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PERSIST real-world study: Guselkumab and ustekinumab for plaque psoriasis
IL-23 plays a key role in the immunopathogenesis of psoriasis, leading to the development of targeted biologic therapies such as guselkumab and ustekinumab. Whilst these therapies have demonstrated efficacy and safety in clinical trials, there is a lack of data in clinical practice. The non-interventional, multicenter, German PERSIST trial (CNTO1275PSO4051) was conducted to evaluate the safety and efficacy of guselkumab (n = 302)and ustekinumab (n = 313) in routine clinical care in patients with moderate to severe plaque psoriasis over 104 weeks.1 The primary endpoint was the proportion of patients achieving a DLQI score of ≤1 after 28 weeks of treatment. Results were published in the Journal of the European Academy of Dermatology and Venereology by Gerdes et al.1
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Key learnings |
| Both guselkumab and ustekinumab demonstrated sustained efficacy over 104 weeks; however, guselkumab generally led to higher PASI response. PASI100 and PASI ≤1 were achieved by 44.3% vs 28.5% and 58.7% vs 49.7% of guselkumab- and ustekinumab-treated patients, respectively. |
| Both treatments led to improved DLQI 0/1 scores (63.6% of guselkumab and 64.4% of ustekinumab recipients) and PASI 90 responses (64.7% of guselkumab and 64.4% of ustekinumab recipients) at Week 104. |
| No new safety signals were observed with either treatment. The most common AEs were mild to moderate, including upper respiratory infections and gastrointestinal symptoms. Patients treated with ustekinumab experienced more viral upper respiratory tract infections vs guselkumab (7.1% vs 3.1%). |
| Improvements in disease activity and QoL were maintained at 2 years with both treatments. Both treatments, but particularly guselkumab, demonstrated greater efficacy in biologic-naïve patients vs biologic-experienced patients, demonstrating the importance of early intervention in plaque psoriasis. |
Abbreviations: AE, adverse event; DLQI, Dermatology Life Quality Index; IL, interleukin; PASI, Psoriasis Area and Severity Index; PASI100, 100% improvement in Psoriasis Area and Severity Index score; QoL, quality of life.
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