A Retrospective Study of Time to Relapse following Guselkumab Withdrawal in Patients with Psoriasis

Abstract

Background. Psoriasis is a chronic immune-mediated skin disease requiring long-term management. However, for various reasons such as financial issues, treatment cessation is common among psoriasis patients who have achieved clinical remission. Currently, only few studies have assessed the time to relapse after guselkumab withdrawal in the real-world setting. Objective. The study aimed at assessing the time to relapse after remission following guselkumab discontinuation in patients with moderate-to-severe plaque psoriasis in the real-world setting. Materials and Methods. Eligible adult moderate-to-severe plaque psoriasis patients received at least 2 doses of administration of guselkumab treatment between March 2020 and March 2022 were enrolled. The study included patients who achieved PASI < 3 at week 12. Relapse was defined as restart of systemic therapy upon guselkumab withdrawal. Time to relapse was defined as the time interval between the last guselkumab administration and restart of systemic therapy. Results. Totally, 76 patients were enrolled. Relapse was found in 60.5% of patients, with a median PASI score at relapse of 4.6 (IQR: 1.6, 8.4) and median time to relapse was 201 (IQR: 159, 314) days. The proportion of patients with comorbidities significantly differed between the relapse and nonrelapse groups at baseline ( $P<0.05$ ). Compared with patients with PASI < 3, those with PASI ≥ 3 at relapse had longer time to relapse ( $P<0.001$ ). Conclusions. Guselkumab provides durable maintenance of response after discontinuation of therapy in the real-world setting. Higher PASI score at relapse was associated with longer time to relapse. This trial is registered with Chinese Clinical Trial Registry: ChiCTR2000041398.