Tremfya super response study

[Fred]

This study looked at the baseline characteristics of patients with moderate to severe psoriasis achieving super response with Tremfya (guselkumab)

Quote:

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Background:
Psoriasis is a chronic immune-mediated inflammatory skin disease that often leads to a diminished quality of life. Goals of treating patients with psoriasis have shifted with more focus on achieving near or complete clearance of the skin. Guselkumab, a fully human monoclonal antibody targeting interleukin-23, is effective in treating moderate-to-severe psoriasis.

Objective:
To describe the baseline characteristics of patients with moderate-to-severe psoriasis achieving super-response (Psoriasis Area and Severity Index [PASI] 100 response at Weeks 20 and 28) after commencing guselkumab treatment.

Methods:
Pooled data from VOYAGE-1 and VOYAGE-2 studies identified super-response; baseline demographic, disease, and pharmacokinetic characteristics were compared with non-super-response. A stepwise logistic regression analysis identified which factors were potentially predictive of super-response status, with significance level of 0.1.

Results:
A subset of patients randomized to guselkumab comprised this post hoc analysis (n=664); 271 patients achieved super-response vs 393 with non-super-response. Patient age at study entry and baseline body weight (≤90 kg vs >90 kg), PASI, and Investigator’s Global Assessment (IGA) score were significant predictors of super-response status, with odds ratios (95% confidence intervals) of 0.98 (0.967-0.993; p=0.003), 1.42 (1.026-1.977; p=0.034), 0.97 (0.955-0.993; p=0.007), and 0.66 (0.433-0.997; p=0.048), respectively. More patients with super-response achieved an early response: Week 2 PASI 75 (5.5% vs 1.8%) and Week 8 PASI 100 (22.5% vs 3.3%) vs non-super-response. Median serum guselkumab concentrations through Week 28 were slightly greater in patients with super-response vs non-super-response.

Conclusion:
Guselkumab was more likely to achieve early clinical responses (complete skin clearance) in younger patients, less obese patients, and patients with less severe psoriasis.

Source: onlinelibrary.wiley.com

*Early view funding unknown

Tremfya (guselkumab)

[KatT]

Maybe the doses (for any biologic) should be adjusted based on weight, age and severity!

[Caroline]

Interesting.
We know that e.g. obesity is a negative factor for psoriasis.
And also it seems logical that if your psoriasis is severe, that it is harder to get rid of it….

This research now shows a definition that:
If you are young, so perhaps psoriasis is relatively new.

If you are not obese, but slender, so there is no negative factor for your psoriasis

If your psoriasis is less severe……

THEN…. You may be a super-responder to the treatment with Tremfya….

Which in my opinion is total nonsense, as probably “any” treatment will work better under this circumstances.
They are introducing a term that signals a situation that is completely logical and can be deducted by anyone with some kind of a thinking brain.

Mixing this with some statistical formulas, and there we have a new result.. pfff…. Stepping off my box again.

[mataribot]

Just like other diseases, P and PSA need a weight based dose of biologics. IBDs and other inflammatory diseases get weight based doses... That's why they start failing around the 6 month mark - the loading dose runs out.

[mataribot]

Many dermatologist in the states try to use the newer biologics as a temporary cure for P. Most people respond rather well to them, and with the IL-17 or 23's it take about a year before you flare up bad. They completely ignore the fact that arthritis doesn't respond similarly...