Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the “minimal disease activity” parameter

Magdaleno‐Tapial, Jorge; Santos-Alarcón, Sergio; Serra-Torres, Marta Carolina; Schneller‐Pavelescu, Luca; López-Martí, Cristina; Salvador, José María Ortiz; Hernández-Bel, P.; Sánchez‐Carazo, J.L.; Pérez‐Ferriols, A.

doi:10.1111/dth.15470

Cited by 4 publications

(6 citation statements)

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“…Moreover, the German registry PERSIST confirmed the efficacy and safety in the short and the long term 18 . Patients with an inadequate response with ustekinumab benefit from switching to guselkumab 20 . Although IL‐23 and IL‐17 partially share their therapeutic target, p19 blockade have been demonstrated as a successful switching strategy after IL‐17 inhibition failure 29–31 .…”

Section: Discussionmentioning

confidence: 90%

“…18 Patients with an inadequate response with ustekinumab benefit from switching to guselkumab. 20 Although IL-23 and IL-17 partially share their therapeutic target, p19 blockade have been demonstrated as a successful switching strategy after IL-17 inhibition failure. [29][30][31] Overall, these studies demonstrated that guselkumab is effective in the real world setting, as measured by patient reported outcomes and skin improvements, even in patients with a high burden of disease and those who have received multiple biologics without new safety signals.…”

Section: Discussionmentioning

confidence: 99%

“…13 Therefore, it is important to know the performance of the different therapeutic alternatives in daily clinical practice. Whereas there is plenty of literature confirming the efficacy and safety of p19 inhibitors in PsO in a real-world setting, [14][15][16][17][18][19][20] PsA data is still limited to a single study describing the efficacy and safety of guselkumab in early PsA. 21…”

Section: Introductionmentioning

confidence: 99%

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Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group

Rocamora

Crespi

Ferrán

et al. 2022

Dermatologic Therapy

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Guselkumab is a monoclonal antibody that selectively blocks the p19 subunit of interleukin 23 and has been approved for the treatment of moderate to severe psoriasis and active psoriatic arthritis in adult patients due to its efficacy in different clinical trials. Therefore, itis important to know the performance of guselkumab in this setting of patients in clinical practice given that a high percentage of them are not represented in these clinical trials. Our objective was to evaluate the effectiveness and tolerability of guselkumab in clinical practice in the first patients with psoriasis and psoriatic arthritis treated since the date of its approval for psoriasis in Spain, in joint dermatology-rheumatology clinics. A multicenter retrospective data collection was carried out, in which 14 hospitals participated, including a total of 90 patients with psoriatic arthritis confirmed by a rheumatologist. Data collection was recorded at baseline and at weeks 12, 24, and 52 for both the articular and cutaneous domains.Ninety PsA patients started treatment with guselkumab and therefore were included in this study. The vast majority had already failed to at least to one biologic therapyprior guselkumab prescription. The median age was 55 years, 61% were female and 46% had a BMI ≥ 30 kg/m 2 . Sixty-nine percent suffered from peripheral arthritis, and in 34% an axial involvement was also detected; dactylitis or enthesitis was present in 24% and 29% of patients, respectively. Guselkumab was effective in controlling both articular and skin manifestations of PsA patients. Absolute PASI significantly decreased from 10.5 to 4.8, 1.9 and 1.3 at weeks 12, 24, and 52, respectively. In 29 out of 61 (48%) of cases, DAPSA was moderate or high, and patients showed a significant reduction in DAPSA at 12, 24, and 52 weeks of treatment (mean DAPSA values at baseline and follow up were 29, 20, 16, and 14, respectively). Patients with DAPSA in low activity or in remission at the time of initiation of guselkumab maintained Vicenç Rocamora and Fernando Gallardo contributed equally to this work.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group

Rocamora

Crespi

Ferrán

et al. 2022

Dermatologic Therapy

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“…Giulia Murgia 1,2 Carlo Alberto Maronese 1,2 Carlo Giovanni Carrera 1 Angelo Cattaneo 1 Angelo Valerio Marzano 1,2 1…”

Section: Conflict Of Interestunclassified

Reply to “Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the “minimal disease activity” parameter”

Murgia

Maronese

Carrera

et al. 2022

Dermatologic Therapy

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The Authors report the results of a multicenter retrospective study on 32 patients with moderate-to-severe psoriasis switched from ustekinumab to guselkumab, after failure in achieving minimal disease activity 2 within 52 weeks of therapy with the former.Herein, we report our real-life experience with a similarly sized, single-center retrospective cohort, consisting of 30 patients with moderate-to-severe psoriasis switching from ustekinumab to guselkumab.The switch was proposed to patients meeting the following inclusion criteria: significant residual Psoriasis Area and Severity Index (PASI) (i.e., failed PASI75), patient-reported dissatisfaction or residual disease in sensitive areas (e.g., face, scalp, palms, soles, and genitals) despite weight-appropriate treatment with ustekinumab for at least 6 months. Need for dose intensification or escalation to dosing every 8 weeks was considered as an adjunctive inclusion criterion.Patients' characteristics, including demographics, comorbidities, previous treatments, and clinical features are summarized in Table 1.At the baseline, a slight male sex preference (M:F = 3.9:1 vs. 1.5:1), greater representation of cardiovascular comorbidities (7/30 [23.3%] vs. 3/32 [9.3%]) and history of previous treatment with IL-17 inhibitors (4/30 [13.3%] vs. 0) were noted in our cohort. Twenty-nine, 25, and 22 patients reached weeks 12, 24, and 52 of therapy, respectively, counting from the time of switching. Although mean PASI at the time of switching was similar across the two studies (6.45 vs. 7.4), the proportion of patients achieving PASI <1 was lower than that reported by Magdaleno-Tapial et al. both at week 12 (45% vs. 82%), at week 24 (56% vs. 87%) and at week 52 (50% vs. 100%). Nevertheless, the therapeutic target of PASI 75 was achieved by 55% of patients at week 12, by 72% of patients at week 24 and by 82% of patients at week 52; whereas the PASI 90 target Mean duration of ustekinumab treatment (months), mean ± SD 50.4 ± 32.8Giulia Murgia and Carlo Alberto Maronese contributed equally and both qualify as first authors.

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“…The selective inhibition of the p19 subunit of IL-23 with guselkumab has shown to be highly effective in patients with inadequate response to ustekinumab (IL-12/IL-23 p40 inhibitor) both in the context of the NAVIGATE clinical trial 2 and in different series of realworld patients. 1,3,4 After reviewing G. Murgia et al data, we found some reasons that potentially could be explaining the differences in guselkumab performance after switching from patients who are sub-optimal responders to ustekinumab.…”

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Reply to Murgia et al., about “Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice: A retrospective multicenter study using the “minimal disease activity” parameter”

Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the “minimal disease activity” parameter

Cited by 4 publications

References 7 publications

Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group

Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group

Reply to “Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice using the “minimal disease activity” parameter”

Reply to Murgia et al., about “Switch from ustekinumab to guselkumab in patients with psoriasis in real clinical practice: A retrospective multicenter study using the “minimal disease activity” parameter”

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