Real-world Drug Survival of Guselkumab in Patients With Psoriasis Stratified by Weight and Comorbidities: Retrospective, Observational Data From the British Association of Dermatologists Biologics and Immunomodulators Register.

In the United Kingdom (UK), 89.1% of patients with moderate-to-severe psoriasis are overweight or obese, and 53.2% have at least one comorbidity. However, real-world data on biologic-treated patients with psoriasis and comorbidities remains limited. Objectives were to compare 36-month drug survival of guselkumab in patients across weight and body mass index (BMI) categories, and in those with or without specific comorbidities. This retrospective cohort study used data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), collected from January 2018 to July 2024. Co-primary outcomes were overall drug survival, and drug survival stratified by weight and BMI categories, over 36 months, for guselkumab-treated patients. Secondary outcomes included 36-month drug survival among guselkumab-treated patients with and without specific comorbidities, including but not limited to, metabolic syndrome, hypertension, anxiety and/or depression. Kaplan-Meier methodology was used to estimate probabilities for time-to-treatment discontinuation across all patient groups analysed. Among the 482 participants included in this analysis who initiated guselkumab treatment, 36-month drug survival was generally high, with an overall drug survival rate of 0.75 (95% CI, 0.71-0.79). Stratified by weight, drug survival rates were 0.71 (95% CI, 0.59-0.86) for patients <80 kg, 0.79 (95% CI, 0.71-0.87) for those 80-<90 kg, 0.74 (95% CI, 0.68-0.82) for those 90-<100 kg, and 0.74 (95% CI, 0.66-0.82) for those ≥100 kg. Drug survival by BMI category was 0.78 (95% CI, 0.71-0.86) for patients <30 kg/m2 and 0.73 (95% CI, 0.69-0.79) for those ≥30 kg/m2. Across all comorbidities analysed, drug survival at 36 months remained ≥0.69, with no significant differences observed in patients with comorbidities compared to those without. In this UK real-world analysis, drug survival rates for guselkumab over 36 months were consistent across patients with psoriasis in different weight and BMI categories, and were not adversely affected by the presence of comorbidities. This analysis has limitations due to the high proportion of missing weight and BMI data at baseline. Nonetheless, these findings support guselkumab use as a durable treatment option in routine practice, for patients with obesity and other common comorbidities.