Real-World Guselkumab Response and Drug Survival in Australian Patients With Psoriasis: Results From the Australasian Psoriasis Registry

Abstract

Aims: Guselkumab’s real-world efficacy, drug survival, and patient characteristics from the Australasian Psoriasis Registry (APR) were compared with the data from the Phase III VOYAGE 1 trial.

Methods: Data from patients with severe plaque psoriasis prescribed guselkumab through the Australian Pharmaceutical Benefits Scheme (PBS) were derived from the APR. Demographic and treatment data (including psoriasis area and severity index [PASI]) at defined timepoints from 4^th September 2018 to 1^st October 2022 were analyzed. The baseline was PASI at the commencement of the first biologic. APR and VOYAGE 1 data were compared using 2-sample t-tests and chi-square tests. Associations between patient characteristics and drug survival/time to PASI score were assessed using Cox proportional hazards regression and Kaplan–Meier estimates.

Results: 102 patients were eligible; 87.3% (n = 89) had received prior biologic therapy versus 21.6% patients in VOYAGE 1. Overall drug survival in APR was 99.0%, 93.1%, 83.3% and 77.1% at 3, 9, 15, and 27 months, respectively. At 9 months, drug survival was 100% for bionaïve and 92.1% for bioexperienced patients. In VOYAGE 1, 91.5% continued guselkumab through Week 48 (∼11 months). In the APR, the median PASI was 24.0 (IQR: 17.9–32.2) at baseline, and 1.1 (IQR: 0–2.7) at 9 months. Absolute PASI ≤ 3 and PASI90 were attained by 73.8% and 64.8%, respectively. In VOYAGE 1, 76.3% reached PASI90 at Week 48. Bionaïve patients in the APR had longer drug survival than bioexperienced.

Conclusions: Guselkumab was efficacious in the real-world treatment of psoriasis, consistent with RCT results. Drug retention rates were high through 27 months, despite a higher proportion of bioexperienced patients in the APR than in VOYAGE 1.