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Winter 2020, Vol. 28 No. 4

Hong Kong J. Dermatol. Venereol. (2020) 28, 174


Reports on Scientific Meetings

HKSDV Scientific Live Webinar

Reported by KW Chan 陳錦華

Date:   17 November, 2020
Venue:   Live Webinar
Organiser:   Hong Kong Society of Dermatology and Venereology

Real World Experience of Guselkumab in treating Plaque Psoriasis

Speaker: DH Kim
Department of Dermatology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Psoriasis is a chronic relapsing disease. A regulatory continuum that is driven by IL-23-induced differentiation of Th17 cells mediates psoriatic pathogenesis. It is hypothesised that IL-23 inhibition prevents the release of pro-inflammatory cytokines and chemokines, which play a key role in plaque psoriasis. Guselkumab is a first-in-class anti-IL-23 specific mAb. Trials evaluating the efficacy of guselkumab compared with IL-17 inhibitor secukinumab for the treatment of moderate-to-severe psoriasis demonstrated superior long-term efficacy at week 48. The proportion of patients with adverse events, infections and serious adverse events between the two treatments were similar. There is also a concern of targeting IL-17 inhibition being associated with adverse events related to inflammatory bowel disease. Other head-to-head analyses on guselkumab treatment compared with adalimumab demonstrated superior results in skin clearance. The effects were maintained through four years. Four patients with severe psoriasis previously treated with conventional systemic treatment, in which two were switched from other biologics, were discussed. They were given guselkumab ranging for few months to two years. Good response in terms of PASI score were observed. Further long-term studies for long-term efficacy and safety of guselkumab are required.

Learning points:
Analyses to date on the use of guselkumab have shown a good efficacy and acceptable safety profile in the treatment of moderate-to-severe plaque psoriasis. Further studies are needed to assess long-term safety and efficacy.