Targeting p19 as a treatment option for psoriasis: an evidence-based review of guselkumab

Therapeutics and Clinical Risk Management
Todd WechterSteven R Feldman

Abstract

Further understanding of psoriasis pathogenesis has led to the development of effective biologic medications. Guselkumab (GUS) is a subcutaneously administered monoclonal antibody that targets the p19 cytokine subunit in IL-23 and IL-39 and is US Food and Drug Administration (FDA) approved for the treatment of moderate-to-severe psoriasis in adult patients. This review evaluates the pharmacology, safety and efficacy of GUS in patients with psoriasis. We performed a literature review by searching online databases including PubMed and Google Scholar. In clinical trials, GUS improved diseases including psoriatic arthritis (PsA) and specific areas of disease (scalp, feet, hands and fingernails). In the Phase III trials VOYAGE 1 and 2, more GUS than adalimumab (ADM) patients experienced a ≥90% reduction in Psoriasis Area and Severity Index (PASI) score (PASI90) (VOYAGE 1: 80.2% vs 53.0%; VOYAGE 2: 75.2% vs 54.8%; P<0.001 for both) and Investigator Global Assessment score of 0 or 1 (VOYAGE 1: 84.2% vs 61.7%; VOAYGE 2: 83.5% vs 64.9%; P<0.001 for both) at Week 24. GUS was also successful in treating patients unresponsive to ADM and ustekinumab in the VOYAGE 2 and NAVIGATE trials, respectively. While long-term data are necessary, GUS a...Continue Reading

Citations

Mar 29, 2019·Expert Review of Clinical Immunology·Lluís Puig
Jun 11, 2019·Expert Review of Clinical Immunology·Maria Sole ChimentiRoberto Perricone
Oct 11, 2019·Dermatologic Therapy·Giovanni DamianiNicola L Bragazzi
Aug 14, 2020·Journal of the European Academy of Dermatology and Venereology : JEADV·M NogueiraT Torres
Jun 12, 2020·Clinical Microbiology Reviews·Joshua S DavisMichael Boyle

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