Efficacy of guselkumab versus secukinumab in subpopulations of patients with moderate-to-severe plaque psoriasis: results from the ECLIPSE study

Abstract

Purpose: Guselkumab, an interleukin (IL)-23 inhibitor, effectively treats moderate-to-severe plaque psoriasis. Materials and methods: ECLIPSE, was a Phase 3, multicenter, 56-week, double-blinded, active-comparator study of guselkumab vs. secukinumab (IL-17A inhibitor) in patients with moderate-to-severe psoriasis. Patients were treated with guselkumab 100 mg (n ¼ 534) or secukinumab 300 mg (n ¼ 514) through week 44. Efficacy (at least a 90% and 100% improvement from baseline in Psoriasis Area and Severity Index [PASI 90 and PASI 100], Investigator's Global Assessment [IGA] 0/1, and IGA 0) was analyzed across subpopulations defined by baseline: age (<45, 45 to <65, and !65 years old), body weight, body mass index (BMI), psoriasis disease severity (body surface area, disease duration, PASI, and IGA), psoriasis by body regions (head, trunk, upper and lower extremities), and prior psoriasis medication history at week 48. Results: Overall, 1048 patients were randomized. At week 48, numerically greater proportions of patients achieved PASI 90, PASI 100, IGA 0/1, and IGA 0 with guselkumab vs. secukinumab regardless of baseline age, body weight, BMI, disease severity, body region, and prior medication. The largest differences were in patients !65 years old and patients weighing >100 kg. Conclusions: Guselkumab treatment provided greater efficacy vs. secukinumab at week 48 in most subpopulations of patients with psoriasis.

Efficacy and Safety of Dimethyl Fumarate in Patients with Moderate-to-Severe Plaque Psoriasis: Results from a 52-Week Open-Label Phase IV Clinical Trial (DIMESKIN 1)

“…For obese patients, similar values for mean absolute PASI and DLQI after DMF treatment versus overall study population were observed, suggesting that DMF improves the main severity and extension indexes as well as quality of life in obese patients with moderate-to-severe psoriasis after 24 weeks of treatment and maintained up to 52 weeks. These results differ from those previously published for other psoriatic drugs, which showed that obese patients with psoriasis often experience a decreased efficacy compared with those who were not obese [ 26 , 27 ]. However, a favorable and body-weight-independent response to FAEs has also been described [ 28 ].…”

Comparative Effectiveness of Biologics Across Subgroups of Patients with Moderate-to-Severe Plaque Psoriasis: Results at Week 12 from the PSoHO Study in a Real-World Setting

“…Also, in PSoHO, treatment effectiveness was comparable between patients in the \ 65 and C 65 years age categories, although the small sample size in the latter age category led to less stability of models and broader CIs. Prior studies investigating the comparative efficacy of biologics for patients in different age groups have shown conflicting results; one clinical trial showed that age did not significantly influence the clinical outcome at week 52 following treatment with RIS or SEC [13], while another study indicated disproportionately better clinical outcomes at week 48 for patients aged 65 or older treated with GUS compared to SEC [34]. Fig.…”

Guselkumab dosing interval optimization in adult patients with moderate‐to‐severe psoriasis switching from ustekinumab

“…Guselkumab (GUS) is a fully human monoclonal antibody, that selectively blocks IL‐23 through binding to its p19 subunit 1 . The blockage of IL23 with GUS has raised the level of skin clearance in psoriatic patients, being superior to adalimumab, secukinumab, and ustekinumab (UST) in phase‐III clinical trials 1,7,8 . The approved dosing of GUS for PSO and psoriatic arthritis is 100 mg administered subcutaneously at week 0 and week 4 followed by a maintenance dosing every 8 weeks 2 .…”

“…psoriatic patients, being superior to adalimumab, secukinumab, and ustekinumab (UST) in phase-III clinical trials. 1,7,8 The approved dosing of GUS for PSO and psoriatic arthritis is 100 mg administered subcutaneously at week 0 and week 4 followed by a maintenance dosing every 8 weeks. 2 To our knowledge, there is only one previous work that addresses dose optimization with GUS in psoriatic patients.…”