Background and Importance Guselkumab represents an important advancement in the treatment of psoriasis. By targeting the IL-23 pathway, it addresses the underlying immune dysregulation that drives psoriasis, leading to significant improvements in symptoms, quality of life, and long-term disease management for many patients.

Aim and Objectives This study aims to evaluate the real-world persistence of Guselkumab in adult patients with moderate-to-severe psoriasis in a multicentre analysis. Secondary objectives of the study were to analyse the effectiveness and safety of Guselkumab in the same cohort of patients.

Material and Methods This retrospective cohort study used registries and medical records from 2 different hospitals (Apr 2019 to Sept 2023). Adults with moderate-to-severe psoriasis who initiated Guselkumab treatment were identified and followed-up until Sept 2023, or disenrollment. Baseline demographic and clinical characteristics studied included: sex, age at diagnosis, current age, psoriasis area severity index (PASI), previous treatment, and comorbidities. Kaplan-Meier analysis was used to estimate Guselkumab persistence at one, two and three years.

Results A total of 62 patients with moderate-to-severe psoriasis were included (age 49.3 ± 13.7 years; 64.5% men). 29% of included patients were naïve to biological treatment. Baseline PASI score was 8.4 and patients received 1.9 ± 0.9 prior lines of treatment. Most common previous biological treatments included ustekinumab (59.1%), anti-TNFα (52.3%) and IL-17 inhibitor drugs (31.8%). 5 out of 62 patients discontinued Guselkumab treatment due to the following reasons: lack of efficacy (4.8%), transaminase elevation (1.6%) and pregnancy (1.6%). Guselkumab persistence was 21.6 ± [2.0] months for all patients. When performing a subgroup analysis, non-naïve patients obtained a persistence of 23.0 ± [1.5] months followed by 16.6 ± [4.1] months for naïve patients (p=0.250). Guselkumab persistence at 1 year, 2 year and 3 year was 95%, 93% and 91%, respectively.

Conclusion and Relevance Guselkumab demonstrated high persistence during the study period, suggesting patient and healthcare professional satisfaction with efficacy and tolerability over time in patients with moderate to severe psoriasis.

Conflict of Interest No conflict of interest.