Assessing the Short-Term Efficacy and Safety of Guselkumab for Moderate-to-Severe Plaque Psoriasis: Meta-Analysis of Randomized Controlled Trials

Abstract

Background. To investigate the efficacy and safety of guselkumab in the treatment of moderate-to-severe plaque psoriasis. Methods. A systematic review was undertaken to identify double-blind randomized controlled trials (RCTs). PubMed, Web of Science, Cochrane Library, EMBASE, and Google Scholar databases were searched before 1 March 2020. The odds ratios (ORs) with 95% confidence interval (CI) were calculated. All analyses were conducted with intention-to-treat basis. A range of sensitivity analyses was undertaken. Results. A total of 7 articles contained 1206 plaque psoriasis patients with guselkumab, 585 patients with placebo, and 1250 patients with adalimumab were included. The results indicated that guselkumab had better efficacy than placebo or adalimumab for Psoriasis Area and Severity Index score reductions from baseline of 75% (PASI 75) (OR=61.37, 95% CI=31.15 to 120.91; OR=3.08, 95% CI=2.35 to 4.06), Investigator’s Global Assessment scores of 0 or 1 (IGA 0/1) (OR=65.75, 95% CI=45.54 to 94.95; OR=2.79, 95% CI=2.17 to 3.59), and Dermatology Life Quality Index scores of 0 or 1 (DLQI 0/1) (OR=29.64, 95% CI=18.80 to 46.73; OR=1.86, 95% CI=1.50 to 2.31). The guselkumab had similar safety with placebo or adalimumab about the incidence of adverse events (AEs) (OR=1.05, 95% CI=0.86 to 1.29; OR=0.97, 95% CI=0.79 to 1.19) and serious adverse events (SAEs) (OR=1.03, 95% CI=0.47 to 2.27; OR=0.91, 95% CI=0.44 to 1.87). Meanwhile, there was no statistically significant association of infections and serious infections compared with the placebo or adalimumab group. The guselkumab was more effective and had the similar tolerance. Conclusion. The guselkumab had excellent efficacy and great safety in moderate-to-severe plaque psoriasis, but long-term safety remained to be determined.

Guselkumab and risankizumab for psoriasis: a 44-week indirect real-life comparison

“…To the Editor: Guselkumab and risankizumab, human monoclonal antibodies targeting interleukin (IL)-23, have been recently approved for the treatment of moderate-to-severe plaque psoriasis. 1 Even if clinical trials reported consistent efficacy and safety data, 2,3 real-life studies are scant with no existing comparison survey. Hence, we performed a retrospective cohort real-life study to compare indirectly their efficacy and safety.…”

“…Phase III trials have shown guselkumab and risankizumab as very effective drugs, reporting superiority to antietumor necrosis factor, antieIL-12/23 and antieIL-17, high percentage of complete skin clearance (47.4%-56.3% at week 48-52) together with an optimal safety profile. 2,3 These results need to be confirmed in real-life settings, dealing with more complicated patients (eg, multiple comorbidities, polypharmacy, common previous biologic failure), which usually do not meet trials' inclusion criteria. 1 Interestingly, our real-life survey did not highlight any particular difference among guselkumab and risankizumab in terms of mean PASI, BSA, PASI 90, PASI 100, and AE frequency up to 44 weeks.…”

“…5 Hence, our results are in line with those of phase III trials and available real-life investigations. [1][2][3][4][5] Limitations were the small numbers of patients, the retrospective nature, and the lack of a randomized controlled setting.…”

“…To the Editor: In animal models, grape polyphenols protect against acute and chronic ultraviolet (UV) radiationeinduced inflammation and DNA damage. 1,2 In addition, topical administration of grape seed proanthocyanidin extract reduced sunburn cell formation and prevented Langerhans cell depletion in humans. 3 To test the hypothesis that oral consumption of dietary table grapes would prevent UV-induced photodamage, a prospective single-group, openlabel, intervention study was carried out at a single center.…”

2020 Korean Consensus Guidelines for Diagnosis and Treatment of Chronic Hand Eczema

“…Since there is an ongoing phase 2 clinical trial to evaluate whether dupilumab is effective for moderate to severe chronic hand eczema refractory to potent topical corticosteroids ( NCT03861455 ) 27 , it remains to be seen. Guselkumab was initially approved for moderate-to-severe psoriasis and palmoplantar pustulosis 28 29 . Because pustules occasionally appear in hand eczema, particularly impetiginized or vesiculopustular type, palmar pustulosis is an important and challenging differential diagnosis of chronic hand eczema; however, guselkumab is not indicated for chronic hand eczema.…”