Two-Year Treatment Persistence of Guselkumab vs Other Biologics in Plaque Psoriasis Patients

Numerous biologic therapies have been approved to treat moderate-to-severe plaque psoriasis with the potential to control disease and reduce the long-term risk of adverse sequelae.¹ However, the optimization of treatment outcomes to achieve long-term safety and durable effectiveness remains challenging.² On July 13, 2017, guselkumab was the first interleukin-23 inhibitor (IL-23i) approved by the United States (US) Food and Drug Administration (FDA) to treat moderate-to-severe plaque psoriasis. Guselkumab has shown promise of sustained efficacy in pivotal clinical trials and in early follow-up from real-world effectiveness studies. Clinical trial data has demonstrated: 1) guselkumab is efficacious and safe through 5 years,^3-5 2) guselkumab has superior efficacy compared to adalimumab and secukinumab,6 and 3) guselkumab has demonstrated efficacy in ustekinumab inadequate responders.⁷ However, evidence of long-term outcomes of guselkumab compared to other biologics in US real-world patients remains limited.

Treatment persistence may be influenced by clinical factors such as effectiveness and safety, patient preference, and non-clinical factors, including insurance and cost. Understanding long-term treatment persistence and relative persistence between different treatments can guide treatment strategies for providers and patients. The primary objective of this study was to compare the 2-year drug persistence of biologic-naïve and biologic-experienced patients initiating guselkumab to patients initiating three commonly prescribed biologics for the treatment of plaque psoriasis: adalimumab, secukinumab, and ixekizumab.