OBJECTIVES: Describe characteristics of patients initiating guselkumab as compared to other biologics for treatment of plaque psoriasis (PsO) in the real-world.

METHODS: Retrospective, observational cohort study using cross-sectional survey data from Adelphi Psoriasis IX Disease Specific Program^® collected August 2018-March 2019 within the US and EU5 (Germany, France, Italy, Spain, UK). Demographic and clinical factors were assessed at time of survey and disease characteristics at biologic initiation. Differences between guselkumab-users (GUS-users) and other biologic-users (non-GUS-users) and by biologic class (αTNF, IL-17, IL-12/23) were assessed; differences <0.05 considered significant.

RESULTS: Among PsO patients receiving biologic therapy (n=1428), median age was 45 years, and majority (58.8%) were male. Compared to non-GUS-users (n=935), GUS-users (n=493) were significantly younger (43 vs 45 years, p<0.01), had lower BMI (25.7 vs 26.2 BMI, p=0.03), and higher full-time employment (66.5% vs 62.6%, p<0.01). GUS-users had shorter duration of PsO compared to non-GUS-users, IL-12/23-users, and IL-17-users (7.2 vs 9.4/10.1/9.7 years, p<0.01/p=0.01/p<0.01, respectively); higher rates of hypertension as compared to non-GUS and IL12/23-users (17.4% vs 22.0%/25.3%, p=0.04/p=0.03, respectively); lower PsA rates compared to non-GUS-users (15.8% vs 25.7%, p<0.01). Concomitant psoriasis medication use was comparable between GUS and non-GUS-users (42% vs 40.3%). However, GUS-users were more likely bio-experienced (43.6% vs 32.5%, p<0.01) with 14.6% of GUS-users having >2 biologics prior to GUS-initiation. Although there were no significant differences between physician-reported disease severity, at treatment initiation GUS-users had higher mean BSA compared to non-GUS-users (25.1(SD17.4) vs 22.9(SD16.3), p=0.02) and greater likelihood of sensitive area lesions (scalp, face, nails, genitalia, palms, soles feet) (46.3% vs 38.5%, p<0.01).

CONCLUSIONS: GUS-users initiating therapy in 2018-2019 were younger, more bio-experienced, and had evidence of higher disease burden (BSA, sensitive area lesions) compared to other biologic therapies. Understanding the potential impact of patient baseline characteristics on treatment outcomes is an important consideration that warrants future research.