Comparison of the Efficacy and Safety of Biologics (Secukinumab, Ustekinumab, and Guselkumab) for the Treatment of Moderate-to-Severe Psoriasis: Real-World Data from a Single Korean Center

Abstract

Biologics are important treatment options for psoriasis; however, direct comparison of their efficacy, safety, and drug survival is insufficient in clinical practice. This retrospective single-center study aimed to compare the efficacy, safety, and drug survival of three commonly used psoriasis biologics (secukinumab, ustekinumab, and guselkumab) and identify the factors affecting drug survival in actual clinics in Korea. We enrolled 111 patients with moderate to severe psoriasis and for at least 56 weeks of follow-up; among these, 27, 23, and 61 were administered secukinumab, ustekinumab, and guselkumab, respectively. All groups were comparable with respect to their baseline characteristics. Secukinumab showed a rapid response, and guselkumab was superior in terms of a long-term response and complete remission compared with other biologics, while ustekinumab showed a lower efficacy compared with other biologics. All three biologics had a favorable and similar safety profile; however, allergic reactions and latent tuberculosis were more common with secukinumab and ustekinumab, respectively. Guselkumab was the most sustained biologic, and the survival rates of secukinumab and ustekinumab were similar. Drug survival was remarkably shorter in female patients and those with hypertension. Introduction of new biologics emerged as a negative factor for drug survival in clinical settings.

Real-world safety and effectiveness of secukinumab in adult patients with moderate to severe plaque psoriasis: results from postmarketing surveillance in Korea

“…Overall, the safety profile of secukinumab was consistent to that in previously reported real-world studies, and no new safety concerns were identified. 19 , 24 , 33 , 36 , 37 The most common AE was pruritus, which is similar to the earlier reports in Korea. 29 Occurrence of treatment-related AEs was found to be much less than in a real-world study conducted in Japan (9.5% versus 24.2%).…”

“…Since patients’ clinical characteristics may differ from those enrolled in RCTs, the results from these RCTs cannot be generalized and may not match the real-world patient population. 19 For instance, older populations or patients with comorbidities may not be included in the clinical trial setting. Real-world studies provide valuable insights for various patient groups to further support the outcomes of the clinical trials.…”

“… 23 – 25 However, routine clinical practice differs from country to country, and limited data are available for the safety and effectiveness of secukinumab in a Korean clinical setting. 19 , 26 Secukinumab (300 mg) was approved in Korea by the Ministry of Food and Drug Safety on 24 September 2015 for the treatment of moderate to severe plaque psoriasis in adults who require phototherapy or systemic therapy. 27 The granted re-examination period was 6 years from the date of approval up to 23 September 2021; this postmarketing surveillance (PMS) would, therefore, evaluate the safety and effectiveness of secukinumab for its approved indication in the real-world setting of Korea.…”

Long-Term Efficacy, Safety, and Drug Survival of Guselkumab in Patients with Psoriasis: Real-World Data from the Czech Republic BIOREP Registry

“…We did not see any worse course of COVID-19 in our patients. Similar results have been published in other studies evaluating patients in a real-world setting, addressing overall favorable safety profile and good tolerance with no new safety signals [ 11 , 15 , 18 , 42 , 44 , 51 , 52 ].…”

The efficacy, safety and pharmacokinetics of IL-17A monoclonal antibody injection (AK111) in patients with moderate to severe plaque psoriasis: a randomized, double-blind, placebo-controlled phase Ib multi-dose escalation clinical study

“…In addition, guselkumab which targets IL-23 to treat psoriasis by acting on the IL-23/Th17 axis. Its therapeutic effect increased to 82.6% of PASI100 from 52 weeks to 56 weeks [20]. In this current clinical trial, a large number of patients reached sPGA0/1, of which 100% of the patients in the AK111 450 mg group reached sPGA0/1.…”