Guselkumab Treatment Outcomes and Persistence in a Nationwide Real-world Cohort of Patients with Plaque Psoriasis

Guselkumab treatment outcomes and persistence were assessed in a real-world cohort of Finnish patients with difficult-to-treat plaque psoriasis over a median follow-up of 1 year. Data on 181 patients who initiated guselkumab at the 15 study centres were collected retrospectively from the patient charts. Prior exposure to biologic therapies was common with 56% and 35% having used at least 1 and 2 biologics, respectively. Median guselkumab treatment duration was 11 months with 21 patients (12%) discontinuing treatment during follow-up. Of 85 patients with a follow-up duration of at least 1 year, 73 (86%) were still on guselkumab at 1 year. Significant improvements during follow-up were seen in the absolute Psoriasis Area and Severity Index (PASI) scores with 32 patients (80%) having absolute PASI ≤ 2 after a 9–14-month treatment. Guselkumab treatment was effective and treatment persistence was high in the nationwide Finnish real-life setting.

Non-Alcoholic Fatty Liver Disease Is Associated With Reduced Glomerular Filtration Rate in Patients With Chronic Plaque Psoriasis

Background Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated. Objectives To assess whether NAFLD is associated with impaired renal function in patients with psoriasis. Methods A multicenter, retrospective, observational study including 337 patients with moderate-to-severe chronic plaque psoriasis, who had no history of excessive alcohol consumption or other secondary causes of chronic liver and renal diseases was conducted. NAFLD was diagnosed by ultrasonography, and CKD stage ≥2 or stage ≥3 were defined by an estimated glomerular filtration rate (e-GFR) of <90 ml min-1 1.73 m-2 or <60 ml min-1 1.73 m-2, respectively. Logistic and linear regression analyses were undertaken to assess the independent association of NAFLD with CKD or eGFR levels. Results Patients with NAFLD ( n = 212, 62.9% of total) had significantly lower e-GFR levels (83.4 ± 18.0 vs. 93.5 ± 15.8 ml min-1 1.73 m-2, P<.001) and a remarkably higher prevalence of both CKD stage ≥2 (56.1% vs. 30.4%, P<.0001) and CKD stage ≥3 (10.4% vs. 3.2%, P<.0001) compared with their counterparts without NAFLD. Multivariable logistic regression analysis showed that NAFLD was associated with a nearly 2.5-fold increased risk of prevalent CKD stage ≥2 (adjusted-odds ratio= 2.60 95% confidence intervals 1.4–4.8, P=.02), independently of components of metabolic syndrome, psoriasis severity, and psoriatic arthritis. Conclusions Ultrasound-diagnosed NAFLD is strongly associated with a reduced eGFR in patients with moderate-to-severe psoriasis, independently of cardiometabolic risk factors and psoriasis-related variables.