Targeting p19 as a treatment option for psoriasis: an evidence-based review of guselkumab

Figures & data

Figure 1 IL-12, IL-23 and IL-39 with their receptors and downstream effects.

Notes: IL-12 and IL-23 share the p40 cytokine subunit, which USM targets. IL-23 and IL-39 share the p19 cytokine subunit, which GUS, risankizumab and tildrakizumab target. IL-12 promotes the T_h1 pathway, and IL-23 promotes the T_h17 pathway.
Abbreviations: USM, ustekinumab; GUS, guselkumab; ADM, adalimumab.

Table 1 Summary of clinical trials

Week/study	IGA 0/1a,b	PASI75	PASI90	DLQI 0/1c,d	SymptomPSSD	f-PGA 0/1e	hf-PGA0/1e	ss-IGA 0/1e
Week 16f
Sofen et al^Citation21 (100 mg GUS/PBO)	N/A	60/0	0/0	N/A	N/A	N/A	N/A	N/A
Gordon et al^Citation15 (100 mg GUS/PBO/ADM)	86/7/58g	79/5/70g	62/2/44g	63/7/49g	N/A	N/A	N/A	N/A
VOYAGE 1^Citation27 (GUS/PBO/ADM)	85/7/66g	91/6/73g	73/3/50g	56/4/39g	42/3/35g	39/16/51g	73/14/56	83/15/70g
VOYAGE 2^Citation28 (GUS/PBO/ADM)	84/9/68g,h	86/8/69h	70/2/47g,h	52/3/39	40/8/33g	52/15/60	77/14/71	81/11/67g
NAVIGATE^Citation29 (GUS/USM)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Week 24i
Sofen et al^Citation21 (100 mg GUS/PBO)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Gordon et al^Citation15 (100 mg GUS/PBO/ADM)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
VOYAGE 1^Citation27 (GUS/PBO/ADM)	84/–/62h	91/–/72h	80/–/53h	61/–/40h	44/–/36h	56/–/62	79/–/57h	85/–/69h
VOYAGE 2^Citation28 (GUS/PBO/ADM)	84/–/65h	89/–/71h	75/–/55h	58/–/41h	42/–/32h	63/–/67	82/–/66	85/–/68
NAVIGATE^Citation29 (GUS/USM)	31/14h	N/A	48/23h	N/A	N/A	N/A	N/A	N/A
Week 48j
Sofen et al^Citation21 (100 mg GUS/PBO)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Gordon et al^Citation15 (100 mg GUS/PBO/ADM)	77/–/49	N/A	N/A	N/A	N/A	N/A	N/A	N/A
VOYAGE 1^Citation27 (GUS/PBO/ADM)	81/–/55h	88/–/63h	76/–/48h	63/–/39h	45/–/33h	75/–/62k	76/–/62k	78/–/61h
VOYAGE 2^Citation28 (GUS/PBO/ADM)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
NAVIGATE^Citation29 (GUS/USM)	36/17h	N/A	51/24h	39/19.0k	N/A	N/A	N/A	N/A

Notes: IGA 0/1, PASI75, PASI90, DLQI 0/1, f-PGA, hf-PGA and ss-IGA are reported as percentages. Symptom PSSD is reported as the mean reduction in PSSD symptom score.

a PGA score of 0 or 1 for Gordon et al.

b Within the group of patients who attained at least a 2-point improvement in the IGA score compared to Week 16 for NAVIGATE.

c Within the group of patients with DLQI scores >1 at baseline for Gordon et al.

d Within the group of patients with DLQI scores >1 at Week 16 for NAVIGATE.

e Within the group of patients who attained improvements of ≥1 point for f-PGA score and ≥2 for hf-PGA and ss-IGA scores.

f Reported at Week 12 for Sofen et al.

g P<0.001 for comparison of GUS to PBO.

h P<0.001 for comparison of GUS to active comparator (ADM or USM).

i Reported at Week 28 for NAVIGATE.

j Reported at Week 40 for Gordon et al and Week 52 for NAVIGATE.

k P<0.05 for comparison of GUS to active comparator (ADM or USM).

Abbreviations: IGA 0/1, Investigator Global Assessment score of 0 or 1; PASI75, at least a 75% improvement in PASI score compared to baseline; PASI90, at leasta 90% improvement in PASI score compared to baseline; DLQI 0/1, Dermatology Quality of Life Index score of 0 or 1; Symptom PSSD, mean reduction in Psoriasis Symptoms and Signs Diary Symptom score; f-PGA, fingernail Physician Global Assessment; hf-PGA, Physician Global Assessment of hands and/or feet; ss-IGA, scalp-specific Investigator Global Assessment; GUS, guselkumab; PBO, placebo; N/A, not available; ADM, adalimumab; USM, ustekinumab; PGA, Physician Global Assessment; PASI, Psoriasis Area and Severity Index; DLQI, Dermatology Quality of Life Index.

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