Fortunately, a recent retrospective longitudinal study has provided helpful real-world evidence on the long-term efficacy of Guselkumab for psoriasis. This study examined a large monocentric cohort of 1,008 patients from ten Italian centers. The research period spanned January 2024 to October 2024. It assessed the patient-reported outcomes of patients who had been on the therapy for at least 20 weeks. The results are now available online, published ahead of print April 16, 2025 in the journal Dermatology and Therapy.
According to these results, Guselkumab is extremely effective. By week 20, 57.6% of patients were considered super responders, reaching a Psoriasis Area Severity Index (PASI) score of 100. This study highlights the value of personalized treatment approaches guided by the unique characteristics of each patient.
Study Protocol and Results
Guselkumab was administered according to a standard protocol: an initial dose of 100 mg subcutaneously at weeks 0 and 4, followed by maintenance doses every eight weeks. NIH launched this study to find predictive factors that determine how patients will respond to the drug.
Among the super responders, notable trends emerged. They had a lower proportion of bio-naive status at 42.4% vs non-super responders 32.6%. Super responders had particularly low rates of obesity at 22.2%. They had lower rates of hypertension 37.1% and diabetes 11.5%, suggesting the important effect these factors can have on treatment outcomes.
Predictive Factors for Response
The predictors of super responder status were determined with multivariate logistic regression analysis. Obesity is associated with worse outcomes with an odds ratio (OR) of 0.74. By contrast, previous biologic therapy shows a much lower OR of 0.57. The larger the baseline PASI score, the lower the probability of reaching super responder status. In fact, it has an odds ratio of 0.97, which is slightly negative.
These findings suggest that weight management and a patient’s treatment history may be critical components in optimizing therapeutic strategies for psoriasis patients receiving Guselkumab.
Long-term Outcomes and Implications
Long-term efficacy data, remaining blinded to treatment assignment, continued to look great. By year four, 85% of these super responders still had PASI 100, and by year five that number was 83.4%. By comparison, only 59.2% of non-super responders found that same long-term success.
The authors highlight the significance of these results in clinical practice:
“Our findings highlight the importance of early and targeted intervention in psoriasis treatment. Identifying predictive factors for super-responder status can facilitate individualized therapeutic strategies, ensuring optimal clinical outcomes, promoting prolonged drug survival, and potentially extending dose intervals for selected patients,” – Edoardo Mortato et al.
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