Guselkumab Improves QoL in Plaque Psoriasis Patients, According to Long-Term G-EPOSS Study Results

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A new analysis of the G-EPOSS study in patients with moderate-to-severe plaque psoriasis revealed the long-term effects of guselkumab regarding clinical efficacy, quality of life, sexual impairment, and perceived stigmatization.¹ The long-term data confirms that treatment with the interleukin-23 inhibitor not only addresses the physical symptoms of the condition but also improves overall patient wellbeing.

Methods & Materials

G-EPOSS is a prospective, non-interventional, German multicenter study that included 295 enrolled patients over 76 weeks. The trial took place between October 2019 and August 2021 at 44 sites. Patients were divided into sub-categories based on body mass index (BMI), age, disease duration, sex, presence of anogenital psoriasis, or depression. They received 100 mg of guselkumab at week 0, week 4, and every 8 weeks thereafter. Over 26% of participants had previously used biologic therapy for their disease.

The primary endpoint was a score of ≤ 3 on the Psoriasis Area and Severity Index (PASI) at week 28. The average baseline PASI was 15.3 with a mean disease duration of 17.4 years. Furthermore, 63.6% of the population had a disease duration of > 10 years. These initial 28-week findings were previously published in 2024.2 Secondary endpoints over 76 weeks are as follows:

• PASI
• Nail Psoriasis Severity Index (NAPSI)
• anogenital Physician's Global Assessment (aPGA)
• Dermatology Life Quality Index (DLQI)
• Relationship and Sexuality Scale (RSS)
• Perceived Stigmatization Questionnaire (PSQ)
• Patient Benefit Index (PBI)

Clinical Efficacy

At week 76, 87.5% of patients achieved PASI ≤ 3, and 47.3% achieved PASI = 0. The mean PASI had decreased to 1.2 by the end of the study. It was found that those with shorter disease duration had higher response rates. Overall, 18.3% of patients were super-responders. A “super response” was defined as a PASI of 0 at weeks 20 and 28. This group also had higher response rates with 95.7% (44/46), 93.5% (43/46), and 82.6% (38/46) achieving PASI ≤ 3, PASI ≤ 1, and PASI = 0, respectively.

The mean NAPSI improved from 4.7 at baseline to 1.3 and the mean aPGA score decreased from 2.7 at baseline to 0.3. It dropped as low as 0.1 in super-responders. These rates improved significantly in each of the subgroups, including BMI, which observed a high aPGA = 0 response rate. Among patients with NAPSI ≥ 1 or aPGA ≥ 1 at baseline, NAPSI = 0 and aPGA = 0 were achieved by 52.2% and 75.8% of patients at week 76, respectively. Improvements in anogenital psoriasis were also noted and no new safety outcomes were recorded. The most common adverse events were infections and infestations as well as administration-site reactions.

Patient-Reported Outcomes

By week 76, 67.4% (149/221) of patients achieved DLQI = 0/1. Average DLQI improved in all patients, regardless of disease duration (11.3 to 1.5). Notably, those with aPGA ≤ 1 at week 28 (n = 110) had lower mean DLQI at the end of the study. After treatment with guselkumab, participants expressed that their skin was less itchy, sore, and painful, and they generally experienced less embarrassment over their condition. Constant perceived stigmatization decreased from 61.6% to 13.1%, with a more significant impact on patients with depression. Over 91% of patients shared that their disease did not impact social and leisure activities, while 88.7% had fewer problems with partners, relatives, or friends, and only 1.8% were having severe sexual difficulties.

Improvements in relationships and sexuality, regardless of age, BMI, and gender, were some of the most prominent findings. Those in the 18 to 30-year-old group had the greatest improvement. Rates of sexual fear decreased from 33.7% to 8.4% after guselkumab therapy and almost 50% of participants were satisfied with the frequency at which they were having sexual intercourse

Conclusion

This research stresses the deeper aspects of plaque psoriasis and can guide ideal treatment strategies for clinicians and patients. The authors believe that G-EPOSS is the first study to assess sexuality and perceived stigmatization in patients with psoriasis across a broad range of demographics and characteristics.

“The findings emphasize the importance of involving the patient's view and considering sensitive topics not always openly communicated by patients...a holistic view of patients and their treatments is important for optimal care,” the authors wrote.

References

1. Gerdes S, Weisenseel P, Groß D, et al. Long-Term Impact of Guselkumab on Skin, Sexuality, and Perceived Stigmatization in Patients With Psoriasis in Routine Clinical Practice: Week 76 Effectiveness and Safety Results From the Prospective German Multicenter G-EPOSS Study. J Dermatol. Published online August 9, 2025. doi:10.1111/1346-8138.17866

2. Gerdes S, Ostendorf R, Süß A, et al. Effectiveness, safety and impact of guselkumab on sexuality and perceived stigmatization in patients with psoriasis in routine clinical practice: Week 28 results from the prospective German multicentre G-EPOSS study. J EurAcad Dermatol Venereol. 2025;39 Suppl 1(Suppl 1):15-26. doi:10.1111/jdv.19927