Guselkumab in patients with residual mild psoriasis following treatment with ustekinumab: Post hoc analysis from the NAVIGATE trial

In patients with residual mild psoriasis, switching to guselkumab vs continuing ustekinumab resulted in higher PASI 90 (47.4% vs 31.3%) and PASI 100 (10.3% vs 7.2%) response rates at Week 24. These response rates with guselkumab were maintained at Week 52 (PASI 90, 59.0% vs 26.5%; PASI 100, 21.8% vs 9.6%).

Patients switching to guselkumab experienced greater improvements in DLQI, with 50% achieving a DLQI of 0 or 1, compared with 21% on ustekinumab, at Week 28. Differences in treatment favoring guselkumab were maintained through Week 52.

Guselkumab-treated patients reported more meaningful reductions in psoriasis symptoms compared with those treated with ustekinumab. At Week 28, the differences in change from baseline in PSSD Symptoms and Signs scores were 17.1 and 15.7 for guselkumab and ustekinumab, respectively. Additionally, mean improvements in combined PSSD Symptoms and Signs scores exceeded the clinically meaningful threshold (≥40) at all time points assessed in guselkumab-treated patients, whereas these thresholds were generally not met in patients continuing ustekinumab.