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TOPLINE:

A new study found that 57.6% of patients with psoriasis achieved super responder status with guselkumab, characterised by complete skin clearance at week 20. Bio-naive status and lower comorbidity rates were associated with superior response, with 85% of super responders maintained Psoriasis Area and Severity Index (PASI) 100 at year 4.

METHODOLOGY:

• This retrospective longitudinal study conducted at ten Italian centres between January and October 2024 analysed data of 1008 patients with psoriasis treated with guselkumab for at least 20 weeks.
• Participants received guselkumab therapy according to the standard protocol: Induction at 100 mg subcutaneously at weeks 0 and 4, followed by maintenance every 8 weeks.
• Researchers classified patients as super responders (those who achieved PASI 100 at week 20) and non–super responders.
• The primary endpoint of the study was the characterisation of super responders; the secondary endpoint was the evaluation of long-term clinical efficacy comparing the super responders and non–super responders up to 5 years.

TAKEAWAY:

• Overall, 57.6% of patients were classified as super responders, achieving PASI 100 by week 20, whereas 42.4% of patients were classified as non–super responders.
• Super responders demonstrated higher rates of bio-naive status (42.4% vs 32.6%) and a lower prevalence of comorbidities, including obesity (22.2% vs 28.1%), hypertension (37.1% vs 40.9%), and diabetes (11.5% vs 17.5%), than non–super responders.
• A multivariate logistic regression analysis identified obesity (odds ratio [OR], 0.74), prior biologic therapy (OR, 0.57), and a higher baseline PASI score (OR, 0.97) as negative predictors for super responder status.
• The evaluation of long-term efficacy showed that 85% and 83.4% of super responders vs 54% and 59.2% of non–super responders maintained PASI 100 at years 4 and 5, respectively.

IN PRACTICE:

"Our findings highlight the importance of early and targeted intervention in psoriasis treatment. Identifying predictive factors for super-responder status can facilitate individualised therapeutic strategies, ensuring optimal clinical outcomes, promoting prolonged drug survival, and potentially extending dose intervals for selected patients," the authors wrote.

SOURCE:

This study was led by Edoardo Mortato, Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy. It was published online on April 16, 2025, in Dermatology and Therapy.

LIMITATIONS:

As a retrospective, observational analysis, this study was subject to inherent biases, including variations in patient management across different centres. The use of real-life data, while reflective of clinical practice, lacked the controlled environment of randomised trials, potentially introducing confounding factors.

DISCLOSURES:

No funding or sponsorship was received for this study. Several authors reported serving as speakers and/or consultants and having other ties with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.