Efficacy and safety of guselkumab in psoriasis patients who failed ustekinumab and/or anti‐ interleukin ‐17 treatment: A real‐life 52‐week retrospective study

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Abstract
Background Recent major research advancements have significantly expanded our understanding of psoriasis’ pathophysiology, resulting in the development of highly‐effective, targeted therapies. Guselkumab is the first interleukin (IL)‐23‐inhibitor approved for the treatment of moderate‐to‐severe‐psoriasis, providing a new therapeutical option for psoriasis. The aim of our study was to evaluate the efficacy of guselkumab in psoriatic patients who previously failed anti‐IL‐12/23 and/or anti‐IL‐17. Methods A 52‐weeks single‐center retrospective study was performed enrolling moderate‐to‐severe patients attending our Psoriasis‐Care‐Center from October‐2018‐to‐May‐2020. Results Study population included 13 patients. 46.1% have been previously treated with ustekinumab, while 69.2% have previously failed an anti‐IL‐17 (38.5% secukinumab, 30.8% ixekizumab, and 38.5% both). At baseline, mean PASI was 13.2±6.8, reducing up to 0.5±0.7 at week 52 (p<0.001). BSA reduced from 22.3±10.5 (baseline), to 0.8±1.1 at week 52 (p<0.001). No statistical significant differences have been found between patients previously treated with anti‐IL‐12/23 compared to anti‐IL‐17 or both. Only 1 patient discontinued guselkumab at week‐36 due to secondary inefficacy. Limitations Single institution study with a relative small sample size. Conclusion Our real‐life‐data confirm trials’ results, showing guselkumab as a safe and effective option in patients with moderate‐to‐severe psoriasis even in those who previously failed ustekinumab and/or anti‐IL‐17.

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