{"title":"Efficacy and safety of guselkumab in European patients with palmoplantar pustulosis: A multi-center, single-arm clinical trial (GAP study)","authors":"Dagmar Wilsmann-Theis MD, PhD , Selina Patt , Andreas Pinter MD, PhD , Sascha Gerdes MD, PhD , Nina Magnolo MD , Robert Németh PhD , Jennifer Schmitz MSc , Cornelia Paul MD , Matthias Augustin MD, PhD , Petra Staubach MD, PhD , Ansgar Weyergraf MD , Ulrike Hüffmeier MD , Kerstin Wolk PhD , Robert Sabat MD, PhD , Rotraut Mößner MD, PhD","doi":"10.1016/j.jdin.2024.09.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disorder that affects palms and soles. Patients suffer significant pain, itching, and daily activity impairment. Guselkumab, an interleukin-23 inhibitor, has been approved for PPP treatment in Japan. However, there is no effective therapy licensed for PPP in Europe and the USA.</div></div><div><h3>Objective</h3><div>To explore the efficacy and safety of guselkumab in patients with moderate-to-severe PPP in the Caucasian population.</div></div><div><h3>Methods</h3><div>A multicenter, single-arm, phase II study involving 50 patients with moderate-to-severe PPP treated with 100 mg guselkumab subcutaneously for 24 weeks was conducted (GAP). Primary endpoint was the reduction of palmoplantar-pustulosis psoriasis area and severity index (PPPASI) at week 24 compared to baseline. Secondary endpoints included physician-assessed and patient-reported measures. Serum samples were taken for exploratory studies.</div></div><div><h3>Results</h3><div>The primary endpoint was met with a significant median PPPASI reduction by 59.6% at week 24 compared to baseline (<em>P</em> < .001). The proportions of patients achieving PPPASI-50 and PPPASI-75 at week 24 were 66.0% and 34.0%, respectively. Median dermatology life quality index dropped from 15 at baseline to 5 at week 24 (<em>P</em> < .001). Week 4 changes in interleukin-19 serum levels predicted week 24 clinical response.</div></div><div><h3>Conclusion</h3><div>Guselkumab may be a promising therapeutic option for PPP in Caucasian patients.</div></div>","PeriodicalId":34410,"journal":{"name":"JAAD International","volume":"18 ","pages":"Pages 69-78"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAAD International","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666328724001524","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background
Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disorder that affects palms and soles. Patients suffer significant pain, itching, and daily activity impairment. Guselkumab, an interleukin-23 inhibitor, has been approved for PPP treatment in Japan. However, there is no effective therapy licensed for PPP in Europe and the USA.
Objective
To explore the efficacy and safety of guselkumab in patients with moderate-to-severe PPP in the Caucasian population.
Methods
A multicenter, single-arm, phase II study involving 50 patients with moderate-to-severe PPP treated with 100 mg guselkumab subcutaneously for 24 weeks was conducted (GAP). Primary endpoint was the reduction of palmoplantar-pustulosis psoriasis area and severity index (PPPASI) at week 24 compared to baseline. Secondary endpoints included physician-assessed and patient-reported measures. Serum samples were taken for exploratory studies.
Results
The primary endpoint was met with a significant median PPPASI reduction by 59.6% at week 24 compared to baseline (P < .001). The proportions of patients achieving PPPASI-50 and PPPASI-75 at week 24 were 66.0% and 34.0%, respectively. Median dermatology life quality index dropped from 15 at baseline to 5 at week 24 (P < .001). Week 4 changes in interleukin-19 serum levels predicted week 24 clinical response.
Conclusion
Guselkumab may be a promising therapeutic option for PPP in Caucasian patients.