Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study

Abstract Introduction Psoriasis is a chronic inflammatory skin disorder, affecting around 2–3% of the global population. The IL-23/Th17 signaling pathway plays a critical role in disease progression. Guselkumab, an IL-23p19 monoclonal antibody, has shown substantial efficacy in clinical trials for t...

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Main Authors: Edoardo Mortato, Marina Talamonti, Lorenzo Marcelli, Matteo Megna, Annunziata Raimondo, Giacomo Caldarola, Nicoletta Bernardini, Anna Balato, Anna Campanati, Maria Esposito, Claudio Bonifati, Viviana Lora, Luca Potestio, Serena Lembo, Francesco Loconsole, Eleonora De Luca, Nevena Skroza, Dario Buononato, Tommaso Bianchelli, Maria Concetta Fargnoli, Nello Tommasino, Felice Primavera, Clara De Simone, Luca Bianchi, Marco Galluzzo
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Dermatology and Therapy
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Online Access:https://doi.org/10.1007/s13555-025-01394-2
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author Edoardo Mortato
Marina Talamonti
Lorenzo Marcelli
Matteo Megna
Annunziata Raimondo
Giacomo Caldarola
Nicoletta Bernardini
Anna Balato
Anna Campanati
Maria Esposito
Claudio Bonifati
Viviana Lora
Luca Potestio
Serena Lembo
Francesco Loconsole
Eleonora De Luca
Nevena Skroza
Dario Buononato
Tommaso Bianchelli
Maria Concetta Fargnoli
Nello Tommasino
Felice Primavera
Clara De Simone
Luca Bianchi
Marco Galluzzo
author_facet Edoardo Mortato
Marina Talamonti
Lorenzo Marcelli
Matteo Megna
Annunziata Raimondo
Giacomo Caldarola
Nicoletta Bernardini
Anna Balato
Anna Campanati
Maria Esposito
Claudio Bonifati
Viviana Lora
Luca Potestio
Serena Lembo
Francesco Loconsole
Eleonora De Luca
Nevena Skroza
Dario Buononato
Tommaso Bianchelli
Maria Concetta Fargnoli
Nello Tommasino
Felice Primavera
Clara De Simone
Luca Bianchi
Marco Galluzzo
author_sort Edoardo Mortato
collection DOAJ
description Abstract Introduction Psoriasis is a chronic inflammatory skin disorder, affecting around 2–3% of the global population. The IL-23/Th17 signaling pathway plays a critical role in disease progression. Guselkumab, an IL-23p19 monoclonal antibody, has shown substantial efficacy in clinical trials for treating moderate-to-severe plaque psoriasis. However, preliminary identification of super responders (SRe: patients achieving PASI 100 at week 20) can help optimize treatment strategies. This study aims to identify predictive factors for SRe status in patients receiving guselkumab therapy for psoriasis and to evaluate long-term effectiveness in the entire cohort and both SRe and non-super-responder (nSRe) groups to understand whether SRe status is also a predictor of long-term response to guselkumab in a real-world setting. Methods A retrospective longitudinal study was conducted at ten Italian centers between January and October 2024. Data from 1008 patients treated with guselkumab for at least 20 weeks were analyzed. Patients were classified as SRe (PASI 100 at week 20) and nSRe. Baseline clinical and anthropometric profiles, comorbidities, and treatment history were collected. Efficacy was evaluated using PASI scores. Logistic regression analysis was performed to identify predictive factors for achieving SRe status. Results Of 1008 patients, 581 (57.6%) were classified as SRe, while 427 (42.4%) were nSRe. SRe patients were more likely to be bio-naïve and had lower baseline PASI scores and comorbidities such as obesity, hypertension, and diabetes. Multivariate logistic regression identified obesity, prior biologic therapy, and a higher baseline PASI as negative predictors for SRe status. Guselkumab demonstrated significant long-term efficacy, with SRe patients achieving sustained PASI 100 in 85% at year 4 and 83.4% at year 5 compared to 54% and 59.2% in nSRe patients, respectively. Conclusions Our study highlights the importance of identifying patients most likely to achieve PASI 100 early in treatment. Factors such as obesity, prior biologic experience, and baseline PASI contribute to predicting complete skin clearance, which can guide clinical decision-making and enable personalized treatment strategies.
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spelling doaj-art-e11123288f4b44cc94aaa1c25a65d1982025-08-20T02:19:07ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722025-04-011551239125010.1007/s13555-025-01394-2Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective StudyEdoardo Mortato0Marina Talamonti1Lorenzo Marcelli2Matteo Megna3Annunziata Raimondo4Giacomo Caldarola5Nicoletta Bernardini6Anna Balato7Anna Campanati8Maria Esposito9Claudio Bonifati10Viviana Lora11Luca Potestio12Serena Lembo13Francesco Loconsole14Eleonora De Luca15Nevena Skroza16Dario Buononato17Tommaso Bianchelli18Maria Concetta Fargnoli19Nello Tommasino20Felice Primavera21Clara De Simone22Luca Bianchi23Marco Galluzzo24Department of Systems Medicine, University of Rome “Tor Vergata”Dermatology Unit, Fondazione Policlinico “Tor Vergata”Department of Systems Medicine, University of Rome “Tor Vergata”Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico IIDepartment of Medicine Surgery and Dentistry, “Scuola Medica Salernitana”, University of SalernoInstitute of Dermatology, Università Cattolica del Sacro CuoreDermatology Unit “Daniele Innocenzi”, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of RomeDermatology Unit, University of Campania Luigi VanvitelliDepartment of Clinical and Molecular Sciences-Dermatological Clinic, Università Politecnica delle MarcheDepartment of Biotechnological and Applied Clinical Sciences, University of L’AquilaDepartment of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCSDepartment of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCSSection of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico IIDepartment of Medicine Surgery and Dentistry, “Scuola Medica Salernitana”, University of SalernoDepartment of Dermatology, University of BariInstitute of Dermatology, Università Cattolica del Sacro CuoreDermatology Unit “Daniele Innocenzi”, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of RomeDermatology Unit, University of Campania Luigi VanvitelliDermatology Unit, IRCCS INRCASan Gallicano Dermatological Institute, IRCCSSection of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico IIDepartment of Dermatology, University of BariInstitute of Dermatology, Università Cattolica del Sacro CuoreDepartment of Systems Medicine, University of Rome “Tor Vergata”Department of Systems Medicine, University of Rome “Tor Vergata”Abstract Introduction Psoriasis is a chronic inflammatory skin disorder, affecting around 2–3% of the global population. The IL-23/Th17 signaling pathway plays a critical role in disease progression. Guselkumab, an IL-23p19 monoclonal antibody, has shown substantial efficacy in clinical trials for treating moderate-to-severe plaque psoriasis. However, preliminary identification of super responders (SRe: patients achieving PASI 100 at week 20) can help optimize treatment strategies. This study aims to identify predictive factors for SRe status in patients receiving guselkumab therapy for psoriasis and to evaluate long-term effectiveness in the entire cohort and both SRe and non-super-responder (nSRe) groups to understand whether SRe status is also a predictor of long-term response to guselkumab in a real-world setting. Methods A retrospective longitudinal study was conducted at ten Italian centers between January and October 2024. Data from 1008 patients treated with guselkumab for at least 20 weeks were analyzed. Patients were classified as SRe (PASI 100 at week 20) and nSRe. Baseline clinical and anthropometric profiles, comorbidities, and treatment history were collected. Efficacy was evaluated using PASI scores. Logistic regression analysis was performed to identify predictive factors for achieving SRe status. Results Of 1008 patients, 581 (57.6%) were classified as SRe, while 427 (42.4%) were nSRe. SRe patients were more likely to be bio-naïve and had lower baseline PASI scores and comorbidities such as obesity, hypertension, and diabetes. Multivariate logistic regression identified obesity, prior biologic therapy, and a higher baseline PASI as negative predictors for SRe status. Guselkumab demonstrated significant long-term efficacy, with SRe patients achieving sustained PASI 100 in 85% at year 4 and 83.4% at year 5 compared to 54% and 59.2% in nSRe patients, respectively. Conclusions Our study highlights the importance of identifying patients most likely to achieve PASI 100 early in treatment. Factors such as obesity, prior biologic experience, and baseline PASI contribute to predicting complete skin clearance, which can guide clinical decision-making and enable personalized treatment strategies.https://doi.org/10.1007/s13555-025-01394-2GuselkumabLong-term efficacyPredictive factorsPsoriasisSuper responders
spellingShingle Edoardo Mortato
Marina Talamonti
Lorenzo Marcelli
Matteo Megna
Annunziata Raimondo
Giacomo Caldarola
Nicoletta Bernardini
Anna Balato
Anna Campanati
Maria Esposito
Claudio Bonifati
Viviana Lora
Luca Potestio
Serena Lembo
Francesco Loconsole
Eleonora De Luca
Nevena Skroza
Dario Buononato
Tommaso Bianchelli
Maria Concetta Fargnoli
Nello Tommasino
Felice Primavera
Clara De Simone
Luca Bianchi
Marco Galluzzo
Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
Dermatology and Therapy
Guselkumab
Long-term efficacy
Predictive factors
Psoriasis
Super responders
title Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
title_full Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
title_fullStr Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
title_full_unstemmed Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
title_short Predictive Factors for Super Responder Status and Long-Term Effectiveness of Guselkumab in Psoriasis: A Multicenter Retrospective Study
title_sort predictive factors for super responder status and long term effectiveness of guselkumab in psoriasis a multicenter retrospective study
topic Guselkumab
Long-term efficacy
Predictive factors
Psoriasis
Super responders
url https://doi.org/10.1007/s13555-025-01394-2
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