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What Factors Predict Super-Response to Guselkumab in Psoriasis?

Patient age, baseline body weight, disease severity measured by PASI, Investigator's Global Assessment predict response to guselkumab

By Dermsquared Editorial Team | December 07, 2022

Guselkumab is more likely to be associated with achieving super-response among patients who are younger, less obese, and have less severe psoriasis, according to a study published in the December issue of the Journal of the European Academy of Dermatology and Venereology.

Kristian Reich, M.D., from the University Medical Center Hamburg-Eppendorf in Germany, and colleagues describe the baseline characteristics of patients with moderate-to-severe psoriasis achieving super-response (Psoriasis Area and Severity Index [PASI] 100 response at weeks 20 and 28) after initiating guselkumab treatment using pooled data from the VOYAGE 1 and VOYAGE 2 studies. Factors that were potentially predictive of super-response status were identified.

The post-hoc analysis included 664 patients: 271 achieved super-response and 393 had a non-super-response. The researchers found that significant predictors of super-response status included patient age at study entry, baseline body weight (≤90 versus >90 kg), PASI, and the Investigator's Global Assessment score. Compared with those with non-super-response, more patients with super-response achieved an early response (week 2 PASI 75: 5.5 versus 1.8 percent; week 8 PASI 100: 22.5 versus 3.3 percent). Patients with versus without super-response had slightly greater median serum guselkumab concentrations through week 28.

"Guselkumab-treated patients with super-response have distinguishable baseline demographic and disease characteristics," the authors write. "These results may allow clinicians to predict which patients at their baseline might achieve super-response, which may be beneficial in drug selection, managing patient expectations of treatment response, and improving patient-physician communication."

Several authors disclosed financial ties to pharmaceutical companies, including Janssen, which manufactures guselkumab and partially funded the study.

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