Guselkumab Efficacy Consistent Across Subpopulations, Aligns with Previous Trials

Knut Schäkel, MD

In the GUIDE study, results were consistent with previous trials on the efficacy of guselkumab for adults with plaque psoriasis, with the rate of super responders (SRes) being reported as higher for patients with a shorter disease duration.

Intervention with guselkumab—an interleukin (IL)-23 inhibitor known for its efficacy in plaque psoriasis patients—may change the course of the disease for patients, depending on whether it is used earlier or later.

“The primary objective of GUIDE is to demonstrate that those who are a super responder (SRe) to guselkumab, defined as sustained complete skin clearance from Week (W) 20 to W28 of treatment, maintain disease control to W68 with prolonged treatment intervals,” wrote the study authors, led by Knut Schäkel of the Department of Dermatology at Heidelberg University Hospital.

Background

The GUIDE investigators implemented a randomized, double-blind, parallel-group, multicenter study recruiting 880 adults with moderate-to-severe plaque psoriasis from both France and Germany.

The goal was to evaluate the participants’ clinical responses to guselkumab treatment. Those with short disease duration (SDD)—reporting their first psoriasis symptoms ≤2 years prior to screening—or longer disease duration (LDD)—reporting symptoms for >2 years—were evaluated regarding the association between baseline prognostic/risk factors and their SRe likelihood.

The investigators found that out of those 880 recruited for GUIDE, 40.6% (357) had an SDD and 59.4% (523) had an LDD.

Findings

Overall, the GUIDE investigators reported that a greater proportion of SDD compared to LDD patients being treated were able to achieve absolute PASI=0 at W20 and at W28, or 49.3% compared to 32.7% of participants (P<0.001) and 51.8% compared to 39.4% (P<0.001), respectively.

Additionally, they found that a total of 34.4% (n=303) of patients were reported to be SRes. The researchers also found that a greater proportion of SDD patients were reported as SRes versus LDD patients (43.7% versus 28.1%, nominal P<0.001).

“W28 data from the GUIDE study demonstrated guselkumab efficacy that was consistent across subpopulations and with previous guselkumab trials,” they wrote. “The rate of SRes was higher in those with a short (psoriasis symptoms ≤2 years) versus long (>2 years) disease duration.”