Long-Term Clinical Outcomes of Guselkumab in Patients With Plaque Psoriasis and Concomitant Psoriatic Arthritis: A 76-Week Real-World Cohort Study
Dermatologic Therapy, cilt.2026, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 2026 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1155/dth/8940603
- Dergi Adı: Dermatologic Therapy
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: biologic therapy, guselkumab, IL-23 inhibitor, psoriasis, psoriatic arthritis, real-world study
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Guselkumab is a selective monoclonal antibody targeting the interleukin-23 (IL-23) p19 subunit and is approved for the treatment of moderate-to-severe plaque psoriasis. Although randomized clinical trials have demonstrated its efficacy and safety, real-world evidence remains essential to evaluate treatment performance in routine clinical practice. Objective: To evaluate the real-world effectiveness and safety of guselkumab in patients with moderate-to-severe plaque psoriasis, including those with concomitant psoriatic arthritis, during long-term follow-up in routine clinical practice. Methods: This retrospective single-center observational study included adult patients with chronic plaque psoriasis treated with guselkumab at a tertiary dermatology center. For the long-term analysis, only patients with available follow-up data up to Week 76 were included in the final cohort. Clinical outcomes were assessed using the Psoriasis Area and Severity Index (PASI), Physician’s Global Assessment (PGA), and Disease Activity Index for Psoriatic Arthritis (DAPSA) during routine follow-up visits. Safety outcomes were evaluated by monitoring adverse events and laboratory parameters. Formal adherence measures such as medication possession ratio (MPR), pharmacy refill–based metrics, or validated adherence questionnaires were not available in this retrospective cohort; therefore, adherence- and persistence-related interpretations were not predefined outcomes of the present analysis. Results: A total of 228 patients were included. Mean PASI decreased significantly from 23.13 ± 2.23 at baseline to 8.6 ± 1.24 at Week 4 and further declined to 1.81 ± 1.1 at Week 76. At Week 76, PASI75, PASI90, and PASI100 responses were achieved in 96%, 89%, and 69% of patients, respectively. Among patients with psoriatic arthritis, DAPSA scores decreased progressively during follow-up, indicating improvement in joint disease activity. Descriptive subgroup analyses suggested sustained clinical improvement in patients with obesity, comorbidities, difficult-to-treat areas, and prior biologic exposure; however, these findings should be interpreted cautiously. No serious adverse events were observed. Conclusion: In this real-world cohort, guselkumab was associated with marked and sustained improvement in skin and joint outcomes during long-term follow-up, with a favorable safety profile. These findings should be interpreted in light of the retrospective design and the absence of formal adherence assessment. Accordingly, the study should be regarded as a real-world evaluation of effectiveness and safety during follow-up rather than as an adherence- or persistence-based analysis.