- Suppression of IL-23-regulated IL-17 and IL-22 is associated with efficacy of guselkumab (Tremfya) after withdrawal in patients with psoriasis, according to results for the VOYAGE 2 trial.
Why this matters
- Patients may need to interrupt therapy for a variety of reasons, necessitating better understanding of efficacy and safety of retreatment after interruption.
- Patients with psoriasis treated with guselkumab who achieved PASI 90 were rerandomized for guselkumab withdrawal (N=182) or guselkumab maintenance (N=193).
- Patients who withdrew from guselkumab and experienced loss of ≥50% of week 28 PASI improvement or by week 72 reinitiated guselkumab.
- Funding: Janssen Research & Development, LLC.
- Patients who received guselkumab maintenance had higher efficacy at week 72 compared with patients who received guselkumab withdrawal (86.0% vs 11.5% achieved ≥90% improvement in Psoriasis Area and Severity Index [PASI 90]; P<.001>
- 80.4% of patients from the guselkumab withdrawal group achieved PASI 90 after 20 weeks of guselkumab retreatment.
- Maintenance of response after withdrawal was associated with suppression of IL-17A, IL-17F, and IL-22.
- Adverse events, discontinuations because of adverse events, and serious adverse events were generally comparable between the guselkumab withdrawal and guselkumab maintenance groups.
- Limited evaluation of serum markers.