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | | | | | - G Argenziano
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
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Megna M, Ruggiero A, Martora F, Vallone Y, Guerrasio G, Potestio L. Long-Term Efficacy and Safety of Guselkumab in Psoriasis Patients Who Failed Anti-IL17: A Two-Year Real-Life Study. J Clin Med 2024; 13:2691. [PMID: 38731220 PMCID: PMC11084869 DOI: 10.3390/jcm13092691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/13/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
Guselkumab is the first approved human IgG1λ monoclonal antibody selectively targeting the p19 subunit of interleukin (IL)-23. Despite its effectiveness and safety, which have been widely reported by clinical trials and real-life experiences, data regarding its use on patients who previously failed anti-IL17 are limited or characterized by a reduced follow-up period. These data are essential to guide clinicians in biologic switching, considering that anti-IL23 and anti-IL17 partially share their therapeutic targets, as well as some patients who may have to interrupt treatment with anti-IL17 for loss of efficacy over time or the development of adverse events (AEs). In this context, we performed a retrospective study with the aim of evaluating the long-term use (2 years) of guselkumab in psoriasis patients who previously failed at least one anti-IL17 in a real-life setting, also focusing attention on psoriasis located in difficult-to-treat areas (the scalp, palms or soles, fingernails, genitals). A total of 61 patients (35 male, 57.4%; mean age 57.6 ± 8.8 years) were enrolled. Of these, 30 (49.2%) patients failed secukinumab, 21 (34.4%) failed ixekizumab, 7 (11.5%) failed brodalumab, and 3 (4.9%) failed both secukinumab and ixekizumab. At the baseline, the mean PASI and BSA were 12.8 ± 8.4 and 24.5 ± 26.6, respectively. During week 16, PASI90 and PASI100 responses were achieved by 60.7% and 37.7% of patients, respectively, which continued to improve up to week 104 (PASI90: 73.8%, PASI100: 59.0%). Clinical improvement in difficult-to-treat areas was detected as well. In particular, a slower improvement for fingernails and the palmoplantar region was reported compared to scalp and genital psoriasis at week 16. However, no differences were found following 28 weeks of therapy. Primary and secondary inefficacy were reported by 1 (1.6%) and 5 (8.2%) patients. As regards safety, no severe AEs were collected.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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3
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Megna M, Balato A, Caccavale S, Cacciapuoti S, Calabrese G, Di Brizzi EV, Di Costanzo L, Manzo R, Marino V, Puca RV, Romano F, Sarno O, Scotto di Luzio G, Lembo S. Real-Life Effectiveness and Safety of Guselkumab in Patients with Psoriasis Who Have an Inadequate Response to Ustekinumab: A 3-Year Multicenter Study. J Clin Med 2024; 13:2552. [PMID: 38731081 PMCID: PMC11084800 DOI: 10.3390/jcm13092552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Guselkumab is the first approved human IgG1λ monoclonal antibody selectively targeting the p19 subunit of IL23. Its effectiveness and safety were widely reported by clinical trials. However, these results must be confirmed in real life since its safety deals with more complicated subjects with respect to trials. Currently, real-life data on the use of guselkumab following treatment failure with ustekinumab are limited, and existing studies usually show a small cohort and/or a reduced follow-up period. In this context, the aim of our study was to evaluate the use of guselkumab in patients who previously did not respond to ustekinumab after up to 3 years of treatment. Methods: A multicenter retrospective study was performed. The study enrolled patients affected by moderate-to-severe plaque psoriasis undergoing treatment with guselkumab who were attending the Psoriasis Center of nine different centers in the Campania region of Italy. Demographic and clinical features were collected for each patient at baseline. Moreover, data on psoriasis severity and adverse events (AEs) were collected at each follow-up visit (week (W)16-W36-W52-W104-W156). Results: A total of 112 patients (70 male, 62.5%; mean age 54.8 ± 11.7 years old) were enrolled. Of these, 48 (42.9%), 34 (30.4%), and 16 (14.3%) reached 1, 2, and 3 years, respectively, of follow-up under guselkumab. A statistically significant clinical improvement was observed since W16, and sustained effectiveness was reported at each timepoint up to W156. No serious AEs were collected. Moreover, a sub analysis on the body mass index, involvement of difficult-to-treat areas, and presence of psoriatic arthritis (PsA) showed that the presence of PsA or palmoplantar psoriasis was associated with a reduced clinical improvement at W16 and W36, without differences from W52. In contrast, the efficacy of guselkumab does not seem to be affected by the BMI, involvement of fingernails, or location in the genital or scalp area. Conclusions: To sum up, our long-term real-life multicenter retrospective study confirmed the efficacy and safety of guselkumab following ustekinumab discontinuation up to 156 weeks of treatment.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology–Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy
| | - Sara Cacciapuoti
- Section of Dermatology–Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy
| | - Giulia Calabrese
- Dermatology and Venereology, San Gennaro Hospital, 80136 Naples, Italy
| | | | - Luisa Di Costanzo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy
| | - Raffaella Manzo
- U.O.C. Dermatologia, ASL Salerno Ospedale Tortora Pagani, 84121 Salerno, Italy
| | - Vincenzo Marino
- Dermatology Unit, Fatebenefratelli Hospital, 20121 Benevento, Italy
| | - Rosa Valentina Puca
- Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy
| | | | - Oriele Sarno
- Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy
| | | | - Serena Lembo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy
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Loras A, Gil-Barrachina M, Hernando B, Perez-Pastor G, Martinez-Domenech A, Mahiques L, Pitarch G, Valcuende-Cavero F, Ballester-Sanchez R, Marques-Torrejon MA, Martinez-Cadenas C. Association between several immune response-related genes and the effectiveness of biological treatments in patients with moderate-to-severe psoriasis. Exp Dermatol 2024; 33:e15003. [PMID: 38284189 DOI: 10.1111/exd.15003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/27/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024]
Abstract
Biological therapies are safer and more effective against psoriasis than conventional treatments. Even so, 30-50% of psoriatic patients show an inadequate response, which is associated with individual genetic heterogeneity. Pharmacogenetic studies have identified several single nucleotide polymorphisms (SNPs) as possible predictive and prognostic biomarkers for psoriasis treatment response. The objective of this study was to determine the link between several SNPs and the clinical response to biological therapies in patients with moderate-severe psoriasis. A set of 21 SNPs related to psoriasis and/or other immunological diseases were selected and analysed from salivary samples of patients (n = 88). Treatment effectiveness and patient improvement was assessed clinically through Relative Psoriasis Area and Severity Index (PASI), also called 'PASI response', as well as absolute PASI. Associations between SNPs and PASI factors were assessed at 3 and 12 months for every treatment category of IL-17, IL-23, IL-12&23 and TNF-α inhibitors. Multivariate correlation analysis and Fisher's exact test were used to analyse the relationship between SNPs and therapy outcomes. Several SNPs located in the TLR2, TLR5, TIRAP, HLA-C, IL12B, SLC12A8, TNFAIP3 and PGLYRP4 genes demonstrated association with increased short and long-term therapy-effectiveness rates. Most patients achieved values of PASI response ≥75 or absolute PASI<1, regardless of the biological treatment administered. In conclusion, we demonstrate a relationship between different SNPs and both short- and especially long-term effectiveness of biological treatment in terms of PASI. These polymorphisms may be used as predictive markers of treatment response in patients with moderate-to-severe psoriasis, providing personalized treatment.
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Affiliation(s)
- Alba Loras
- Department of Medicine, Jaume I University of Castellon, Castello de la Plana, Spain
- Department of Surgery, University of Valencia, Valencia, Spain
| | - Marta Gil-Barrachina
- Department of Medicine, Jaume I University of Castellon, Castello de la Plana, Spain
| | - Barbara Hernando
- Computational Oncology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Gemma Perez-Pastor
- Department of Dermatology, Valencia General University Hospital, Valencia, Spain
| | | | - Laura Mahiques
- Department of Dermatology, Castellon General University Hospital, Castello de la Plana, Spain
| | - Gerard Pitarch
- Department of Dermatology, Castellon General University Hospital, Castello de la Plana, Spain
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Vaiopoulos AG, Dalamaga M, Katsimbri P, Koumourtzis M, Lampadaki K, Theodoropoulos K, Theotokoglou S, Kanelleas A, Syrmali A, Filippopoulou A, Zoupidou K, Katoulis A, Papadavid E. Real-world data show high efficacy of IL23 inhibitors guselkumab and risankizumab in psoriatic arthritis and difficult-to-treat areas. Int J Dermatol 2023; 62:1404-1413. [PMID: 37747093 DOI: 10.1111/ijd.16849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Psoriasis and psoriatic arthritis are chronic inflammatory skin and joint diseases requiring effective therapies. Although clinical studies have shown the efficacy of IL-23 inhibitors, real-world data are limited. METHODS We conducted a single-center retrospective Greek study enrolling patients with psoriatic arthritis and moderate-to-severe plaque psoriasis being treated at our multidisciplinary psoriasis outpatient clinic. Our aim was to investigate the efficacy and safety of IL-23 inhibitors guselkumab and risankizumab. Additionally, we sought to determine the clinical characteristics affecting treatment response. Primary endpoints were the evaluation of absolute Psoriasis Area and Severity Index (aPASI) and Disease Activity Index for Psoriatic Arthritis (DAPSA) at week 24. RESULTS Fifty-nine patients (55.9% male, 69.5% early onset) with a mean age of 51.7 years were included. Twenty-four patients (40.7%) had a concomitant psoriatic arthritis. Obesity was the main comorbidity (49.2%) with a mean body mass index (BMI) of 31.3 kg/m2 . Additional comorbidities were hypertension (44.1%), dyslipidemia (32.2%), and diabetes (18.6%). Only eight patients (13.6%) were naïve to previous systemic treatments, whereas 40 patients (67.8%) were bio-experienced. A statistically significant improvement of aPASI and DAPSA was demonstrated after 4, 16, and 24 weeks of treatment (P < 0.05). IL23 blockers were also efficacious in difficult-to-treat areas. Clinical outcome was affected from previous treatment with biologics. Treatment response was the same between guselkumab and risankizumab (P > 0.05). CONCLUSION This real-world study confirms the efficacy and safety of guselkumab and risankizumab in psoriatic arthritis and psoriasis reported from clinical trials.
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Affiliation(s)
- Aristeidis G Vaiopoulos
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Dalamaga
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Biologic Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pelagia Katsimbri
- Rheumatology and Clinical Immunology Unit, 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Marios Koumourtzis
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Lampadaki
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Theodoropoulos
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Theotokoglou
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Kanelleas
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Syrmali
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Filippopoulou
- Rheumatology and Clinical Immunology Unit, 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Konstantina Zoupidou
- Rheumatology and Clinical Immunology Unit, 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Alexander Katoulis
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Papadavid
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Blauvelt A, Chiricozzi A, Ehst BD, Lebwohl MG. Safety of IL-23 p19 Inhibitors for the Treatment of Patients With Moderate-to-Severe Plaque Psoriasis: A Narrative Review. Adv Ther 2023; 40:3410-3433. [PMID: 37330926 PMCID: PMC10329957 DOI: 10.1007/s12325-023-02568-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/25/2023] [Indexed: 06/20/2023]
Abstract
The approved biologics targeting interleukin (IL)-23 p19 for the treatment of moderate-to-severe plaque psoriasis, including guselkumab, tildrakizumab, and risankizumab, have generally favorable safety profiles. The aim of the current review is to describe in detail the safety of these selective inhibitors. A literature search was performed using PubMed from inception to 1 November 2022, to identify clinical trials and real-world evidence publications using the keywords "guselkumab," "tildrakizumab," and "risankizumab." Overall, the most common adverse events (AEs) associated with IL-23 p19 inhibitors in clinical trials were nasopharyngitis, headache, and upper respiratory tract infections. Rates of serious AEs and AEs of interest, including serious infections, nonmelanoma skin cancer (NMSC), malignancies excluding NMSC, major adverse cardiovascular events, and serious hypersensitivity reactions, were not increased with long-term use in clinical trials. Selectively targeting IL-23 p19 was also not associated with elevated risk of opportunistic infections, tuberculosis reactivation, oral candidiasis, or inflammatory bowel disease. Results from real-world studies were similar, supporting the safe long-term use of these biologics in a wider population of patients with psoriasis, including older patients, patients for whom multiple biologics failed, and those with comorbidities such as obesity, metabolic syndrome, cardiovascular disease, dyslipidemia, diabetes, hypertension, and psoriatic arthritis. This review is limited by the lack of direct comparisons among therapeutic agents due to differences among study designs and safety data reporting methods. In conclusion, the favorable safety profiles of IL-23 p19 inhibitors support their long-term use in the management of patients with moderate-to-severe psoriasis.
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Affiliation(s)
- Andrew Blauvelt
- Oregon Medical Research Center, 9495 SW Locust Street, Suite G, Portland, OR, 97223, USA.
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Benjamin D Ehst
- Oregon Medical Research Center, 9495 SW Locust Street, Suite G, Portland, OR, 97223, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Galluzzo M, Marcelli L, Vellucci L, Paganini C, Maffei V, Tofani L, Belcastro A, Bianchi L, Talamonti M. Guselkumab for treatment of moderate-to-severe plaque psoriasis: real-life effectiveness and drug-survival for up to 148 weeks. Expert Opin Biol Ther 2023; 23:371-381. [PMID: 36971507 DOI: 10.1080/14712598.2023.2194485] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Real-world data are useful to guide the management of psoriasis. Here, we present data on the effectiveness and survival of guselkumab in moderate-to-severe chronic plaque psoriasis for up to 148 weeks. RESEARCH DESIGN AND METHODS Cross-sectional study of 122 patients receiving guselkumab (100 mg at weeks 0 and 4, and then every 8 weeks thereafter) for>12 weeks, from November 2018 to April 2022. MAIN OUTCOME MEASURES Clinical features and drug survival were analyzed up to 148 weeks. RESULTS Obese patients (32.8%) and those receiving prior biologics (64.8%) were included. Guselkumab treatment was associated with a rapid decrease in PASI, from 16.2 to 3.2 at week 12, and long-term improvements in all subgroups (97.6%, 82.9%, and 63.4% of patients, respectively, achieved PASI 75, 90, and 100 after 148 weeks). More non-obese than obese patients achieved PASI 100 at week 148 (86.4% vs 38.9%), as did bio-naïve vs bio-experienced patients (86.7% vs 50.0%). Previous biologic therapy was a negative prognostic factor for achieving PASI 100 over the long-term by multivariate analysis (p = 0.005). Overall, 96% of patients were on treatment after 2 years. CONCLUSIONS Real-world data confirm the long-term effectiveness of guselkumab in patients with psoriasis.
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Yang J, Hu K, Li X, Hu J, Tan M, Zhang M, Kuang Y, Lv C, Chen J. Effectiveness and Safety of Guselkumab for the Treatment of Psoriasis in Real-World Settings at 52 weeks: A Retrospective, Observational, Multicenter Study from China. Dermatol Ther (Heidelb) 2023; 13:477-485. [PMID: 36481840 PMCID: PMC9884724 DOI: 10.1007/s13555-022-00869-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Real-life studies evaluating the long-term efficacy of guselkumab in moderate-to-severe psoriasis in China are limited and not available. METHODS In this real-life study, we retrospectively examined a total of 27 patients with moderate-to-severe psoriasis treated with guselkumab [100 mg, subcutaneous (s.c.)] with a follow-up period of at least 52 weeks in a real-life setting conducted at the Department of Dermatology, Xiangya Hospital, Central South University and Department of Psoriasis, Dalian Dermatosis Hospital. The primary endpoint of the study was long-term effectiveness [reduction of Psoriasis Area and Severity Index (PASI) score, improvement of Dermatology Life Quality Index (DLQI)], safety, and tolerability of guselkumab. RESULTS Guselkumab treatment decreased the mean PASI score from 12.46 ± 6.34 at baseline to 4.03 ± 3.25 (P < 0.001) and 0.77 ± 1.25 (P < 0.001) at 12 and 52 weeks. At 12 weeks, PASI 75, 90, and 100 response was achieved in 44.4%, 18.5%, and 11.1% of patients, respectively. At 1 year, PASI 75, 90, and 100 response was achieved in 88%, 72%, and 48% of patients, respectively. At 52 weeks, 96% of patients achieved a PASI score of ≤ 3 and 80% of patients achieved DLQI (0/1). No patients withdrewed from the study due to primary or secondary ineffectiveness or failure to adhere to the medication. During the follow-up period, only two adverse events were reported (tinea capitis and diarrhea). CONCLUSIONS Our findings confirm that guselkumab is an appropriate therapeutic option in routine clinical practice, particularly when treating sophisticated patients with comorbidities or who failed to previous biologic therapy.
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Affiliation(s)
- Jing Yang
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kun Hu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xingyu Li
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jingjin Hu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Minjia Tan
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Mi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Chengzhi Lv
- Department of Psoriasis, Dalian Dermatosis Hospital, Dalian, China.
| | - Junchen Chen
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 41000, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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9
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Gargiulo L, Ibba L, Malagoli P, Angileri RG, Bardazzi F, Bernardini N, Burlando M, Carrera CG, Chiricozzi A, Dapavo P, Dini V, Fabbrocini G, Gaiani FM, Galluzzo M, Giofré C, Guarneri C, Loconsole F, Malara G, Marcelli L, Megna M, Piaserico S, Talamonti M, Costanzo A, Narcisi A. Real-life effectiveness and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: A 104-week multicenter retrospective study - IL PSO (ITALIAN LANDSCAPE PSORIASIS). J Eur Acad Dermatol Venereol 2023; 37:1017-1027. [PMID: 36695061 DOI: 10.1111/jdv.18913] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Guselkumab is a fully human monoclonal antibody that binds selectively to the p19 subunit of interleukin-23, which has shown efficacy in patients with previous incomplete response to ustekinumab in the NAVIGATE clinical trial. [Correction added on [28-02-2023], after first online publication: 'humanized monoclonal antibody' has been changed to 'fully human monoclonal antibody' in the preceding sentence.] OBJECTIVES: We conducted a 104-week multicenter retrospective study to assess the effectiveness and safety of guselkumab in patients affected by plaque psoriasis with an inadequate response to ustekinumab in a real-life setting. METHODS Our retrospective study included 233 adults affected by moderate-to-severe plaque psoriasis, enrolled in 14 different Italian centres, and treated with guselkumab after failing therapy with ustekinumab. Patient characteristics and PASI (Psoriasis Area and Severity Index) score at each visit (baseline, weeks 16, 52 and 104) were recorded. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI, compared with baseline, were registered. RESULTS At week 52, PASI 75 was reached by 89.88% of patients, PASI 90 by 71.43%, PASI 100 by 58.83% and absolute PASI ≤2 by 90.48%. At week 104, similar effectiveness results were observed. Compared to the NAVIGATE trial, we observed higher rates of PASI 75/90/100. Patients with the involvement of difficult-to-treat areas were significantly less likely to achieve PASI90 and PASI100 at week 16. Obese patients had significantly lower rates of PASI75 and PASI ≤2 at week 52. At week 104, comparable responses were observed among all patients' subgroups, regardless of BMI status, involvement of difficult-to-treat areas, presence of cardiometabolic comorbidities and concomitant psoriatic arthritis. No significant safety findings were reported throughout the study. CONCLUSION Our data suggest that the efficacy of guselkumab in patients with inadequate response to ustekinumab for plaque psoriasis in 'real-life' clinical practice is comparable with NAVIGATE study with higher percentages of patients achieving PASI90 and PASI100 at weeks 16, 52 and 104.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | | | - Federico Bardazzi
- Dermatology Unit, Department of Specialistic, Diagnostic and Experimental Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Nicoletta Bernardini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Terracina, Italy
| | - Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Carlo G Carrera
- Fondazione Cà Granda IRCCS Maggiore Policlinico Hospital, Milan, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine Ospedale Santa Chiara, Pisa, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesca Maria Gaiani
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Marco Galluzzo
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | | | - Giovanna Malara
- UOC of Dermatology, Great Metropolitan Hospital "BMM", Reggio Calabria, Italy
| | - Lorenzo Marcelli
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padova, Padua, Italy
| | - Marina Talamonti
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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10
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Ruggiero A, Megna M, Fabbrocini G, Ocampo-Garza SS. Anti-IL23 biologic therapies in the treatment of psoriasis: real-world experience versus clinical trials data. Immunol Res 2023; 71:328-355. [PMID: 36598647 PMCID: PMC9811885 DOI: 10.1007/s12026-022-09356-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023]
Abstract
Nowadays, the biological equipment available for the treatment of moderate-to-severe psoriasis is plenty. Anti-interleukin-23 represents the latest class of biologic approved for the management of moderate-to-severe psoriasis. Their efficacy and safety have been assessed through two major sources: clinical trials (CTs) and real-world experiences data (RWE). Notably, the two sources differ from one another, but together, they complement information and current knowledge on both efficacy and safety of biological therapy. We carry out a review on CTs and RWE reports on the latest group of biological approved for moderate-to-severe psoriasis: anti-IL23 (guselkumab, risankizumab, and tildrakizumab).
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Affiliation(s)
- Angelo Ruggiero
- grid.4691.a0000 0001 0790 385XSection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Matteo Megna
- grid.4691.a0000 0001 0790 385XSection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Gabriella Fabbrocini
- grid.4691.a0000 0001 0790 385XSection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Sonia Sofia Ocampo-Garza
- grid.4691.a0000 0001 0790 385XSection of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy ,grid.411455.00000 0001 2203 0321Dermatology Department, Universidad Autónoma de Nuevo León, University Hospital “Dr, José Eleuterio González”, Monterrey, NL Mexico
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11
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Ruggiero A, Fabbrocicni G, Cacciapuoti S, Potestio L, Gallo L, Megna M. Tildrakizumab for the Treatment of Moderate-to-Severe Psoriasis: Results from 52 Weeks Real-Life Retrospective Study. Clin Cosmet Investig Dermatol 2023; 16:529-536. [PMID: 36873660 PMCID: PMC9983574 DOI: 10.2147/ccid.s402183] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
Background Tildrakizumab, an anti-IL-23, showed promising efficacy and safety profiles in two randomized clinical-trials (reSURFACE-1 and reSURFACE-2), comparing tildrakizumab superiority to placebo and etanercept. Due to its recent availability in clinical-practice, real-life data are still limited. Objective To assess the efficacy and safety of tildrakizumab in a real-world-practice in patients suffering from moderate-to-severe psoriasis. Methods A 52-week observational retrospective study enrolled patients suffering from moderate-to-severe plaque-psoriasis, starting tildrakizumab treatment. Results A total of 42 patients were included in the study. Mean PASI showed a significant reduction at each follow-up (p<0.001), reducing from 13.5±5.9 at baseline, 2.8±3.8 at week-28, resulting stable up to week-52. High rates of patients reached both PASI90 and PASI100 responses at both week 16 (PASI90: 52.4%, PASI100: 33.3%) and week 28 (PASI90: 76.1%, PASI100: 61.9%), maintaining these up to week 52 (PASI90: 73.8%, PASI100: 59.5%). The impact of treatment on patient's quality of life has been evaluated with DLQI, which showed a significant reduction during follow-ups. Conclusion Our data confirm tildrakizumab as an effective and generally safe treatment for the management of moderate-to-severe psoriasis, with high rates of both PASI90 and PASI100 responses, and very few reported adverse events, up to 52 weeks of follow-up.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocicni
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sara Cacciapuoti
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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12
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Ruggiero A, Camela E, Potestio L, Fabbrocini G, Megna M. Drug safety evaluation of tildrakizumab for psoriasis: a review of the current knowledge. Expert Opin Drug Saf 2022; 21:1445-1451. [PMID: 36527300 DOI: 10.1080/14740338.2022.2160447] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease that may have an important negative impact on a patient's quality of life. Biological agents deeply changed the management of its moderate-to-severe forms. Interleukin-23 inhibitors represent the latest biologics class approved for the treatment of moderate-to-severe psoriasis. In particular, tildrakizumab, the latest available anti-interleukin-23 on the Italian market, is a humanized monoclonal antibody specifically targeting the p19 subunit of IL-23. AREAS COVERED The objective of this review is to evaluate the safety profile of tildrakizumab in moderate-to-severe psoriasis patients. A literature review included articles until July 2022. EXPERT OPINION Our analysis showed tildrakizumab as a generally safe option for the treatment of psoriasis, with most of the reported adverse events being classified as mild or moderate, and rarely requiring treatment discontinuation. Furthermore, in line with other interleukin-23 inhibitor, no concerns have been raised for tildrakizumab in regard to inflammatory bowel diseases, which represent a significant comorbidity to investigate before starting other biologics (IL-17 inhibitors). However, more real-life long-term data are needed to confirm trial results to further confirm tildrakizumab as a generally safe treatment option for psoriasis.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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13
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Bardazzi F, Viviani F, Merli Y, Di Lernia V, Peccerillo F, Conti A, Lasagni C, Tabanelli M, D'Adamio S, Di Nuzzo S, Cortellazzi C, Filippi F. Guselkumab for the treatment of psoriasis: a 60-week real-life multicenter retrospective experience. Expert Opin Biol Ther 2022; 22:1561-1566. [PMID: 35388713 DOI: 10.1080/14712598.2022.2064216] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Real-world data for guselkumab, the first interleukin-23 inhibitor approved to treat moderate-to-severe psoriasis, are scarce. This study represents the first 60-week, real-life, multicenter, retrospective experience to investigate the effectiveness, safety, tolerability, and drug retention of guselkumab in psoriatic patients. RESEARCH DESIGN AND METHODS Clinical information was collected at baseline and at weeks 12, 24, 36, 48, and 60. RESULTS The mean baseline Psoriasis Activity Severity Index (PASI) reduced from 14.2 to 3.1 at week 12 and decreased to around 0 at weeks 36, 48, and 60. PASI 75, PASI 90, and PASI 100 were 100%, 96.8%, and 83.9% at week 60, respectively. Multiple logistic regression analysis showed that neither body mass index >30, smoking, ≥3 comorbidities, difficult-to-treat areas, nor a failure to ≥2 prior biologic treatments significantly influenced PASI reduction (p > 0.05). CONCLUSIONS Our findings confirm guselkumab as an appropriate therapeutic option in routine clinical practice, especially when dealing with complex patients with comorbidities or previous failure to biologic treatments.
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Affiliation(s)
- Federico Bardazzi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Filippo Viviani
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Yuri Merli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Vito Di Lernia
- Dermatology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Andrea Conti
- Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Lasagni
- Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Sergio Di Nuzzo
- Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Cortellazzi
- Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Federica Filippi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
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14
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Galluzzo M, Talamonti M, Bernardini N, Chiricozzi A, De Simone C, Bonifati C, Bruni P, Diotallevi F, Esposito M, Graceffa D, Hansel K, Loconsole F, Moretta G, Mugheddu C, Papini M, Richetta A, Skroza N, Atzori L, Fargnoli MC, Persechino S, Offidani A, Stingeni L, Peris K, Potenza C, Bianchi L. Real-world outcomes in patients with moderate-to-severe plaque psoriasis treated with guselkumab for up to 1 year. Expert Opin Biol Ther 2022; 22:1585-1592. [PMID: 35708257 DOI: 10.1080/14712598.2022.2090835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Real-world data on guselkumab, especially at times >6 months, are limited. RESEARCH DESIGN AND METHODS We performed a longitudinal, retrospective analysis on 307 patients with moderate-severe chronic plaque psoriasis (Psoriasis Area Severity Index [PASI] >10) treated with guselkumab for up to 12 months. MAIN OUTCOME MEASURES PASI 75, PASI 90, and PASI 100 were assessed at baseline and at 4, 12, 20, 28, 36, 44, and 52 weeks. RESULTS At 12 weeks, PASI 75, PASI 90, and PASI 100 were achieved in 56.4%, 33.6%, and 24.1% of patients, respectively. At 52 weeks, PASI 75, PASI 90, and PASI 100 were achieved in 82.7%, 68.7%, and 51.1% of patients, respectively. Patients without comorbidities and those naïve to previous biological therapy had better responses. The mean Dermatology Life Quality Index score decreased from 14.0 at baseline to 3.1 at 12 weeks and 1.6 at 6 months, which was maintained at later times. Similar improvements were seen in pruritus visual analog scale. CONCLUSIONS Guselkumab maintains its efficacy for up to 12 months among responders in a real-world cohort of patients with moderate-severe plaque psoriasis, confirming data from prior real-world studies with smaller cohorts and shorter duration of follow-up.
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Affiliation(s)
- Marco Galluzzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - Marina Talamonti
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | | | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Clara De Simone
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Claudio Bonifati
- Dermatology Unit, San Gallicano Dermatological Institute - IRCCS, Roma, Italy
| | - Pierluigi Bruni
- Dermatology University of Perugia, Terni Hospital, Terni Italy
| | - Federico Diotallevi
- Dermatology Unit, Dept. of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Maria Esposito
- Dermatology, Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Dario Graceffa
- Dermatology Unit, San Gallicano Dermatological Institute - IRCCS, Roma, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Dermatology and Venereology, University of Perugia, Perugia, Italy
| | - Francesco Loconsole
- Dermatology clinic, University hospital "Policlinico universitario di Bari", Bari, Italy
| | | | | | - Manuela Papini
- Dermatology University of Perugia, Terni Hospital, Terni Italy
| | - Antonio Richetta
- Dermatology, Sapienza University of Rome - Umberto I Hospital, Rome, Italy
| | - Nevena Skroza
- Dermatology, Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - Laura Atzori
- Dermatology, University of Cagliari, Cagliari, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Severino Persechino
- Department of Neuroscienze Salute Mentale e Organi di Senso (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Annamaria Offidani
- Dermatology Unit, Dept. of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Dermatology and Venereology, University of Perugia, Perugia, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Concetta Potenza
- Dermatology, Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
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15
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Ruiz-Villaverde R, Rodriguez-Fernandez-Freire L, Armario-Hita JC, Pérez-Gil A, Vasquez Chinchay F, Galán-Gutiérrez M. Effectiveness, survival and safety of guselkumab attending to basal characteristics in moderate-to-severe psoriatic patients: a cohort study. F1000Res 2022; 11:1178. [PMID: 36567685 PMCID: PMC9755754 DOI: 10.12688/f1000research.122945.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Psoriasis is a chronic inflammatory disease which can impact quality of life. In the past decade multiple biologic treatments have been released with encouraging results. Guselkumab is a monoclonal antibody targeting IL-23p19. Multiple randomized clinical trials have demonstrated its efficacy in psoriasis, but response differences among patient subpopulations have not been extensively reported. Furthermore, patients in real life are often non-eligible for clinical trials and their responses may differ from pivotal studies. Methods: This is a retrospective, observational study of real clinical practice of patients receiving guselkumab treatment in Spain. Patients treated with guselkumab were included between February 2019 to December 2021. This study evaluates the potential differential effect of baseline demographic and disease characteristics on therapeutic responses to guselkumab. We measured effectiveness and survival by the psoriasis area and severity index, the dermatology life quality index as well as Kaplan meier curves, respectively. Categorical and quantitative variables are reported with frequencies, and with mean and standard deviation, respectively. Differences between groups in psoriasis area and severity index and dermatology life quality index, were calculated using a mixed-effects analysis. Survival was calculated using Kaplan meier curves and log-rank tests. Results: A total of 87 patients were included. In this study, our objective was to evaluate the effectiveness, safety and survival of guselkumab attending to demographic characteristics. No differences in psoriasis area and severity index or dermatology life quality index baseline values or therapeutic responses were noted at 52 weeks of follow-up among all the subgroups analysed (age, sex, psoriasis duration, body mass index, and comorbidities). A difference in drug survival was only seen between gender groups. Conclusions: Our research has demonstrated the consistency of guselkumab effectiveness across patient subgroups. No baseline features affected the effectiveness or drug survival of guselkumab, except for lower drug survival in female patients.
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Affiliation(s)
| | | | | | - Amalia Pérez-Gil
- Dermatology Department, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
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16
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Mastorino L, Siliquini N, Avallone G, Zenone M, Ortoncelli M, Quaglino P, Dapavo P, Ribero S. Guselkumab shows high efficacy and maintenance in the improvement of response until week 48, a real-life study. Dermatol Ther 2022; 35:e15670. [PMID: 35762118 PMCID: PMC9786539 DOI: 10.1111/dth.15670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/07/2022] [Accepted: 06/25/2022] [Indexed: 12/30/2022]
Abstract
Guselkumab is an IL-23 inhibitor that has been demonstrated to be effective and safe for the treatment of moderate-to-severe plaque psoriasis in clinical trials. The data pool relating to the use of guselkumab in a real-life setting is still lacking. To evaluate the efficacy and safety of guselkumab in a real-life setting, focusing on predictors of early clinical response, a single-center prospective study was conducted enrolling patients with moderate-to-severe psoriasis. The clinical data relating to the efficacy and safety of the drug were acquired at initiation of treatment and at all subsequent clinical follow-ups: the primary endpoint was PASI90 and PASI100 response at week 12, 24, and 48. Out of the total cohort of 74 patients, 62 (83.8) reached a 48-week follow-up 64 (87.8%) reached a 24-week follow-up, while 72 (97.3%) a 12-week follow-up. Treatment with guselkumab reduced the mean PASI from the initial 11 ± 6.3 to 2.5 ± 3.1 at 12 weeks, to 1.2 ± 1.8 at 24 weeks, and to 0.8 ± 1.6 at 48 weeks. At week 12, a PASI 90 and PASI 100 response was achieved by 44.4% and 23.6% of patients, respectively. After 24 weeks, 63% of patients reported a PASI 90 while 46.1% achieved PASI 100. Previous treatment with one or more other biologics did not impact significantly on the achievement of the PASI 90 and 100 at any endpoints analyzed. We reported no difference between bio-naïve and non-naïve patients in the response to guselkumab, high safety, and efficacy was showed in both populations.
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Affiliation(s)
- Luca Mastorino
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Niccolò Siliquini
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Gianluca Avallone
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Mattia Zenone
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Michela Ortoncelli
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Paolo Dapavo
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
| | - Simone Ribero
- Dermatologic Clinic, Department of Medical SciencesUniversity of TurinTurinItaly
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17
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Ruiz‐Villaverde R, Chinchay FV, Rodriguez‐Fernandez‐Freire L, Armario‐Hita JC, Pérez‐Gil A, Galán‐Gutiérrez M. Guselkumab dosing interval optimization in adult patients with moderate‐to‐severe Psoriasis switching from ustekinumab. Dermatol Ther 2022; 35:e15835. [DOI: 10.1111/dth.15835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | - Amalia Pérez‐Gil
- Dermatology Department Hospital Universitario Virgen de Valme Sevilla Spain
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18
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Camela E, Potestio L, Ruggiero A, Ocampo-Garza SS, Fabbrocini G, Megna M. Towards Personalized Medicine in Psoriasis: Current Progress. Psoriasis (Auckl) 2022; 12:231-250. [PMID: 36071793 PMCID: PMC9444142 DOI: 10.2147/ptt.s328460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022] Open
Abstract
Although innovative targeted therapies have positively revolutionized psoriasis treatment shifting treatment goals to complete or almost complete skin clearance, primary or secondary lack of efficacy is still possible. Hence, identifying robust biomarkers that reflect the various clinical psoriasis phenotypes would allow stratify patients in subgroups or endotypes, and tailor treatments according to the characteristics of each individual (precision medicine). To sum up the current progress in personalized medicine for psoriasis, we performed a review on the available evidence on biomarkers predictive of response to psoriasis treatments, with focus on phototherapy and systemic agents. Relevant literature published in English was searched for using the following databases from the last five years up to March 20, 2022: PubMed, Embase, Google Scholar, EBSCO, MEDLINE, and the Cochrane library. Currently, more evidence exists towards biologicals, as justified by the huge health care costs as compared to phototherapy or conventional systemic drugs. Among them, most of the studies focused on anti-TNF and IL12/23, with still few on IL17 (mainly secukinumab). The most discussed biomarker gene is the HLA-C*02:06 status that has been shown to be associated with psoriasis, and also differential response to biologicals. Although its positivity is associated with great response to MTX, debatable results were retrieved concerning both anti-TNF and IL12/23 while it seems not to affect secukinumab response. Personalized treatment in psoriasis would provide excellent outcome minimizing the risk of side effects. To date, although several candidates were proposed and assessed, the scarcity and heterogeneity of the results do not allow the identification of the gold-standard biomarker per each treatment. Anyway, the creation of a more comprehensive panel would be more reliable for the treatment decision process.
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Affiliation(s)
- Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Correspondence: Elisa Camela, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sonia Sofia Ocampo-Garza
- Dermatology Department, Universidad Autónoma de Nuevo León, University Hospital ¨Dr. José Eleuterio González¨, Monterrey, Nuevo León, México
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Ruggiero A, Picone V, Martora F, Fabbrocini G, Megna M. Guselkumab, Risankizumab, and Tildrakizumab in the Management of Psoriasis: A Review of the Real-World Evidence. Clin Cosmet Investig Dermatol 2022; 15:1649-1658. [PMID: 35996400 PMCID: PMC9392468 DOI: 10.2147/ccid.s364640] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/07/2022] [Indexed: 12/16/2022]
Abstract
Interleukin (IL)-23 inhibitors, guselkumab, risankizumab, and tildrakizumab, represent the latest class of biologics approved for the treatment of moderate-to-severe psoriasis. Since their approval numerous real-life studies were published on anti-IL-23 use in routine clinical practice. Indeed, real-life data are important to improve the dermatological decision-making process, including patients who are typically excluded from clinical trials, such as subjects suffering from several comorbidities, subjects on polypharmacy, as well as multifailure patients. Herein, we performed a comprehensive literature review about real-life data available on guselkumab, risankizumab, and tildrakizumab. Real-life data of anti-IL-23 seem to confirm the promising results of IL-23 shown by clinical trials, highlighting the efficacy and safety profiles of this new class of biologics also in clinical practice.
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Affiliation(s)
- Angelo Ruggiero
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Picone
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
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20
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Berenguer‐Ruiz S, Rivera R, Herranz P, de la Cueva P, Hospital M, Ruiz‐Genao D, Roustan G, Daudén E, Llamas‐Velasco M. Ustekinumab to Guselkumab Transitions: A Series of 54 Patients Emulating the Navigate Trial in Real Life. Dermatol Ther 2022; 35:e15757. [DOI: 10.1111/dth.15757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Raquel Rivera
- Department of Dermatology Hospital Universitario 12 de Octubre Madrid Spain
| | - Pedro Herranz
- Department of Dermatology Hospital Universitario La Paz Madrid Spain
| | - Pablo de la Cueva
- Department of Dermatology Hospital Universitario Infanta Leonor Madrid Spain
| | - Mercedes Hospital
- Department of Dermatology Hospital Universitario Puerta de Hierro Madrid Spain
| | - Diana Ruiz‐Genao
- Department of Dermatology Hospital Fundación de Alcorcon Madrid Spain
| | - Gastón Roustan
- Department of Dermatology Hospital Universitario Puerta de Hierro Madrid Spain
| | - Esteban Daudén
- Department of Dermatology Hospital Universitario La Princesa Madrid Spain
| | - Mar Llamas‐Velasco
- Department of Dermatology Hospital Universitario La Princesa Madrid Spain
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21
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Ruiz‐Villaverde R, Rodriguez‐Fernandez‐Freire L, Armario‐Hita JC, Pérez‐Gil A, Chinchay FV, Galán‐Gutiérrez M. Guselkumab as a switching strategy after
anti‐TNFα
,
anti‐IL17
or
anti‐IL12
/23 therapies in moderate‐to‐severe psoriasis. Dermatol Ther 2022; 35:e15760. [DOI: 10.1111/dth.15760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/23/2022] [Accepted: 08/06/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - Amalia Pérez‐Gil
- Dermatology Department Hospital Universitario Virgen de Valme Sevilla Spain
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22
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Megna M, Potestio L, Fabbrocini G, Ruggiero A. Long-Term Efficacy and Safety of Guselkumab for Moderate to Severe Psoriasis: A 3-Year Real-Life Retrospective Study. Psoriasis (Auckl) 2022; 12:205-212. [PMID: 35859710 PMCID: PMC9292056 DOI: 10.2147/ptt.s372262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/06/2022] [Indexed: 12/11/2022] Open
Abstract
Introduction Guselkumab safety and efficacy profiles in psoriasis have been showed by VOYAGE (1 and 2) trials. Although trial results have been already previously confirmed by real-life studies, long-term real-life data, and drug survival data about guselkumab are still poor. Patients and Methods We performed a 3-year retrospective study, with the aim of assessing guselkumab efficacy and safety profile in the management of plaque psoriasis in a real-life setting. Results Thirty-one patients completed the study. Both Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) statistically improved since week 16, and up to week 144 [PASI reduction from 16.4 ± 6.2 to 0.6 ± 0.9 (p < 0.0001) at week 144 while BSA from 33.2 ± 14.6 to 1.9 ± 1.4 (p < 0.0001)]. At week 12 PASI90 and PASI100 were achieved by 19 (61.3%) and 11 (35.4%) patients, respectively, as well as 24 (77.4%) and 18 (58.1%) subjects reached PASI 90 and PASI 100 at week 144. As regards the safety, no cases of injection site reaction, candida, serious AEs, malignancy, or major cardiovascular events were reported. Of note, mild AEs were collected with pharyngitis as the main one (7, 22.6%), followed by headache (5, 16.1%) and flu-like illness (5, 16.1%), all without requiring treatment discontinuation. Conclusion Our experience confirmed the efficacy and safety of guselkumab in daily clinical practice up to 3 years, suggesting this drug as an effective treatment option in psoriasis long-term management.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
- Correspondence: Angelo Ruggiero, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Napoli, 80131, Italy, Tel +39 081 7462457, Fax +39 081 7462442, Email
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23
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Meta-Analysis of the Efficacy and Safety of Interleukin-23-Targeted Drugs in the Treatment of Moderate-to-Severe Psoriasis. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:2172980. [PMID: 35845729 PMCID: PMC9256449 DOI: 10.1155/2022/2172980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/29/2022] [Accepted: 06/02/2022] [Indexed: 12/17/2022]
Abstract
In this study, our purpose was to systematically evaluate the efficacy and safety of interleukin-23 (IL-23)-targeted drugs in the treatment of moderate-to-severe psoriasis and provide an evidence-based reference for clinical treatment. A computer search of PubMed, EMBASE, Web of Science, Cochrane Library, Chinese Journal Full Text Database, Chinese Science and Technology Journal Database, and Wanfang Database was conducted from the establishment of the database to 2021-09-30. The efficacy of IL-23-targeted drugs (trial group) was compared with placebo (control group) in the treatment of psoriasis; i.e., PASI score improvement of 75% or more (PASI 75, PASI 90, and PASI 100) and the safety of randomized controlled trials (RCTs) were collected. Meta-analysis was performed using Rev Man 5.4.3 statistical software after data extraction for clinical studies that met the inclusion criteria. A total of 9 studies were included, all included studies were large multicenter, randomized, double-blind, placebo-controlled studies, and all used correct randomization methods and were of good quality. Meta-analysis showed that the improvement rates of PASI 75, PASI 90, and PASI 100 in the test group were superior to those in the control group (OR = 70.21 (42.25, 166.66), P < 0.00001), (OR = 78.41 (53.09, 115.79), P < 0.00001), and (OR = 77.10 (38.61, 153.99), P < 0.00001), P < 0.05. However, more adverse effects occurred, and the differences were statistically significant. IL-23-targeted drugs have significantly higher response rates compared to placebo in the treatment of psoriasis, and the safety was acceptable.
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Megna M, Potestio L, Camela E, Fabbrocini G, Ruggiero A. Ixekizumab and brodalumab indirect comparison in the treatment of moderate to severe psoriasis: results from an Italian single-centre retrospective study in a real-life setting. Dermatol Ther 2022; 35:e15667. [PMID: 35762107 PMCID: PMC9540270 DOI: 10.1111/dth.15667] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/22/2022] [Accepted: 06/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Eleven biologic drugs are currently approved for psoriasis management. Real-life studies are needed to guide clinicians in choosing a tailored-tail therapy. The aim of our retrospective study is to indirectly compare the efficacy and safety of ixekizumab and brodalumab in psoriasis patients. METHODS A single-centre real-life retrospective study was performed enrolling moderate-to-severe psoriatic patients under biologic treatment with ixekizumab or brodalumab. For each patient, clinical and demographic data were collected and the effectiveness and safety of brodalumab and ixekizumab treatment were evaluated at weeks 4, 12 and 24. Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) were used for psoriasis severity. RESULTS A total of 139 patients were included in the study: 98(70.5%) and 41(29.5%) patients received ixekizumab and brodalumab, respectively. Mean PASI and BSA significantly reduced at each follow up for both ixekizumab and brodalumab groups. Even if ixekizumab reached higher rates of PASI90 and PASI100 than brodalumab (PASI90: 43.8%vs39.0% PASI100: 20.4%vs17.1% at week4 and PASI90: 83.6%vs75.6% PASI100: 71.5%vs60.9% at week24), these results were not statistically significant. Adverse events, mainly mild, were registered in 25.5% of ixekizumab and 26.8% of brodalumab group, respectively. Discontinuation rate was higher for brodalumab (17.1%vs9.1%), without statistical significance. CONCLUSION Our study showed comparable efficacy and safety for ixekizumab and brodalumab.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Elisa Camela
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
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25
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Ruggiero A, Potestio L, Camela E, Fabbrocini G, Megna M. Bimekizumab for the Treatment of Psoriasis: A Review of the Current Knowledge. PSORIASIS (AUCKLAND, N.Z.) 2022; 12:127-137. [PMID: 35707807 PMCID: PMC9189155 DOI: 10.2147/ptt.s367744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/02/2022] [Indexed: 12/17/2022]
Abstract
Bimekizumab, a novel humanized monoclonal IgG1 antibody that neutralizes both IL-17A and IL-17F, was recently approved the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. Bimekizumab represents the latest anti IL-17 treatment available for the management of moderate to severe psoriasis. Bimekizumab safety and efficacy profiles were evaluated in four Phase III clinical trials, which evaluated bimekizumab versus placebo and ustekinumab (BE VIVID), versus placebo (BE READY), versus adalimumab (BE SURE), and versus secukinumab (BE RADIANT). Overall, bimekizumab displayed promising results in terms of both efficacy and safety, allowing reach PASI90 and PASI100 in short time (as early as week 4) and maintain it in the long term (52 weeks), with acceptable safety profile. Also, bimekizumab showed a rapid onset of response and a higher efficacy when compared to adalimumab, ustekinumab and secukinumab, with comparable safety profile. Herein, we carried out a comprehensive literature review of the available literature data about bimekizumab in the treatment of moderate to severe psoriasis.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, 80131, Italy
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26
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Murgia G, Maronese CA, Carrera CG, Cattaneo A, Marzano AV. Reply to "Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the "minimal disease activity" parameter". Dermatol Ther 2022; 35:e15644. [PMID: 35708288 DOI: 10.1111/dth.15644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Giulia Murgia
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Cattaneo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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27
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Magdaleno-Tapial J. Reply to Murgia et al., about "Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice: a retrospective multicentre study using the "minimal disease activity" parameter". Dermatol Ther 2022; 35:e15643. [PMID: 35708289 DOI: 10.1111/dth.15643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/12/2022] [Indexed: 11/28/2022]
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28
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Megna M, Tommasino N, Potestio L, Battista T, Ruggiero A, Noto M, Fabbrocini G, Genco L. Title: Real-world practice indirect comparison between guselkumab, risankizumab and tildrakizumab: results from an Italian 28-week retrospective study. J DERMATOL TREAT 2022; 33:2813-2820. [PMID: 35603992 DOI: 10.1080/09546634.2022.2081655] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Guselkumab, tildrakizumab and risankizumab, acting on interleukin(IL)23 axis, have been recently approved for psoriasis management. However, real-life data regarding their comparison are scant. OBJECTIVES The aim of our real life study was to perform an indirect efficacy and safety comparison among anti-IL23s, particularly focusing on difficult-to-treat areas. METHODS A 2-year single-center retrospective observational study was performed enrolling moderate-to-severe psoriasis patients treated with anti-IL23. For each patient clinical and demographical data were collected at baseline and at week4, week16 and week28. PASI, BSA, NAPSI and specific BSA regarding difficult to treat areas were evaluated. RESULTS 150 patients were included in the study: 63 (42%) received guselkumab, 21 (14%) tildrakizumab and 66 (44%) risankizumab. The three groups were comparable for age, sex and disease severity, only differing for psoriasis duration, psoriatic arthritis prevalence (higher in guselkumab), and previous systemic treatment failure (lower for tildrakizumab). Mean PASI and BSA significantly reduced from baseline up to week 28 without significant differences among the 3 drugs (reduction of 95-97.3% for PASI and 94.8-96.7% for BSA). No significant differences were registered for PASI75, 90 or 100 responses, in particular PASI100 was reached by 73.4-85% of patients. As regards difficult-to-treat areas, all the drug displayed a high efficacy, with significant differences registered only for the rapidity of action on palmoplantar psoriasis. CONCLUSIONS Our 28-weeks study demonstrated a comparable efficacy and safety profile for all anti-IL23, with guselkumab and risankizumab appearing slightly faster than tildrakizumab particularly on palmoplantar lesions in the short-term.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Nello Tommasino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Teresa Battista
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Matteo Noto
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Lucia Genco
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
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Van Muijen ME, Thomas SE, Groenewoud HMM, Otero ME, Ossenkoppele PM, Njoo MD, Dodemont SRP, Kop EN, Berends MAM, Koetsier MIA, Mommers JM, Körver JEM, Tupker RA, De Bruin-Weller MS, Weppner-Parren LJMT, Peters B, Kleinpenning MM, Kuijpers ALA, Arnold WP, Van Lümig PPM, Van den Reek JMPA, De Jong EMGJ. Direct Comparison of Real-world Effectiveness of Biologics for Psoriasis using Absolute and Relative Psoriasis Area and Severity Index Scores in a Prospective Multicentre Cohort. Acta Derm Venereol 2022; 102:adv00712. [PMID: 35356990 PMCID: PMC9574692 DOI: 10.2340/actadv.v102.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Real-world evidence, directly comparing the effectiveness of interleukin (IL)17-inhibitors, IL23-inhibitors, tumour necrosis factor alpha (TNF-α)-inhibitors and an IL12/23-inhibitor in psoriasis, is scarce. The aim of this study was to directly compare the first-year effectiveness of biologic therapies for psoriasis, corrected for confounders. This prospective, multicentre cohort study assessed BioCAPTURE data on etanercept, adalimumab, ustekinumab, secukinumab, ixekizumab, and guselkumab in 1,080 treatment episodes of 700 patients with psoriasis. The course of the mean absolute Psoriasis Area and Severity Index (PASI) and the proportion of patients who achieved PASI90/PASI75 were compared using linear mixed models and mixed logistic regression models respectively, corrected for baseline PASI, biologic naivety, and weight. Patients treated with adalimumab, ustekinumab, secukinumab, ixekizumab, or guselkumab all had a significantly lower mean PASI after 12 months compared with etanercept, and significantly higher overall odds of reaching PASI90 than those treated with etanercept. Patients treated with ixekizumab or guselkumab also had higher probabilities of reaching PASI90 than adalimumab, ustekinumab, and secukinumab. Relative to randomized controlled trials, the proportions of patients who reached PASI90/75 were lower in this real-world study.
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Affiliation(s)
- Marloes E Van Muijen
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, NL-6500 HB Nijmegen, The Netherlands.
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Tawfik NZ, Abdallah HY, Hassan R, Hosny A, Ghanem DE, Adel A, Atwa MA. PSORS1 Locus Genotyping Profile in Psoriasis: A Pilot Case-Control Study. Diagnostics (Basel) 2022; 12:diagnostics12051035. [PMID: 35626191 PMCID: PMC9139320 DOI: 10.3390/diagnostics12051035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The psoriasis susceptibility 1 (PSORS1) locus, located within the major histocompatibility complex, is one of the main genetic determinants for psoriasis, the genotyping profile for three single-nucleotide polymorphisms (SNPs) comprising the PSORS1 locus: rs1062470 within PSORS1C1/CDSN genes, rs887466 within PSORS1C3 gene, rs10484554 within LOC105375015 gene, were investigated and correlated with psoriasis risk and severity. (2) Methods: This pilot case-controlled study involved 100 psoriatic patients and 100 healthy individuals. We investigated three SNPs and assessed the relative gene expression profile for the PSORS1C1 gene. We then correlated the results with both disease risk and severity. (3) Results: The most significantly associated SNP in PSORS1 locus with psoriasis was rs10484554 with its C/T genotype 5.63 times more likely to develop psoriasis under codominant comparison. Furthermore, C/T and T/T genotypes were 5 times more likely to develop psoriasis. The T allele was 3 times more likely to develop psoriasis under allelic comparison. The relative gene expression of PSORS1C1 for psoriatic patients showed to be under-expressed compared to normal controls. (4) Conclusions: Our study revealed the association of the three studied SNPs with psoriasis risk and severity in an Egyptian cohort, indicating that rs10484554 could be the major key player in the PSORS1 locus.
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Affiliation(s)
- Noha Z. Tawfik
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
- Correspondence: ; Tel.: +20-127-4504926
| | - Hoda Y. Abdallah
- Medical Genetics Unit, Histology & Cell Biology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
- Center of Excellence in Molecular and Cellular Medicine, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ranya Hassan
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
| | - Alaa Hosny
- Ministry of Health, Cairo 11435, Egypt; (A.H.); (D.E.G.); (A.A.)
| | - Dina E. Ghanem
- Ministry of Health, Cairo 11435, Egypt; (A.H.); (D.E.G.); (A.A.)
| | - Aya Adel
- Ministry of Health, Cairo 11435, Egypt; (A.H.); (D.E.G.); (A.A.)
| | - Mona A. Atwa
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
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Medina-Catalán D, Riera P, Pagès-Puigdemont N, Masip M, López-Ferrer A, Vilarrasa E, Puig L. A cohort study of guselkumab in the treatment of psoriasis refractory to previous biologic therapies: effectiveness, safety and adherence. Int J Clin Pharm 2022; 44:725-730. [PMID: 35380392 DOI: 10.1007/s11096-022-01400-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/10/2022] [Indexed: 11/05/2022]
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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Affiliation(s)
- David Medina-Catalán
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - Pau Riera
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain.,U705, ISCIII Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - Neus Pagès-Puigdemont
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain.
| | - Montserrat Masip
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - Anna López-Ferrer
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Eva Vilarrasa
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Lluís Puig
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
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Magdaleno-Tapial J, Santos-Alarcón S, Serra-Torres MC, Schneller-Pavelescu L, López-Martí C, Ortiz-Salvador JM, Hernández-Bel P, Sánchez-Carazo JL, Pérez-Ferriols A. Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the "minimal disease activity" parameter. Dermatol Ther 2022; 35:e15470. [PMID: 35332626 DOI: 10.1111/dth.15470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/04/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022]
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Megna M, Fabbrocini G, Gallo L, Patrì A, Ruggiero A. A Case of Chronic HCV Infection Reactivation in a Psoriasis Patient Treated with Guselkumab. Curr Drug Saf 2022; 17:390-392. [DOI: 10.2174/1574886317666220307112926] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/25/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022]
Abstract
Introduction:
Psoriasis is a chronic inflammatory skin disease requiring long-term treatment. Although there are approximately 71 million individuals with chronic HCV infection worldwide. In psoriatic patients affected by chronic HCV infection, conventional systemic drugs may be frequently contraindicated, while data on biologics use are limited.
Case presentation:
The case of a 48-year-old Caucasian-man suffering from a severe form of plaque psoriasis and affected by a chronic-HCV-infection treated with guselkumab has been reported. Despite a huge improvement of the skin lesions (PASI reduced from 18 to 2), guselkumab was discontinued due to an HCV-infection reactivation after 3 months of treatment.
Conclusion:
To the best of our knowledge, this is the first case report of the use of guselkumab in an HCV psoriatic patient. Further studies are needed to evaluate the safety of guselkumab in chronic HCV patients.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Lucia Gallo
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Angela Patrì
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
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Ruggiero A, Megna M, Marino V, Costanzo L, Fabbrocini G, Ocampo-Garza SS, Miano C, Gallo L. A case of esophageal candidiasis in a psoriatic patient treated with ixekizumab: should treatment be discontinued? Dermatol Ther 2022; 35:e15361. [PMID: 35137503 PMCID: PMC9286677 DOI: 10.1111/dth.15361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Vincenzo Marino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Luca Costanzo
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Sonia Sofía Ocampo-Garza
- Servicio de Dermatología, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Chile
| | - Chiara Miano
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Lucia Gallo
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
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Megna M, Potestio L, Ruggiero A, Camela E, Fabbrocini G. Guselkumab is efficacious and safe in psoriasis patients who failed anti-IL17: a 52-week real-life study. J DERMATOL TREAT 2022; 33:2560-2564. [PMID: 35098859 DOI: 10.1080/09546634.2022.2036674] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Interleukin (IL)23/Th17 axis is the leading actor of psoriasis pathogenesis. Guselkumab is the first anti-IL23 approved for psoriasis. Anti-IL23 and anti-IL17 partially share their therapeutic target currently appearing as the most efficacious available psoriasis treatments. Real-life data on guselkumab performance in anti-IL17 failure patients are scant. METHODS A 52-week real-life single-center retrospective study was performed to evaluate the long-term efficacy and safety of guselkumab in patients who previously failed anti-IL17. RESULTS A total of 44 patients were enrolled (28 male, 63.6%; mean age 59.0 ± 10.2years). A statistically significant improvement of Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) was assessed at each follow-up (PASI decreased from 13.9 ± 8.1 to 0.9 ± 0.7 at week52 while BSA from 24.3 ± 19.6 to 1.3 ± 1.4, p < 0.001). Nail Psoriasis Severity Index (NAPSI) improvement was collected as well, even if being statistically significative only at week28 and thereafter [2.9 ± 6.2 at baseline, 0.9 ± 1.5 at week28, (p < 0.05)]. Only 3(6.8%) patients discontinued guselkumab due to secondary inefficacy. No cases of serious Adverse Events were assessed. CONCLUSION Our real-life study confirmed the efficacy and safety of guselkumab in daily clinical practice suggesting it as a valuable weapon also in psoriasis patients who previously failed anti-IL17 treatments.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Elisa Camela
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II
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Michelucci A, Margiotta FM, Panduri S, Tonini A, Romanelli M, Morganti R, Janowska A, Dini V. A real-life experience as a proof of Guselkumab effectiveness and safety in patients with moderate to severe psoriasis. Dermatol Ther 2022; 35:e15339. [PMID: 35088508 DOI: 10.1111/dth.15339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/03/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
Psoriasis is a skin disorder characterized by chronic inflammation driven by different immunologic pathways, among which the IL-23/Th17 axis plays a pivotal role. For this reason, the use of IL23p19 inhibitors in psoriasis treatment has been evaluated over the years. Guselkumab, a totally human IgG1 lambda monoclonal antibody, that selectively blocks the p 19 subunit of IL- 23 has demonstrated high efficacy and safety throughout several, randomized, double-blind phase III trials (VOYAGE 1 and 2, NAVIGATE and ECLIPSE). We designed a single-center retrospective cohort study in a population consisting of 46 patients followed from December 2018 to April 2021. After a diagnosis of moderate to severe psoriasis, all the patients were considered suitable to receive treatment with Guselkumab. In our population, among those who achieved clinical improvement in terms of Psoriasis Area Severity Index (PASI), PASI 75,90, and 100 were achieved on average on weeks 14,19,21 respectively. We then analyzed a subgroup of our population, consisting of 35 patients, who had an identical follow-up time of 28 weeks, thus observing the trend in mean PASI at subsequent assessments and the number of patients who had reached PASI 75, PASI 90, and PASI 100 at week 4 (10; 3;1), week 12 (12; 13; 11), week 20 (7;6;2) and week 28 (1;4;6), respectively. The results obtained are in line with those obtained from previous studies, thus confirming that Guselkumab is an excellent choice in terms of security, long-term efficacy and overall tolerance.
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Affiliation(s)
| | - Flavia Manzo Margiotta
- Department of Dermatology, University of Pisa, Pisa, Italy.,Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | - Riccardo Morganti
- Statistical Support to Clinical Trials Department, University of Pisa, Pisa, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
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Abstract
INTRODUCTION Psoriasis is a chronic immune-mediated disease affecting 125 million people globally. It is characterized by erythematous plaques in the skin, covered by silvery scales. However, non-cutaneous manifestations (e.g., joint symptoms in psoriatic arthritis) and a high prevalence of other immune-mediated diseases such as inflammatory bowel diseases reflect its systemic nature. So far, research on psoriasis pathogenesis has improved our knowledge of the roles of the immune system, and cytokines play significant roles in immune responses. AREAS COVERED Herein, we review cytokine changes in psoriasis patients. Moreover, we will investigate the possible relationships between disease severity and cytokines alongside describing cytokine alterations in psoriasis patients with other comorbidities. Lastly, we will discuss the biologics and their effects on cytokines in psoriasis patients. EXPERT OPINION Psoriasis could develop various clinical types and clinical manifestations in people. It is an immune-mediated disease, and these manifestations are associated with different impaired cytokines. Imbalanced cytokines could lead to abnormal keratinocytes, neovascularization, and inflammation in psoriasis patients. So, a better understanding of the cytokine roles can help one choose a specific cytokine-targeting biologic to treat psoriasis. Moreover, these cytokines may be used as a severity marker for following up with these patients.
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Affiliation(s)
- Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Del Alcázar E, López-Ferrer A, Martínez-Doménech Á, Ruiz-Villaverde R, Del Mar Llamas-Velasco M, Rocamora V, Julià M, Notario J, Rodríguez Fernández-Freire L, Sahuquillo-Torralba A, Vidal D, Rivera R, Carretero G, Mateu A, de la Cueva P, Carrascosa YJM. Effectiveness and safety of guselkumab for the treatment of psoriasis in real-world settings at 24 weeks: A retrospective, observational, multicentre study by the Spanish Psoriasis Group. Dermatol Ther 2021; 35:e15231. [PMID: 34820971 DOI: 10.1111/dth.15231] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/22/2021] [Accepted: 11/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Data on the effectiveness and safety of a drug in real-world clinical practice complement the evidence from clinical trials, which are carried out in a different setting. Little has been published on the effectiveness and safety of guselkumab in the treatment of psoriasis in clinical practice. OBJECTIVES To assess the effectiveness and safety of guselkumab at 24 weeks in patients with moderate to severe plaque psoriasis in routine clinical practice. METHODS Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis treated with guselkumab for at least 24 weeks in Spain. RESULTS We studied 343 patients, 249 of whom were followed for 24 weeks. By week 24, the mean (SD) Psoriasis Area and Severity Index (PASI) had decreased from 11.1 (7.3) to 1.7 (2.8) (-9.3; [-10.2;-8.4]), 85.9% of the patients had achieved PASI score of 4 or less and 77.9% a PASI score of 2 or less. In terms of relative PASI response, 59.4% of the patients achieved a PASI-90 response and 49.0% a PASI-100 response. On multivariate analysis, 2 factors reduced the probability of a PASI of 2 or less at 24 weeks: a BMI ≥30 (OR, 0.44; 95% CI, 0.22-0.88) and a greater previous exposure to biologic therapy (OR, 0.69; 95% CI, 0.56-0.84]). Adverse events were rare (9.9%) and led to withdrawal from treatment in only 9 patients (2.6%) by the end of the follow-up period. CONCLUSION The results of this study confirm the high efficacy and safety of guselkumab indicated by the clinical trial data. In clinical practice, the absolute PASI score appears to be a better marker of response to treatment than the relative value.
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Affiliation(s)
- Elena Del Alcázar
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Anna López-Ferrer
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Vicenç Rocamora
- Department of Dermatology, Hospital de Manacor (Illes Balears), Spain
| | - Marc Julià
- Department of Dermatology, Hospital Universitario de Basurto, Bilbao (Vizcaya), Spain
| | - Jaime Notario
- Department of Dermatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | | | - Antonio Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia. Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - David Vidal
- Department of Dermatology, Complex Hospitalari Moisès Broggi, Sant Joan Despí (Barcelona), Spain
| | - Raquel Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gregorio Carretero
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria (Las Palmas), Spain
| | - Almudena Mateu
- Department of Dermatology, Hospital Universitario Dr. Peset, Valencia, Spain
| | | | - Y José Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona (UAB), Badalona, Spain
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Ruggiero A, Fabbrocini G, Cinelli E, Megna M. Real world practice indirect comparison between guselkumab and risankizumab: Results from an Italian retrospective study. Dermatol Ther 2021; 35:e15214. [PMID: 34800070 PMCID: PMC9285826 DOI: 10.1111/dth.15214] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/05/2021] [Accepted: 11/16/2021] [Indexed: 12/28/2022]
Abstract
IL‐23‐inhibitors, such as guselkumab and risankizumab, represent the newest class of biologics approved for psoriasis. Phase III trials have shown their efficacy and safety. However, real life data are still scant. to indirectly compare the effectiveness, safety and tolerability of guselkumab and risankizumab in real world practice. An Italian single‐center retrospective cohort study enrolling moderate‐to‐severe psoriasis patients from September 1, 2018 and December 31, 2020 was performed to indirectly compare guselkumab and risankizumab efficacy and safety. Sixty eight patients were included (36 received guselkumab and 32 risankizumab). The groups were comparable for all analyzed characteristics, except for mean psoriasis duration (p < 0.01) which was higher for guselkumab. In guselkumab group, mean PASI reduced from 16.1 ± 6.4 (baseline) 2.1 ± 0.9 (week‐28) (p < 0.001) up to 0.9 ± 0.8 (week‐44) (p < 0.001). In risankizumab group mean PASI decreased from 13.5 ± 4.9 (baseline) 1.9 ± 0.8 (p < 0.001), (week‐28) (p < 0.001) up to 0.9 ± 0.4 (week‐40) (p < 0.001). No significant difference in mean PASI and BSA were observed between the treatments. No cases of serious AEs, injection site reaction, candida, malignancy, cardiovascular events were reported in both groups. Guselkumab and risankizumab showed favorable efficacy and safety profile, being comparable in terms of PASI90 and PASI100 responses as well as in AEs frequency and discontinuation rates.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Eleonora Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Hampton P, Borg E, Hansen JB, Augustin M. Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison. PSORIASIS-TARGETS AND THERAPY 2021; 11:123-131. [PMID: 34765537 PMCID: PMC8575184 DOI: 10.2147/ptt.s326121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/19/2021] [Indexed: 12/12/2022]
Abstract
Purpose Both brodalumab and guselkumab improve skin clearance in patients with moderate-to-severe plaque psoriasis after inadequate response to ustekinumab. In the absence of a direct head-to-head comparison, the relative efficacy of brodalumab and guselkumab in non-responders to ustekinumab were compared using a matching-adjusted indirect comparison (MAIC). Patients and Methods Individual patient data for brodalumab (n = 121) were pooled from the AMAGINE-2 and -3 trials and adjusted using a propensity score reweighting method, so that baseline and week 16 characteristics matched the aggregate published data of patients with an inadequate response to ustekinumab who switched to guselkumab (n = 135) in the NAVIGATE trial. Results After inadequate response to ustekinumab, brodalumab resulted in significantly higher psoriasis area and severity index (PASI) 90 rates versus guselkumab at post-treatment switch week 12 (62.7% vs 48.1%, relative difference 14.6% [95% confidence interval [CI] 5.3–23.9], p = 0.002 [number needed to treat [NNT] = 6.8]) and week 36 (63.7% vs 51.1%; relative difference 12.6% [95% CI 4.1–21.0]; p = 0.004 [NNT = 7.9]) and PASI 100 rate at week 36 (40.3% vs 20.0%; relative difference 20.3% [95% CI 11.8–28.7]; p < 0.001 [NNT = 4.9]). Conclusion In this MAIC, brodalumab was associated with greater improvements than guselkumab in inadequate responders to ustekinumab. Switching to brodalumab in such patients may be a more effective strategy than switching to guselkumab.
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Affiliation(s)
- Philip Hampton
- Department of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Hung YT, Lin YJ, Chiu HY, Huang YH. Impact of previous biologic use and body weight on the effectiveness of guselkumab in moderate-to-severe plaque psoriasis: a real-world practice. Ther Adv Chronic Dis 2021; 12:20406223211046685. [PMID: 34729147 PMCID: PMC8485267 DOI: 10.1177/20406223211046685] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Real-life data on patients with psoriasis treated with guselkumab are few and are needed to compare with trial-based data. We investigated the effect of clinical factors on real-world effectiveness of guselkumab. Methods: This multicentre study retrospectively included 135 patients with psoriasis treated with guselkumab from June 2018 until November 2020. Effectiveness was assessed using the degree of improvement in the Psoriasis Area and Severity Index (PASI) scores at baseline and after 4, 12, 20, 28, and 36 weeks. Predictors of effectiveness were also evaluated. Results: At week 36, 67% of the patients achieved PASI 75. Multivariate logistic regression analysis revealed that heavier patients were less likely to achieve PASI 75 at week 4 than patients with lower body weights. Fewer patients exposed to only one biologic achieved PASI 75 at weeks 4, 20, 28, and 36 [odds ratio (OR) = 0.08 (95% CI, 0.01–0.48), 0.21 (95% CI, 0.05–0.74), 0.04 (95% CI, 0.00–0.35), and 0.07 (95% CI, 0.00–0.68), respectively] than biologic-naïve patients. Patients previously treated with more than one biologic were less likely to achieve PASI 75 at weeks 12, 20, 28, and 36 [OR = 0.05 (95% CI, 0.01–0.22), 0.03 (95% CI, 0.01–0.16), 0.00 (95% CI, 0.00–0.03), and 0.00 (95% CI, 0.00–0.044), respectively] than biologic-naïve patients. Patients with previous anti-interleukin (IL)-17 exposure, rather than tumour necrosis factor-α and IL-12/23 inhibitors, had lower PASI improvements to guselkumab than biologic-naïve patients at weeks 12, 20, and 28 [OR = 0.19 (95% CI, 0.03–0.90), 0.10 (95% CI, 0.02–0.55), and 0.03 (95% CI, 0.00–0.29), respectively]. Conclusions: The effectiveness of guselkumab was compromised in a real-world setting. Delayed onset of therapeutic response was noted in heavier patients. Biologic exposure, the number of previously used biologics, and previous exposure to IL-17 inhibitors were clinical predictors of a reduced response to guselkumab. Physicians may share this information with patients to make treatment decisions.
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Affiliation(s)
- Yi-Teng Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City
| | - Yu-Jr Lin
- Research Services Center for Health Information, Chang Gung University, Taoyuan City
| | - Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hsin-Chu Hospital, No. 25, Lane 442, Section 1, Jingguo Road, Hsinchu City 300
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333. School of Medicine, College of Medicine, Chang Gung University, Taoyuan City
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Ruggiero A, Fabbrocini G, Cinelli E, Ocampo Garza SS, Camela E, Megna M. Anti-interleukin-23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real-world practice. Clin Exp Dermatol 2021; 47:561-567. [PMID: 34642965 PMCID: PMC9299162 DOI: 10.1111/ced.14979] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022]
Abstract
Background Elderly patients (aged ≥ 65 years) represent an increasing proportion of patients with psoriasis and 15% of these have moderate to severe disease. Biologics are being used frequently in this group of patients even though safety and efficacy data are limited. In addition, owing to anti‐interleukin (IL)‐23 therapies being a relatively recent option, no data have been reported about their use in elderly patients with psoriasis. Aim To evaluate and compare the safety and efficacy of guselkumab, risankizumab and tildrakizumab in real‐world practice in elderly patients. Methods This was a single‐centre retrospective study that enrolled patients aged ≥ 65 years with moderate to severe plaque psoriasis, treated with guselkumab, risankizumab or tildrakizumab. The length of the study for each group depended on the drug (44 weeks for risankisumab, 40 weeks for guselkumab and 28 weeks for tildrakizumab, owing to its more recent availability in Italy). Results In total, 34 patients were enrolled (n = 20 on guselkumab; n = 8 on risankizumab; n = 6 on tildrakizumab). At Week 4, 29.4% reached 90% improvement in Psoriasis Area and Severity Index (PASI90) and 8.8% reached 100% improvement in PASI (PASI100); at Week 28, PASI90 and PASI100 was reached by 58.8% and 29.4%, respectively. At the final follow‐up (Week 40 or 44, depending on drug), data were available only for the risankizumab (Week 40) and guselkumab (Week 44) and groups, and showed that 71.4% of patients had reached PASI90 and 53.5% had reached PASI100. Four patients (11.7%) discontinued treatment. No significant differences were found between the three groups. The limitations of the study included its retrospective nature of the study, small sample size, and different numbers of patients and follow‐up duration for the different groups (highest for guselkumab, lowest for tildrakizumab). Conclusion The three anti‐IL‐23 therapies assessed are promising, safe and effective options in elderly patients, and there was no significant difference between them. However, more data are needed to confirm our results and to understand their role in the management of this group of patients.
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Affiliation(s)
- A Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - E Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - S S Ocampo Garza
- Department of Dermatology, University Hospital Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - E Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Ocular Manifestations in Psoriasis Screening (OcMaPS) Questionnaire: A Useful Tool to Reveal Misdiagnosed Ocular Involvement in Psoriasis. J Clin Med 2021; 10:jcm10051031. [PMID: 33802255 PMCID: PMC7958956 DOI: 10.3390/jcm10051031] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Psoriasis is an immune-mediated, chronic inflammatory disease, which mainly affects the skin, although it has systemic pathological effects. Comorbidities of psoriasis include ocular disorders, which are often nonspecific or mildly symptomatic. The aim of this study was to show the importance of ocular-disease screening in psoriatic patients using the Ocular Manifestations in Psoriasis Screening (OcMaPS) questionnaire. Patients suffering from moderate-to-severe psoriasis referring at our outpatient-clinic were consecutively enrolled. Each patient was asked to complete a screening questionnaire (OcMaPS). Patients reporting ocular symptoms were referred for an ophthalmological examination. A total of 372 patients were enrolled in the study. Ocular symptoms were detected in 39 patients (10.5%), and 37 patients were referred to ophthalmological examination which confirmed the presence of ocular manifestation in 30 patients. There were three cases (10%) of uveitis, 14 (46.6%) of dry eye and 13 (43.3%) of cataract, in progress or already treated with surgery. In the remaining seven patients, no ocular manifestations were found. Ocular manifestations in psoriatic patients are not rare. It is important to be aware of ocular symptoms in psoriatic patients, screening patients (with a consultation or OcMaPS questionnaire), which leads to earlier diagnosis and treatment.
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Megna M, Cinelli E, Gallo L, Camela E, Ruggiero A, Fabbrocini G. Risankizumab in real life: preliminary results of efficacy and safety in psoriasis during a 16-week period. Arch Dermatol Res 2021; 314:619-623. [PMID: 33609180 DOI: 10.1007/s00403-021-02200-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/19/2021] [Accepted: 02/06/2021] [Indexed: 01/03/2023]
Abstract
No data on real-life experiences of risankizumab efficacy and safety are reported, apart from two isolated case reports. We carried out a single-centre, prospective study to assess the efficacy and safety of risankizumab. Fourteen patients were included (mean age 44.5 ± 14.2 years). Mean PASI decreased from 12.3 ± 5.2 (baseline) to 4.4 ± 2.7 at week 4 (p < 0.01), and to 2.7 ± 1.7 at week 16 (p < 0.001). A similar trend was observed for BSA. In patients previously treated with biologics (71.4%, n = 10) versus the naïve ones, mean baseline PASI was similar (12.7 ± 5.8 vs 11.3 ± 3.8). Mean BSA was higher in multifailure (23.5 ± 11.8 vs 15.5 ± 11.8). At 4 and 16 weeks, a significant improvement in PASI and BSA was observed in both groups. An improvement in NAPSI score, mean scalp, and palmo-plantar area reduction was noticed during follow-up. No AEs were reported up to week 16 and few and mild grade laboratory tests were reported. Our initial data confirm the promising results on efficacy and safety of Risankizumab, even in a more challenging and "real" population, composed of a high percentage of multi-failure psoriatic patients who have benefitted from a new class agent.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy.
| | - Eleonora Cinelli
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Lucia Gallo
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Elisa Camela
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Angelo Ruggiero
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Napoli, Italy
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