%0 Journal Article
%T Guselkumab for the Treatment of Moderate
%A A. Schubert
%A A. Situ
%A A. Varu
%A B. Hutton
%A C. Cameron
%A C. Druchok
%A R. Villacorta
%A S. McElligott
%A S. Nair
%J Journal of Psoriasis and Psoriatic Arthritis
%@ 2475-5311
%D 2019
%R 10.1177/2475530318818816
%X Guselkumab is an interleukin-23 inhibitor indicated for treatment of moderate-to-severe plaque psoriasis. The objective was to determine the relative efficacy and safety of guselkumab compared to other biologics. A systematic review was performed to identify randomized controlled trials (RCTs). Bayesian network meta-analyses (NMAs) were conducted using meta-regression analyses that adjusted for cross-trial differences and risk differences. The primary outcome was Psoriasis Area and Severity Index (PASI) 90 response. Other efficacy and safety outcomes were considered. Several meta-regressions were performed to account for variations in patient and study characteristics: baseline risk adjustment (ie, control group response), prior biologic use, duration of psoriasis, weight, age, race, and baseline PASI/dermatology life quality index scores. The best-fitting model using predefined criteria was selected. Forty-five RCTs were identified. Patient and study characteristics differed between RCTs as reflected in variations in control group response. Both the baseline risk-adjusted NMA and the risk-difference NMA fit the data best and suggested guselkumab has one of the highest PASI 90 responses. Pairwise comparisons from the baseline risk-adjusted PASI 90 NMA suggested guselkumab has comparable efficacy with ixekizumab (relative risk [RR]: 0.999, 95% credible intervals [CrIs]: 0.89-1.13) and brodalumab (RR: 1.04, 95% CrIs: 0.91-1.17) and superior efficacy versus all other treatments in the network (RR range, 1.20 to 43.22). Guselkumab was superior or comparable to other therapies for other efficacy outcomes and had a more favorable safety profile than most. Guselkumab has one of the highest PASI 90 responses among psoriasis treatments; similar findings were observed for other efficacy outcomes. Guselkumab has a favorable benefit¨Crisk balance compared to moderate-to-severe psoriasis therapies
%K systematic review
%K network meta-analysis
%K psoriasis
%K biologic
%K guselkumab
%U https://journals.sagepub.com/doi/full/10.1177/2475530318818816