Psoriasis (PsO) patients have multiple biologic treatments to choose from, including the interleukin-23 inhibitors guselkumab and risankizumab. Both have demonstrated superior skin efficacy, as assessed using Psoriasis Area and Severity Index (PASI) scores, in their respective trials. While no direct comparisons between these treatments have been conducted, indirect treatment comparisons (ITCs) can be used to help inform treatment selection for clinicians.
To bridge this gap, Richard G. Langley, M.D.; the team at Janssen Pharmaceuticals (Sarah Alulis, Fareen Hassan, Steve Peterson, Rachel E. Teneralli and Jennifer Lee); and the Value & Evidence team at EVERSANA (Barkha P. Patel and Tim Disher) indirectly compared guselkumab and risankizumab using an unanchored matching-adjusted indirect comparison (MAIC) on change from baseline PASI scores. This technique involves matching the guselkumab and risankizumab cohorts on eligibility criteria and reweighting the matched guselkumab patients to align with the characteristics of the risankizumab trial
Prior ITCs of guselkumab and risankizumab have examined responder definitions for PASI scores (i.e., categorized thresholds of 50%, 75%, 90% and 100%), which have known limitations. To address these limitations, the current study analyzed PASI scores as a continuous measure in the form of percent improvement from baseline from week 4 through week 40.
The MAIC results demonstrated that guselkumab and risankizumab deliver comparable mean percent change from baseline in PASI, though the differences between treatments were small and their clinical significance is unclear. This finding is key, as previous analyses based on responder definitions may have overestimated treatment differences. For decision-makers and clinicians, this study underscores the value of ITCs in guiding optimal PsO treatment strategies.
For a deeper understanding, access the JAAD International article: https://pubmed.ncbi.nlm.nih.gov/38882038/.
Author
Barkha is a Manager on the Value & Evidence team at EVERSANA and supports various projects in Health Economics and Outcomes Research (HEOR). Since joining in 2021, Barkha has worked on a number of…
Senior Director, Biostatistics
Tim is an experienced analyst and emerging thought leader in the application of Bayesian methods to complex problems. His Vanier Canada Graduate Funded dissertation research focused on the incorporation of multivariate evidence synthesis in…