4CPS-086 Observational study to assess guselkumab adherence in clinical practice in patients with moderate to severe psoriasis

<h3>Background and Importance</h3> Despite the established relationship between clinical outcomes and patient-reported outcomes (PROs), discrepancies often arise between clinical remission and patients’ perceptions of their symptoms. Integrating PROs is essential for comprehensive assessment, and effective monitoring and optimisation of biologic therapies, especially important in implementing value-based healthcare for patients with psoriasis. <h3>Aim and Objectives</h3> The main objective is to assess 12-month adherence to guselkumab in patients with moderate to severe psoriasis in real-world clinical setting. Secondary objectives included the relationship between adherence and PROs. <h3>Material and Methods</h3> Observational, prospective multicentre study (39 centres) including adult patients with moderate to severe psoriasis who started guselkumab treatment. Baseline characteristics including psoriasis area severity index (PASI), body surface area (BSA) and dermatology life quality index (DLQI) were recorded. Medication Possession Ratio (MPR) and Morisky Medication Adherence Scale (MMAS-8) were used to assess optimal adherence (MPR≥90% and/or MMAS-8=8). PROs questionnaires completed on-line including medication satisfaction questionnaire (TSQM) and the psoriasis signs and symptoms diary (PSSD). We present a 6-month interim analysis. <h3>Results</h3> Of 215 patients (50.6 years, SD 11.9), 97 (45.1%) completed the 6-month visit. Mean psoriasis progression was 17.2 years (SD 13.56 n=149), 31.3% had psoriatic arthritis, 48.8% had ≥10% BSA, and 86.2% had previously received biologics. Mean basal PASI was 10.5 (SD 7.8, n=92), with 75.5% having PASI &gt;5, and mean basal DLQI was 10.4 (SD 6.5, n=83). At 6 months, 79 (n=94, 84.0%) patients were adherent according to MPR, 48 (n=62, 77.4%) according to MMAS-8, and 39 (n=60, 65.0%) combining MPR and MMAS-8 criteria. TSQM for global satisfaction and PSSD lacked significant differences between adherent (combined assessment) and non-adherent patients at baseline. At 6 months, mean (SD) TSQM scores were 80.5 (13.6) in adherent patients and 66.1 (18.2) in non-adherent (p=0.0010); mean (SD) PSSD symptoms and PSSD signs of adherent and non-adherent patients were 16.2 (15.7) and 35.1 (28.1) (p=0.0080) and 17.7 (15.3) and 36.6 (24.3) (p=0.0031), respectively. <h3>Conclusion and Relevance</h3> At 6-months of guselkumab treatment, a significant proportion of patients (&gt;65%) remained adherent according to the three adherence criteria. Adherent patients have a lower perception of psoriasis symptoms and higher satisfaction with treatment compared to non-adherent. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> Corporate sponsored research or other substantive relationships: Research sponsored by Johnson and Johnson