Psoriasis Treatment More Effective with Long-Term Use
Superior maintenance of high efficacy response rates was achieved with continuous guselkumab (Tremfya) treatment compared to withdrawal, and the majority of retreated patients achieved Psoriasis Area and Severity Index 90 (PASI90), according to the findings of a recent study. The findings of the study were presented at the 2018 American Academy of Dermatology Annual Meeting. Maintenance of PASI90 after drug withdrawal was associated with continued suppression of IL-17A, IL-17F, and IL-22.
The study included 375 participants with moderate to severe plaque psoriasis who had been randomized to receive guselkumab during the first 28 weeks of the clinical trial. Participants who achieved PASI90 after the first 28 weeks of treatment were re-randomized to either continued treatment with guselkumab through week 72 (n=193) or placebo/withdrawal (n=182), which included retreatment with GUS following a loss of 50% or more improvement in PASI that was achieved at week 28 before week 72, or at week 72 if they did not meet retreatment criteria.
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Overall, the efficacy of guselkumab was maintained through week 72 among participants who received continuous treatment compared with those who were withdrawn from treatment (86% vs 11.5%, respectively).
Among participants who were in the placebo/withdrawal group, 117 were retreated with guselkumab before week 72 and 56 did not meet the retreatment criteria and had to initiate retreatment at week 72. PASI90 was achieved within 6 months by 87.6% of participants who underwent retreatment.
In addition, maintenance of PASI90 response following drug withdrawal was associated with continued suppression of Interleukin (IL)-17A, IL-17F, and IL-22 and the loss of response was associated with increased levels of these circulating cytokines.
The researchers did not observe any new safety signals among participants who underwent withdrawal and retreatment of GUS through week 100.
Gordon K, Armstrong A, Foley P, et al. Long-term efficacy of guselkumab treatment after drug withdrawal and retreatment in patients with moderate-severe plaque psoriasis: results from VOYAGE 2. Presented at: American Academy of Dermatology Annual Meeting; February 16-20, 2018; San Diego, CA.