Will Guselkumab Raise the Bar for Judging Response in Future Studies of Psoriasis?

Guselkumab may be effective for plaque psoriasis, and anti–interleukin-23 therapy is promising for controlling psoriasis.

The traditional measure of response to psoriasis treatment is the percentage of patients with a 75% improvement in the Psoriasis Area and Severity Index (PASI 75) score. However, many recent studies measure PASI 100 as a secondary outcome. These investigators used as a primary endpoint the proportion of patients with a Physician Global Assessment (PGA) score of 0 (clear) or 1 (minimal disease) to assess the efficacy and safety of guselkumab, an anti–interleukin-23 agent under development for psoriasis treatment.

In this phase 2 study, the sponsor compared guselkumab with placebo or adalimumab, a tumor necrosis factor antagonist. Of 293 patients, 42 received placebo, 43 received adalimumab (80 mg initial dose, then 40 mg every other week), an…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)