In the Journals

Guselkumab shows superior long-term efficacy vs. secukinumab based on PASI 90

Kristian Reich, MD
Kristian Reich

A significantly greater proportion of patients with psoriasis receiving guselkumab achieved a 90% reduction or more in the Psoriasis Area and Severity Index at week 48 than those receiving secukinumab, according to researchers in The Lancet.

“The study results are indicative of a higher potential of the interleukin-23 inhibitor guselkumab to maintain high levels of disease control in psoriasis over a 48-week period compared to the IL-17A inhibitor secukinumab. It will be interesting to see how these study results compare to future findings on drug survival rates in treatment registries,” Kristian Reich, MD, PhD, professor of translational research in inflammatory skin diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Germany, told Healio Dermatology.

In the phase 3 ECLIPSE study, 1,048 patients with moderate to severe psoriasis were randomly assigned 1:1 to receive Tremfya (guselkumab, Janssen Research & Development) 100 mg at weeks 0 and 4 and then every 8 weeks or Cosentyx (secukinumab, Novartis Pharmaceuticals) 300 mg at weeks 0, 1, 2, 3 and 4, and then every 4 weeks.

Twenty-seven of 534 patients in the guselkumab group and 48 of 514 patients in the secukinumab group discontinued study treatment.

A significantly greater proportion of 451 patients (84%) in the guselkumab group met PASI 90 at week 48 compared with 360 patients (70%) in the secukinumab group (P < .0001).

Safety profiles in both groups were similar to previous studies.

Between weeks 3 and 12, more patients achieved PASI 90 in the secukinumab group than in the guselkumab group; at weeks 16 and 20, they were similar in both groups; and from week 28 to 48, the proportion of patients achieving PASI 90 was higher in the guselkumab group.

“This comparator study provides valuable information for understanding the effects of targeting IL-23p19 versus IL-17A for the treatment of psoriasis, particularly as it provides a comprehensive and unbiased evaluation of efficacy throughout a nearly 1-year duration, which is important because psoriasis is a lifelong, chronic disease,” Reich and colleagues wrote. – by Abigail Sutton

 

Disclosures: Reich reports he has served as an advisor and paid speaker and has participated in clinical trials for AbbVie, Affibody, Almirall, Amgen, Avillion, Biogen, Boehringer Ingelheim, Celgene, Covagen, Forward Pharma, Fresenius Medical Care, GlaxoSmithKline, Janssen, Janssen-Cilag, Kyowa Kirin, Leo Pharma, Eli Lilly, Medac, Merck Sharp & Dohme, Novartis, Miltenyi Biotec, Ocean Pharma, Pfizer, Regeneron, Samsung Bioepis, Sanofi, Sun Pharma, Takeda, UCB, Valeant, XBiotech and Xenoport. Please see the study for all other authors’ relevant financial disclosures.

Kristian Reich, MD
Kristian Reich

A significantly greater proportion of patients with psoriasis receiving guselkumab achieved a 90% reduction or more in the Psoriasis Area and Severity Index at week 48 than those receiving secukinumab, according to researchers in The Lancet.

“The study results are indicative of a higher potential of the interleukin-23 inhibitor guselkumab to maintain high levels of disease control in psoriasis over a 48-week period compared to the IL-17A inhibitor secukinumab. It will be interesting to see how these study results compare to future findings on drug survival rates in treatment registries,” Kristian Reich, MD, PhD, professor of translational research in inflammatory skin diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Germany, told Healio Dermatology.

In the phase 3 ECLIPSE study, 1,048 patients with moderate to severe psoriasis were randomly assigned 1:1 to receive Tremfya (guselkumab, Janssen Research & Development) 100 mg at weeks 0 and 4 and then every 8 weeks or Cosentyx (secukinumab, Novartis Pharmaceuticals) 300 mg at weeks 0, 1, 2, 3 and 4, and then every 4 weeks.

Twenty-seven of 534 patients in the guselkumab group and 48 of 514 patients in the secukinumab group discontinued study treatment.

A significantly greater proportion of 451 patients (84%) in the guselkumab group met PASI 90 at week 48 compared with 360 patients (70%) in the secukinumab group (P < .0001).

Safety profiles in both groups were similar to previous studies.

Between weeks 3 and 12, more patients achieved PASI 90 in the secukinumab group than in the guselkumab group; at weeks 16 and 20, they were similar in both groups; and from week 28 to 48, the proportion of patients achieving PASI 90 was higher in the guselkumab group.

“This comparator study provides valuable information for understanding the effects of targeting IL-23p19 versus IL-17A for the treatment of psoriasis, particularly as it provides a comprehensive and unbiased evaluation of efficacy throughout a nearly 1-year duration, which is important because psoriasis is a lifelong, chronic disease,” Reich and colleagues wrote. – by Abigail Sutton

 

Disclosures: Reich reports he has served as an advisor and paid speaker and has participated in clinical trials for AbbVie, Affibody, Almirall, Amgen, Avillion, Biogen, Boehringer Ingelheim, Celgene, Covagen, Forward Pharma, Fresenius Medical Care, GlaxoSmithKline, Janssen, Janssen-Cilag, Kyowa Kirin, Leo Pharma, Eli Lilly, Medac, Merck Sharp & Dohme, Novartis, Miltenyi Biotec, Ocean Pharma, Pfizer, Regeneron, Samsung Bioepis, Sanofi, Sun Pharma, Takeda, UCB, Valeant, XBiotech and Xenoport. Please see the study for all other authors’ relevant financial disclosures.