Palmoplantar pustulosis: guselkumab shows good efficacy

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Takeaway

  • A small Japanese randomized controlled trial suggests that guselkumab (Tremfya) is associated with good efficacy and safety in patients with moderate to severe palmoplantar pustulosis (PPP).

Why this matters

  • Study suggests that guselkumab, an anti-IL-23 monoclonal antibody, may represent a good therapeutic option for patients with moderate to severe PPP.

Key results

  • Guselkumab patients had better improvements in mean PPP severity index total scores compared with placebo patients at week 16 (−3.3 vs −1.8; P=.03).
  • Guselkumab patients had significantly better improvements in mean PPP area and severity index score (−10.2 vs −6.4; P=.009) and proportion of patients achieving 50% improvement in PPP area and severity index score (60% vs 21%; P=.009) compared with placebo patients at week 16.
  • Guselkumab and placebo patients had similar rates of treatment-emergent adverse events (76% vs 75%).

Study design

  • 49 patients with moderate to severe PPP, 41 who completed the study at week 24, were randomly assigned 1:1 to receive guselkumab or placebo at week 0 and 4 and analyzed for efficacy and safety outcomes.
  • Funding: Janssen Pharmaceutical K.K., Tokyo, Japan.

Limitations

  • Small patient sample size.
  • Short treatment period with only 2 doses.