A study comparing guselkumab and ustekinumab for treating psoriasis

Psoriasis is a persistent autoimmune condition that causes red, itchy, scaly plaques of skin. According to the World Psoriasis Day consortium, psoriasis affects 125 million people worldwide, about 2‐3 percent of the total population. Biologics are a type of drug used to treat psoriasis and this study compared the efficacy of two biologics, guselkumab and ustekinumab, in a group of patients who had not taken biologics before (biologic‐naïve) and a group who had (biologic‐experienced). Data from individual patients treated with guselkumab in trials called the VOYAGE 1 and 2 trials were combined and compared with corresponding patient data for ustekinumab from the NAVIGATE trial. In the analysis, the authors used appropriate statistical methods, adjusting for differences between patient and disease characteristics, to allow for robust interpretation of their results. The Psoriasis Area and Severity Index (PASI) is used to record the redness, thickness and scaling of a patient's psoriasis and to measure how well a treatment works, as a reduction in the PASI score means a reduction in these symptoms. For example, a PASI 90 response represents a 90% reduction in a patient's PASI score after starting treatment compared to at the start (baseline). The authors performed analyses comparing 100 mg guselkumab dosing and weight‐based 45/90 mg ustekinumab dosing for the achievement and maintenance of PASI 75, 90, and 100 responses. The analyses proved that patients treated with guselkumab are significantly more likely to achieve and maintain PASI 75, 90, and 100 responses through up to 40 weeks of treatment compared to patients treated with ustekinumab. Linked Article:   Diels et al. Br J Dermatol 2020; 183 :276–284.