The following is a summary of “Time to Loss of Disease Control Following Guselkumab Withdrawal in Relation to Initial Speed of Response: A Post-Hoc Analysis of the VOYAGE 2 Trial,” published in the December 2024 issue of Dermatology by Kirby et al.
Psoriasis is a chronic inflammatory skin condition mandating lifelong treatment, and understanding factors that predict disease control during treatment breaks could enhance long-term management.
Researchers conducted a retrospective study to evaluate how initial response speed to guselkumab treatment affected time to loss of disease control after treatment withdrawal and to identify baseline characteristics associated with maintaining disease control.
They analyzed patients with moderate-to-severe plaque psoriasis who were assigned to treatment withdrawal after achieving a Psoriasis Area and Severity Index (PASI)90 response following 2 or 4 guselkumab doses. Loss of disease control was defined as PASI ≥3 and assessed using Kaplan–Meier analysis. A Cox proportional hazards model was employed to assess the association between baseline characteristics and the maintenance of response.
The results showed that 149/248 (60%) patients randomized to placebo and switched to guselkumab at Week 16 achieved PASI90 after 2 guselkumab doses (Week 28). Of the patients randomized to guselkumab, 377/496 (76%) achieved PASI90 after 4 guselkumab doses (Week 28), with 182 re-randomized to withdrawal. Among these, 131 achieved PASI90 after 2 guselkumab doses (Week 12) and 51 after 4 doses (Week 28). Patients who achieved PASI90 after 2 guselkumab doses had longer maintenance of disease control post-withdrawal compared to those who achieved it after 4 doses. Lower body mass index, biological naïve status, and shorter disease duration at baseline were associated with a longer time to PASI ≥3 after withdrawal.
Investigators concluded the faster initial response to guselkumab treatment was linked with longer maintenance of disease control after treatment withdrawal, proposing the personalized dosing strategies that might enhance treatment adherence and long-term outcomes.
Source: karger.com/drm/article/doi/10.1159/000542344/917609/Time-to-Loss-of-Disease-Control-Following
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