OBJECTIVES: Describe the differences in patient characteristics initiating guselkumab for treatment of plaque psoriasis by country (US, Germany, France, Italy, Spain, and United Kingdom).

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 time of initiation of guselkumab. Differences between guselkumab users (GUS-users) by country of origin were assessed; differences <0.05 considered significant.

RESULTS: 493 patients initiated guselkumab, 26.4% from US, 20.1% Germany, 16.6% France, 15.0% Spain, 10.3% Italy, 11.6% UK. The majority were male (59-73%) with a median age ranging from 41-43 years, and average time on guselkumab ranged 8-24weeks. Significant differences in race, employment, BMI, disease duration and severity, co-morbidities, treatment history, and time on guselkumab were observed. US had the highest full-time employment(82%), shortest median overall PsO disease-duration (3.0 years) at time of survey and highest concomitant PsA(30%). Germany had more severe disease activity (median BSA of 30) and were more likely bio-naïve(75%), had the highest percentage of concomitant-topical therapy(57%), and depression(17%). France reported the highest percentage of anxiety(27%) as well as sensitive area lesions (scalp, face, nails, genitalia, palms, soles feet)(59%). UK had the highest non-white percentage(30%), highest median BMI(27), longest overall PsO duration at time of survey(10.4 years), highest physician-reported severity(81%), and were more likely to be treated with biologic as monotherapy(79%). Spain had shortest median duration on guselkumab therapy at 4 weeks(IQR 8-12).

CONCLUSIONS: Patient and disease characteristics of GUS-users initiating therapy in 2018-2019 varied by country with evidence of higher disease burden (severity and PsO duration) in the UK. These differences may be an important aspect of assessing and comparing treatment outcomes of patients from different countries.