Guselkumab is efficacious and safe in psoriasis patients who failed anti-IL17: a 52-week real-life study

Background Interleukin (IL)23/Th17 axis is the leading actor of psoriasis pathogenesis. Guselkumab is the first anti-IL23 approved for psoriasis. Anti-IL23 and anti-IL17 partially share their therapeutic target currently appearing as the most efficacious available psoriasis treatments. Real-life data on guselkumab performance in anti-IL17 failure patients are scant. Methods A 52-week real-life single-center retrospective study was performed to evaluate the long-term efficacy and safety of guselkumab in patients who previously failed anti-IL17. Results A total of 44 patients were enrolled (28 male, 63.6%; mean age 59.0 +/- 10.2 years). A statistically significant improvement of Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) was assessed at each follow-up (PASI decreased from 13.9 +/- 8.1 to 0.9 +/- 0.7 at week52 while BSA from 24.3 +/- 19.6 to 1.3 +/- 1.4, p < .001). Nail Psoriasis Severity Index (NAPSI) improvement was collected as well, even if being statistically significative only at week28 and thereafter [2.9 +/- 6.2 at baseline, 0.9 +/- 1.5 at week28, (p < .05)]. Only 3 (6.8%) patients discontinued guselkumab due to secondary inefficacy. No cases of serious Adverse Events were assessed. Conclusion Our real-life study confirmed the efficacy and safety of guselkumab in daily clinical practice suggesting it as a valuable weapon also in psoriasis patients who previously failed anti-IL17 treatments.