Background and importance Treatment with biologic drugs is indicated in patients with moderate to severe psoriasis, and the therapeutic goal is an improvement equal to or greater than Psoriasis Area and Severity Index (PASI) 75.
Aim and objectives To analyse the use of profile guselkumab in a tertiary hospital and to evaluate the effectiveness, safety and adherence of the treatment in clinical practice in moderate-severe plaque psoriasis
Material and methods Observational, retrospective, descriptive study including all the patients who were prescribed guselkumab from 2019 to October 2021.
Demographic (sex, age) and clinical data (previous biological treatment, date of initiation of treatment and subsequent doses administered, adverse effects and reason for ending treatment) were collected from the digital medical record and the electronic prescription programme.
Effectiveness was derived from PASI levels and recorded over an average of 56 weeks. Safety was measured by the rate of adverse effects.
Results 33 patients (48.5% male and 51.5% female) with a mean age of 49 years. 6.1% received guselkumab as the first line of treatment, 48.9% as the second line and 45.4% as the third or more lines. The biological drugs which were previously used were etanercept (63.6%), adalimumab (30.3%), ustekinumab (30.3%), secukinumab (27.3%), ixekizumab (12.1%) and apremilast (3%).
An average of 57.53 days of difference between medication administration dates was recorded, confirming good adherence to the treatment (100 mg subcutaneous every 56 days).
In terms of effectiveness evaluation, the mean baseline PASI was 10.6 and the mean PASI over a 56-week period was 2.17. This represents an average reduction of 79.5% in PASI levels.
26 patients achieved a decrease in PASI, and of these 12 reached PASI 100.
Adverse effects were detected in 3 patients (9%): diarrhoea, candida spp infection and suppurative outbreak. Treatment discontinuation occurred in 5 patients (15.1%) due to the appearance of adverse effects (2) inefficiency of treatment (2) and desire for pregnancy (1).
Conclusion and relevance The use of guselkumab is an appropriate therapeutic option in patients diagnosed with moderate-to-severe plaque psoriasis after failure of at least one biologic treatment. The achievement of a PASI 79, as well as the few adverse effects that made it necessary to discontinue treatment, demonstrate its therapeutic effectiveness and safety.
Conflict of interest No conflict of interest
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