Progression of Quality of Life in Patients with Plaque Psoriasis Who Achieved Three or More Years of Complete Skin Clearance with Guselkumab Treatment: a Post hoc Analysis of the VOYAGE 1 Clinical Trial
Por:
Puig, L, Costanzo, A, de Jong, EMGJ, Torres, T, Warren, RB, Wapenaar, R, Wegner, S, Gorecki, P, Gramiccia, T, Jazra, M, Buyze, J, Conrad, C
Publicada:
1 sep 2024
Ahead of Print:
1 ago 2024
Resumen:
IntroductionThe interleukin-23p19 subunit inhibitor, guselkumab, has demonstrated improvements in clinical and patient-reported outcome (PRO) measures in patients with moderate-to-severe psoriasis. Understanding the relationship among clinical response, PRO measures and baseline characteristics could help clinicians individualize treatment plans. The objective of this analysis was to examine changes in signs, symptoms and quality-of-life (QoL) PRO measures in patients who maintained complete skin clearance through >= 3 years in the phase 3 VOYAGE 1 trial.MethodsA descriptive post hoc analysis of data from VOYAGE 1 was conducted to compare baseline characteristics of patients who maintained complete skin clearance (Psoriasis Area and Severity Index [PASI] = 0 for >= 156 consecutive weeks) versus patients who did not. Mean scores for individual domains of the Dermatology Life Quality Index (DLQI) and Psoriasis Symptom and Sign Diary (PSSD) were evaluated in patients who maintained complete skin clearance, and baseline characteristics of patients who achieved PRO scores of DLQI = 0/1 and PSSD = 0 were compared with those who did not.ResultsOf the 329 patients included in this post hoc analysis, 73 (22.2%) maintained PASI = 0 for >= 156 weeks. This group had a numerically lower proportion of patients at baseline with obesity, depression or previous biologic treatment and a higher proportion who had never smoked. Patients who maintained PASI = 0 generally achieved positive DLQI and PSSD outcomes, though some impact of residual disease was observed, largely related to the DLQI "Symptoms and feelings" sub-scale and PSSD components "Dryness," "Redness" and "Itch." Patients reporting continued disease impact (despite sustaining PASI = 0) had greater disease severity at baseline versus those achieving DLQI = 0/1 and PSSD = 0.ConclusionClinical measures alone do not capture the full patient experience. While both QoL and clinical symptoms are responsive to highly effective treatment, a subset of patients with complete clinical response is still impacted by their psoriasis. Further investigation into this population is warranted.Trial registrationClinicalTrials.gov, NCT02207231.
Filiaciones:
Puig, L:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Dermatol, IIB ST PAU, Barcelona, Spain
Costanzo, A:
Humanitas Univ, Dept Biomed Sci, Dermatol, Milan, Italy
Humanitas Clin & Res Ctr IRCCS, Milan, Italy
de Jong, EMGJ:
Radboud Univ Nijmegen, Med Ctr, Dept Dermatol, Nijmegen, Netherlands
Torres, T:
Ctr Hosp Univ Porto, Porto, Portugal
Univ Porto, Inst Biomed Sci Abel Salazar, Porto, Portugal
Warren, RB:
Univ Manchester, Northern Care Alliance NHS Fdn Trust, Natl Inst Hlth Res Manchester Biomed Res Ctr, Dermatol Ctr, Manchester, England
Wapenaar, R:
Janssen Cilag BV, Breda, Netherlands
Wegner, S:
Janssen Cilag GmbH, Neuss, Germany
Gorecki, P:
Janssen Cilag Ltd, High Wycombe, England
Gramiccia, T:
Janssen Cilag SpA, Milan, Italy
Jazra, M:
Janssen Cilag, Paris, France
Buyze, J:
Janssen Pharmaceut NV, Beerse, Belgium
Conrad, C:
Lausanne Univ Hosp CHUV, Dept Dermatol, Lausanne, Switzerland
Univ Lausanne, Lausanne, Switzerland
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