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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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Solak EÖ, Aba FC, Çınar SL, Kartal D, Borlu M. Real-life data over 36 weeks of guselkumab treatment in psoriasis patients: A single-center study from Turkey. J Cosmet Dermatol 2024; 23:1912-1917. [PMID: 38491736 DOI: 10.1111/jocd.16260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Psoriasis is an important health problem responsible for morbidity and workforce loss. In recent years, anti-IL-23 drugs have become essential in psoriasis treatment. OBJECTIVES This study aimed to investigate the efficacy and safety of guselkumab therapy, recently used in Turkey, by examining real-life data over 36 weeks. METHODS A total of 39 psoriasis patients (>18 years old) who received guselkumab treatment between December 2021 and December 2022 in the dermatology department of our hospital were included in the study. Patients" ages, sexes, body mass index (BMI), comorbidities, duration of illness, drugs used before guselkumab treatment, clinical response to guselkumab treatment, and side effects, if any, were recorded. Psoriasis Area and Severity Index (PASI) scores at baseline and Weeks 4, 12, 24, and 36 were evaluated, as well as the Dermatology Life Quality Index (DLQI) at the beginning and end of the study. RESULTS The PASI scores at Weeks 4, 12, 24, and 36 and the DLQI at Week 36 decreased statistically compared with baseline (p < 0.05). The PASI score at baseline and Weeks 4, 24, and 36 did not differ between groups based on IL-17 use (p > 0.05). No significant correlation was observed between BMI, disease duration, and PASI scores at baseline and Weeks 4, 12, 24, and 36. No side effects were observed in any of the patients during treatment. CONCLUSION This study includes real-life data on the use of guselkumab therapy for psoriasis in the Turkish population. Based on the results, guselkumab is a highly effective and safe treatment.
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Puig L, Costanzo A, de Jong EMGJ, Torres T, Warren RB, Wapenaar R, Wegner S, Gorecki P, Gramiccia T, Jazra M, Buyze J, Conrad C. Guselkumab-Treated Patients with Plaque Psoriasis Who Achieved Complete Skin Clearance for ≥ 156 Consecutive Weeks: A Post-Hoc Analysis From the VOYAGE 1 Clinical Trial. Am J Clin Dermatol 2024; 25:315-325. [PMID: 37804472 PMCID: PMC10866772 DOI: 10.1007/s40257-023-00816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Treatment of moderate-to-severe plaque psoriasis with biologics, such as guselkumab, has demonstrated greater efficacy over traditional non-biologic treatments. However, given patient diversity, greater understanding of the relationship between patient characteristics, positive clinical outcomes, and long-term response to biologics is crucial for optimizing treatment choices. MATERIALS AND METHODS This post-hoc analysis of the 5-year VOYAGE 1 clinical trial compares baseline characteristics of patients maintaining a Psoriasis Area and Severity Index (PASI) score of 0 at all visits for ≥ 156 consecutive weeks (PASI = 0 group) with those that never achieve PASI = 0 (comparator group), using descriptive statistics and a multiple logistic regression model. Guselkumab plasma trough concentrations in both response groups were assessed from Weeks 4-156. RESULTS Of patients who started guselkumab treatment at Week 0 or at Week 16 after switching from placebo, 22.7% (112/494) maintained PASI = 0 for ≥ 156 consecutive weeks. Numerical differences in baseline characteristics, including age, obesity, diabetes, PASI score, disease duration, smoking status, and psoriatic arthritis comorbidity, were identified between the PASI = 0 group and comparator group. Plasma guselkumab levels were consistently higher in the PASI = 0 group. Multiple logistic regression analysis revealed absence of diabetes, lower Dermatology Life Quality Index score at baseline, and higher Week 4 guselkumab plasma concentration as significantly (p < 0.05) associated with the PASI = 0 group. CONCLUSION A substantial (22.7%) number of guselkumab-treated patients in the VOYAGE 1 clinical trial maintained complete skin clearance for a consecutive period of ≥ 156 weeks. Factors associated with this outcome may suggest clinical benefits of holistic treatment approaches. TRIAL REGISTRATION NCT02207231.
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Affiliation(s)
- Luis Puig
- Department of Dermatology, IIB Sant Pau, Hospital de Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Antonio Costanzo
- Dermatology, Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tiago Torres
- Centro Hospitalar Universitário do Porto, Porto, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | | | | | | | | | | | | | - Curdin Conrad
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
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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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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: 49] [Impact Index Per Article: 24.5] [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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