Evaluation of Short-to-medium Term Efficacy of Guselkumab and Secukinumab in Overweight and Obese Patients with Moderate to Severe Plaque Psoriasis: A 24-Week Single-center Retrospective Study

Abstract Background: Overweight and obesity are common in patients with psoriasis and are associated with increased disease severity and declined treatment response. Aims: To evaluate the short-to-medium term (24w) efficacy and safety of two biologics, including Guselkumab and Secukinumab, in overweight and obese patients (body mass index BMI ≥25 kg/m 2 ) with moderate to severe psoriasis. Materials and Methods: We retrospectively analyzed the data of patients with moderate to severe plaque psoriasis treated with Guselkumab or Secukinumab in Dermatology Hospital of Southern Medical University in 2020. Totally 34 and 67 patients were treated with Guselkumab and Secukinumab, respectively; the patient groups with BMI ≥25 kg/m 2 comprised 16 and 33 cases, respectively. Baseline demographics and clinical characteristics were recorded, and Psoriasis Area and Severity Index (PASI) scores, adverse events, and biochemical parameters were assessed at weeks 12, 16, and 24. Results: Both Guselkumab and Secukinumab demonstrated good clinical efficacy. In patients with BMI ≥25 kg/m 2 , there was a higher percentage of cases achieving PASI 100 at week 16 in the Secukinumab group; however, at week 24, the proportion of patients treated with Guselkumab achieving PASI 100 was significantly higher than that of cases treated with Secukinumab ( P = 0.037 and P < 0.001, respectively). Conclusions: Guselkumab and Secukinumab demonstrated good short-to-medium-term efficacy in Chinese patients with moderate to severe plaque psoriasis. In patients with a BMI ≥25 kg/m 2 , Secukinumab demonstrated a faster onset of efficacy, while Guselkumab demonstrated significantly higher efficacy at week 24.