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Review
. 2024 Jul 1;14(3):e2024181.
doi: 10.5826/dpc.1403a181.

Guselkumab - In Psoriasis and Beyond

Aditya Kumar Bubna  1 , Vinayak Viplav  1
Affiliations
Review

Guselkumab - In Psoriasis and Beyond

Aditya Kumar Bubna et al. Dermatol Pract Concept. .

Abstract

Introduction: Guselkumab is an interleukin 23p19 inhibitor, and the first in this group, to be approved by the US Food and Drug Administration for the management of moderate to severe psoriasis. Apart from its utility in psoriasis, there are a number of other dermatologic conditions where guselkumab has demonstrated value.

Objectives: The aim of this narrative review is to describe the utility of guselkumab in psoriasis as well as its implication in off-label dermatologic disorders.

Methods: Pubmed, Google Scholar, Scopus and ResearchGate were searched for scholarly articles related to guselkumab and its utility in dermatology using the search terms "Guselkumab" AND "Psoriasis" AND "other dermatological disorders".

Results: Guselkumab is a valuable biologic agent for the management of psoriasis and psoriatic arthropathy. It has also been used successfully for other dermatologic disorders like hidradenitis suppurativa, lichen planus, pityriasis rubra pilaris and pyoderma gangrenosum. Recently, its utility in Stewart-Treves angiosarcoma (STA) has been exemplified.

Conclusion: Guselkumab usage is not limited to psoriasis. Its benefit extends to many more dermatologic conditions. Its utility in STA could open an avenue for its application in the field of oncology. Furthermore, it has an acceptable safety profile.

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Conflict of interest statement

Competing Interests: None.

Figures

Figure 1
Figure 1
Level of evidence for the utility of guselkumab in off-label dermatologic indications. A: Double blind study: At least one prospective randomized double blind controlled trial without major design flaws. B: Clinical trial with 20 or more subjects: Prospective clinical trials with 20 or more subjects, trials lacking adequate controls or another key facet design, which would normally be considered desirable. C: Clinical trial with less than 20 subjects: small trials with less than 20 subjects with significant design limitations, very large number of case reports (at least 20 such in literature). D. Series of 5 or less subjects: Series of patients reported to respond with at least five reports of the same in literature. E: Anecdotal case reports.
Figure 2
Figure 2
Role of IL-23 in psoriasis pathogenesis.
Figure 3
Figure 3
Monitoring guidelines for guselkumab.
See this image and copyright information in PMC

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