Comparative Efficacy of Ustekinumab and Guselkumab in Improving Itch in Severe Psoriasis Patients.

BACKGROUND

Biologics effectively improve psoriatic skin lesions, but their impact on itch relief remains unclear.

OBJECTIVE

To evaluate itch improvement in severe psoriasis patients treated with ustekinumab or guselkumab.

METHODS

This retrospective study analyzed patients with severe psoriasis who completed initial efficacy evaluations after treatment with either biologic. Itch severity was assessed using numerical rating scale (NRS), visual analog scale, and verbal rating scale. NRS improvement was evaluated after three injections.

RESULTS

Among 108 patients (74 on ustekinumab, 34 on guselkumab), 77 (71.3%) had moderate-to-severe itch (NRS ≥4) at baseline. Of these, 63 (81.8%) achieved an NRS improvement of ≥4 points. Ustekinumab showed greater itch relief compared to guselkumab in NRS (=0.033). On the other hand, guselkumab showed more reduction for psoriatic skin lesions than ustekinumab in the Psoriasis Area and Severity Index (=0.040). In the moderate-to-severe itch group, patients with large plaques experienced significantly greater improvement in NRS than those with small plaques (=0.012).

CONCLUSION

While guselkumab is generally preferred for psoriatic skin lesions, ustekinumab may provide superior itch relief.