Guselkumab Benefits Patients With Skin of Color, Psoriasis
Guselkumab significantly improved skin clearance and quality of life in patients with moderate-to-severe psoriasis who self-identify as belonging to a racial or ethnic category other than White in a phase 3 trial.
METHODOLOGY:
Researchers conducted a phase 3b randomized study of a cohort in the VISIBLE trial, which included 103 adults with skin of color and moderate-to-severe psoriasis (mean age, 44.1 years; 28.2% women; Fitzpatrick skin types IV-VI, 68.9%) at 39 sites in the United States and Canada from August 2022 to June 2024.
More than 50% were non-White Hispanic, 23.3% were Asian, 10.7% were Black, and 7.8% were Middle Eastern individuals.
Participants were randomly assigned 3:1 to receive guselkumab or placebo with crossover to guselkumab at week 16.
Coprimary endpoints were Investigator's Global Assessment [IGA] score of 0 or 1 and Psoriasis Area and Severity Index (PASI) improvement of ≥ 90% at week 16. Secondary outcomes included complete clearance (IGA 0, PASI 100), percentage changes in PASI and body surface area, and Dermatology Life Quality Index (DLQI) scores.
TAKEAWAY:
At week 16, a significantly higher proportion of patients treated with guselkumab than those on placebo achieved IGA 0/1 (74.0% vs 0; P < .001) and PASI 90 (57.1% vs 3.8%; P < .001). No serious adverse events were reported at that time.
Complete clearance was higher in the guselkumab group: IGA 0 (32.5% vs 0%; P < .001) and PASI 100 (29.9% vs 0%; P = .002).
At week 16, guselkumab led to greater improvements in PASI (least-squares mean [LSM] change, 84.5% vs 8.3%; P < .001), body surface area (LSM change, 78.0% vs -0.4%; P < .001), and DLQI (LSM change, -12.1 vs -2.5; P < .001).
By week 48, two patients experienced serious adverse events and more than 70% of participants had IGA 0/1 and PASI 90 in both treatment groups, with nearly 50% achieving complete clearance.
IN PRACTICE:
The findings showed that 'guselkumab is highly effective for the treatment of moderate-to-severe plaque psoriasis in individuals with skin of color, inclusive of all objectively measured skin tones,' the authors wrote. The trial also demonstrated, they added, 'that achievement of diversity in randomized clinical trials is attainable, including in diseases like psoriasis, where prevalence is lower in those with skin of color.'
SOURCE:
The study was led by Andrew Alexis, MD, MPH, Department of Dermatology, Weill Cornell Medicine, New York City, and was published online on June 25 in JAMA Dermatology.
LIMITATIONS:
Use of handheld colorimeters introduced new measurement tools that lacked established reference data.
DISCLOSURES:
This study was supported by Johnson & Johnson. Alexis reported receiving personal fees and grants from multiple pharmaceutical companies, including Johnson & Johnson. Several other authors reported receiving personal fees, grants, advisory fees, research funding, and having stock options in multiple companies, including Johnson & Johnson.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
26 minutes ago
- Yahoo
Flesh-eating bacteria have caused several deaths in Florida and Louisiana this summer. How to reduce your risk of Vibrio vulnificus infection before swimming in the ocean.
Infections are rare, but a person can get sick by swimming in the ocean with an open wound or by eating contaminated raw shellfish. Health officials in several states are alerting residents about a flesh-eating bacteria that thrives in warm coastal waters. Approximately 60 cases of Vibrio vulnificus have been confirmed in 11 states, according to Today. The highest numbers have been in Louisiana (17 cases, including 4 deaths) and Florida (16 cases, including 5 deaths). North Carolina has also seen 7 cases, Yahoo News confirmed with the state's Department of Health and Human Services via email. Vibrio vulnificus cases are considered rare, with between 150 and 200 infections reported in the U.S. each year, according to the Cleveland Clinic. However, many people with an infection can become seriously ill, requiring intensive care or limb amputation. 'About 1 in 5 people with this infection die, sometimes within a day or two of becoming ill,' according to the Centers for Disease Control and Prevention. Does this mean you should avoid the ocean altogether? Here's what to know and what safety measures to keep in mind: What is Vibrio vulnificus? Vibrio are a type of bacteria that thrive in warm coastal waters during the summer months from May to October. This includes salt water and brackish water, which is a mixture of salt and freshwater often found where rivers meet the ocean. The bacteria are found particularly along the Gulf Coast states like Florida, Louisiana, Texas, Alabama and Mississippi. There are different kinds of Vibrio that can lead to various infections. Vibrio vulnificus can be particularly dangerous because it can cause severe and life-threatening infections. This specific type of bacteria is known as 'flesh-eating' because it can destroy muscle tissue and skin. 'Many people with [Vibrio] vulnificus wound infection require intensive care or surgical tissue removal,' the CDC says. How do people get infected? There are two ways that people can get infected: When a person's open wound is exposed to ocean water or seafood contaminated with Vibrio bacteria. A small cut, scrape or wound from a recent surgery, piercing or tattoo can allow bacteria in. This can happen when a person goes swimming or fishing or prepares raw seafood. When someone eats raw or undercooked seafood or ingests contaminated water while swimming. Oysters, in particular, can concentrate the Vibrio bacteria inside them. What are the symptoms of a Vibrio infection? These are the common signs and symptoms of a Vibrio infection, according to the CDC: Watery diarrhea Stomach cramps Nausea and vomiting Fever/chills Signs of a Vibrio bloodstream infection: Fever/chills Dangerously low blood pressure Blistering skin lesions Signs of a Vibrio wound infection: Fever Pain, redness, swelling, warmth at the wound site Redness Pain Swelling Warmth Discoloration (turning a color other than normal) Discharge (leaking fluids) The Cleveland Clinic and the CDC advise people to go to the emergency room immediately if there are signs of a suspected Vibrio vulnificus infection. Are some people more at risk of an infection? Anyone can become infected with the bacteria through a wound. People with underlying health conditions like liver disease, diabetes and immunocompromising conditions are at higher risk for wound infection, according to the CDC. How can people stay safe? Florida's Health Department and the CDC provide some tips to prevent Vibrio vulnificus infections: Don't eat raw oysters and other raw shellfish. Instead, cook them thoroughly. Avoid cross contamination with raw seafood and other cooked food or shellfish. If you have an open wound or broken skin, avoid warm salt or brackish water, if possible. Cover your wound with a waterproof bandage if it could come into contact with coastal water, raw seafood or its drippings or juices. Wear protective gloves or clothing when handling raw shellfish. Be vigilant after coastal floods, hurricanes and storm surges. Coastal waters forced into inland areas increase the risk for Vibrio wound infections, particularly for people who are older or who have underlying health conditions.
CBS News
29 minutes ago
- CBS News
Trusty K-9 companion suiting up to keep University of Minnesota medical student safe
A dog named Nova is suiting up for a very special purpose: keeping a close eye on her human, University of Minnesota medical student Wesley Flint. "Everyday we come in and I put on her boots and her lab coat and her goggles," Flint said. It's all part of Nova's personal protection equipment (PPE) routine as Flint's trusted assistant. Nova is led to her work space, a plush mat under a nearby table, and patiently waits until she's needed. "She's my medical alert dog. I'm a Type-1 diabetic," Flint said. "Diabetic alert dogs can actually smell the change in your blood sugar before any glucose sensor can pick it up a lot of the time." Sometimes, Nova can sense a blood-sugar drop up to a half hour before Flint's arm sensor does. "When my blood sugar is low, she'll get off the mat and come over to me and head butt me against the thigh," Flint said. "If she gives me an alert, I can check my sensor to see which way I'm trending. She's pretty accurate. Pretty rare for her to be wrong." Is Flint worried about technology or AI replacing Nova some day? "I don't think AI has a nose yet, and I'm not sure we can manufacture a robotic nose sensitive enough," Flint said.
CBS News
29 minutes ago
- CBS News
Massachusetts firefighter with PTSD fights for disability benefits: "This is costing people's lives"
Jeff Sirois's flashbacks come on without warning. They are vivid memories of the worst traumas the Methuen fire lieutenant experienced over his more than two-decade long career. During one of those traumas, Sirois tried to resuscitate a baby who was in a car that filled with engine exhaust. "And I have the mother the whole time screaming, 'save my baby, save my baby, that's all I have to live for.' And the baby didn't make it," Sirois recalled, "I was a mess because, at the time, I had a one-and-a-half-year-old." In the moment, Sirois did not realize that the symptoms of Post Traumatic Stress Disorder were seeping into his life. "I would cry all the time. I'd have panic attacks. I would have flashbacks. I didn't know what it was at the time until it was explained to me. My wife, I've known her since I've been four years old and she would say, I don't even know who you are," he said. In 2020, Sirois said he went to a call that broke him. He claims he was in a smoke-filled basement when he started to lose oxygen from his mask. "I'm lost in this room and now I'm panicking. I had a severe panic attack. Thought I was going to die," he said. Since then, Sirois says he has fought for his life and for a Methuen Retirement Board to recognize his disability and compensate him for it. In Massachusetts, first responders who can prove they were injured on the job are eligible for 72% of their salary, tax free, for life with approval from a local retirement board. In Methuen, the board is made up five people, some of them elected, others appointed by the mayor. After the 2020 call, Sirois says his therapist diagnosed him with severe complex PTSD. He left work and had four different inpatient hospital stays and then applied for retirement benefits. Despite input from roughly a dozen doctors who connected his PTSD to his job, the board denied him twice. "It's just insane when I have all these doctors saying the same thing," Sirois said. The problem for Sirois is a Massachusetts law which requires injured first responders to seek retirement within two years of being injured. His therapist, Jeff Zeizel, told WBZ that formula does not work when it comes to PTSD. "The problem with the two year rule is a first responder could be exposed literally decades prior, the systems show up currently," Zeizel said. There is proposed legislation at the State House to amend the two year rule. The 2020 call happened within two years of Sirois seeking retirement but the Methuen Retirement Board sent WBZ a statement saying the board did not agree that that event caused Sirois's PTSD. "Thus, while Mr. Sirois was able to convince the medical panel which examined him that the December 29, 2020 incident was what caused him to stop working 6 months later and aggravated his PTSD to the point of permanent incapacity, the Board - as the fact finder - believes the evidence does not support that opinion," said Michael Sacco, an attorney who represents the Methuen Retirement Board. Zeizel also argues that retirement boards have the power to disregard medical opinions. "You have non-medical or psychiatric professionals rendering opinions about psychiatric injuries that they have no experience about," he said. Sirois appealed the Board's denials and won his appeal before a magistrate. Now, the Retirement Board is seeking to overturn that decision before another state board, a process which could take five to seven years. While he waits, Sirois says he wants to help erase the stigma around first responder mental health and help others who are suffering from PTSD seek treatment. "I can't take the pressure. I can't take the sadness. I can't take the pain. I can't take the people not believing me. It's got to change. This is costing people's lives," he said. If you or someone you know is a first responder suffering from mental health issues, there are resources in our area:
