INTRODUCTION
Psoriasis is a common, chronic inflammatory disease, affecting approximately 2% to 3% of the population over 20 years of age.1,2 This condition is a systemic disease that often causes immune dysregulation and significantly affects people’s quality of life and well-being.
The etiology of this disease is complex, but most theories describe, amongst other factors, cytokine disbalance due mainly to IL-23 with IL-17 as effector cytokine. The abnormal immune response leads to various effects such as keratinocyte proliferation, immune activation, and altered differentiation, as well as local and systemic inflammation.2,3 Psoriasis can present with different types of skin manifestation: plaque psoriasis being the most common. Moderate-to-severe psoriasis can be treated with more traditional approaches, including phototherapy, retinoids, methotrexate, and cyclosporine.4 These therapies often result in minimal response, with some cases of intolerance or adverse effects (AEs). Biologic therapies generally result in higher levels of response and are well tolerated with fewer drug-related AEs than traditional therapies.6 Guselkumab (Tremfya; CNTO 1959, Janssen Biotech, Inc., PA, USA) is a selective IL-23 antagonist indicated for the treatment of moderate-to-severe plaque psoriasis in adults. It was approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in 2017.5,7 Guselkumab is a fully human monoclonal antibody that selectively targets and binds to IL-23, a key cytokine in psoriasis pathogenesis, named interleukin-23 (IL-23).7
In this study we present our single-center real-life experience in treating moderate-to-severe plaque psoriasis with guselkumab, underscoring the efficacy and safety of this biological agent.
The etiology of this disease is complex, but most theories describe, amongst other factors, cytokine disbalance due mainly to IL-23 with IL-17 as effector cytokine. The abnormal immune response leads to various effects such as keratinocyte proliferation, immune activation, and altered differentiation, as well as local and systemic inflammation.2,3 Psoriasis can present with different types of skin manifestation: plaque psoriasis being the most common. Moderate-to-severe psoriasis can be treated with more traditional approaches, including phototherapy, retinoids, methotrexate, and cyclosporine.4 These therapies often result in minimal response, with some cases of intolerance or adverse effects (AEs). Biologic therapies generally result in higher levels of response and are well tolerated with fewer drug-related AEs than traditional therapies.6 Guselkumab (Tremfya; CNTO 1959, Janssen Biotech, Inc., PA, USA) is a selective IL-23 antagonist indicated for the treatment of moderate-to-severe plaque psoriasis in adults. It was approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in 2017.5,7 Guselkumab is a fully human monoclonal antibody that selectively targets and binds to IL-23, a key cytokine in psoriasis pathogenesis, named interleukin-23 (IL-23).7
In this study we present our single-center real-life experience in treating moderate-to-severe plaque psoriasis with guselkumab, underscoring the efficacy and safety of this biological agent.
MATERIALS AND METHODS
A retrospective cohort study design was used. The electronic database of the Dermatology Department in Milan was searched for patients treated with guselkumab for moderate-to-severe psoriasis since 2019. Data were collected from the clinic's electronic registry. The primary efficacy endpoint was psoriasis area and severity index (PASI) 90 response at week
