Summary

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• This summary is based on the review of 32 systematic review(s)/meta-analysis(es). ^[1-32]
• Palmoplantar Pustulosis (PPP): Guselkumab showed efficacy in treating PPP, with a PPPASI-50 response ranging from 57.4% to 78.3% at week 16. A network meta-analysis found a significant improvement in palmoplantar score (weighted mean difference of 31.73).
• Psoriatic Arthritis (PsA): Guselkumab had a significantly higher ACR20 response rate compared to placebo (RR = 1.74) and demonstrated better skin efficacy (PASI 90) than TNF and JAK inhibitors. ACR responses were similar to IL-17 inhibitors, risankizumab, and upadacitinib.
• Psoriasis: Guselkumab was more effective than adalimumab in achieving PASI 75, PASI 90, and IGA 0/1 scores. It consistently ranked highly in network meta-analyses for achieving PASI 90 and PASI 100, outperforming biologics such as ustekinumab and anti-TNF agents.
• Comparison with Other Drugs: Guselkumab was superior to ustekinumab, adalimumab, and certolizumab in achieving PASI 90 responses, with some comparisons showing risankizumab, ixekizumab, and brodalumab having higher PASI responses.
• General Safety: Guselkumab had a similar incidence of adverse events (AEs) and serious adverse events (SAEs) compared to placebo and adalimumab. Common adverse effects included nasopharyngitis, headache, upper respiratory tract infection, and back pain.
• Specific Adverse Effects: Elevated transaminases were more frequent in the guselkumab group compared to placebo, but there was no significant difference in the risk of infections or serious infections.
• Guselkumab was effective and safe across various subgroups, including patients with palmoplantar pustulosis (PPP), psoriatic arthritis (PsA), and moderate-to-severe psoriasis. Clinically relevant findings include significant improvements in skin manifestations (PASI 90) for PsA patients and long-term efficacy and safety in moderate-to-severe psoriasis. Additionally, improvements in work productivity and activity impairment were noted in PsA patients.