Guselkumab for the treatment of psoriasis – evidence to date

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Psoriasis is a chronic, immune-mediated, inflammatory, and debilitating skin disease with significant impact on patients’ quality of life. Its pathogenesis is complex and not yet fully understood. However, the IL-23/IL-17 axis is currently considered the main pathogenic pathway in psoriasis. Guselkumab is a fully human immunoglobulin G1 λ (IgG1λ) monoclonal antibody (mAb) that binds to the p19 subunit of IL-23. It is the first of its class, already approved by the US Food and Drug Administration (FDA), as well as the European Medicines Agency (EMA) for the treatment of adult patients with moderate-to-severe plaque psoriasis who are candidates for either systemic therapy or phototherapy. Several clinical trials have demonstrated potential benefits of guselkumab over other already approved immunomodulators in terms of safety and efficacy. The results of the head-to-head trial ECLIPSE were recently released and are addressed in this review. They contribute to the increasing confidence in guselkumab, demonstrating great potential for long-term treatment of psoriasis. However, further long-term data and additional comparative studies will be essential for positioning guselkumab in the therapeutic armamentarium for psoriasis.

Keywords: antibodies, biological products, interleukin-23, monoclonal, psoriasis.

Citation: Nogueira M, Torres T. Guselkumab for the treatment of psoriasis – evidence to date. Drugs in Context 2019; 8: 212594. DOI: 10.7573/dic.212594

Contributions: Both authors contributed equally to the preparation of this review. The named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Miguel Nogueira has no conflicts of interest. Tiago Torres is a scientific consultant/speaker/clinical study investigator for AbbVie, Amgen, Boehringer Ingelheim, Biogen, Celgene, Janssen, LEO-Pharma, Eli-Lilly, MSD, Novartis, Pfizer, Samsung Bioepis, Sanofi. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2019. Nogueira M, Torres T. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Nogueira M, Torres T. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Tiago Torres, Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal.

Provenance: invited; externally peer reviewed.

Submitted: 16 April 2019; Peer review comments to author: 6 June 2019; Revised manuscript received: 6 June 2019; Accepted: 6 June 2019; Publication date: 9 July 2019.

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