Guselkumab induction therapy demonstrates long-lasting efficacy in patients with mild psoriasis, results from a randomized, placebo-controlled exploratory clinical trial

To the Editor: Biologics are rapidly becoming the standard of care for managing moderate-to-severe psoriasis but remain unavailable for patients with mild psoriasis. After exhausting topical treatment options, these patients are commonly left without effective treatment modalities due to the unfavorable benefit-to-risk profile associated with systemic treatments and high costs of biologics. 1 Menter A. Gelfand J.M. Connor C. et al. Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies. J Am Acad Dermatol. 2020; 82: 1445-1486 Abstract Full Text Full Text PDF PubMed Scopus (146) Google Scholar A “hit hard and early” approach for patients with moderate-to-severe psoriasis has been proposed that holds prospects of long-term disease modification. 2 Eyerich K. Weisenseel P. Pinter A. et al. IL-23 blockade with guselkumab potentially modifies psoriasis pathogenesis: rationale and study protocol of a phase 3b, randomised, double-blind, multicentre study in participants with moderate-to-severe plaque-type psoriasis (GUIDE). BMJ Open. 2021; 11e049822 Crossref Scopus (27) Google Scholar Extending this approach to mild psoriasis may constitute a novel therapeutic strategy. Here, we report on the efficacy of anti-interleukin (IL)-23 therapy in mild psoriasis and its potential for the induction of long-term disease remission.