Guselkumab - In Psoriasis and Beyond
Keywords:
guselkumab, psoriasis, hidradenitis suppurativa, pyoderma gangrenosum, pityriasis rubra pilarisAbstract
Introduction: Guselkumab is an interleukin 23p19 inhibitor, and the first in this group, to be approved by the US Food and Drug Administration (FDA) for the management of moderate to severe psoriasis. Apart from its utility in psoriasis, there are a number of other dermatologic conditions where guselkumab has demonstrated value.
Objectives: The aim of this narrative review is to describe the utility of guselkumab in psoriasis as well as its implication in off-label dermatologic disorders.
Methods: Pubmed, Google Scholar, Scopus and ResearchGate were searched for scholarly articles related to guselkumab and its utility in dermatology using the search terms “Guselkumab” AND “Psoriasis” AND “other dermatological disorders”.
Results: Guselkumab is a valuable biologic agent for the management of psoriasis and psoriatic arthropathy. It has also been used successfully for other dermatologic disorders like hidradenitis suppurativa, lichen planus, pityriasis rubra pilaris and pyoderma gangrenosum. Recently, its utility in Stewart-Treves angiosarcoma (STA) has been exemplified.
Conclusion: Guselkumab’s usage is not limited to psoriasis. Its benefit extends to many more dermatologic conditions. Its utility in STA could open an avenue for its application in the field of oncology. Furthermore, it has an acceptable safety profile.
References
Markham A. Guselkumab: First Global Approval. Drugs 2017;77(13):1487–92.
Wilson NJ, Boniface K, Chan JR, McKenzie BS, Blumenschein WM, Mattson JD, et al. Development, cytokine profile and function of human interleukin 17–producing helper T cells. Nat Immunol 2007;8(9):950–7.
McGeachy MJ, Bak-Jensen KS, Chen Y, Tato CM, Blumenschein W, McClanahan T, et al. TGF-β and IL-6 drive the production of IL-17 and IL-10 by T cells and restrain TH-17 cell–mediated pathology. Nat Immunol 2007;8(12):1390–7.
Jeon C, Sekhon S, Yan D, Afifi L, Nakamura M, Bhutani T. Monoclonal antibodies inhibiting IL-12, -23, and -17 for the treatment of psoriasis. Hum Vacc Immunother 2017;13:2247–59.
Ciric B, El-behi M, Cabrera R, Zhang GX, Rostami A. IL-23 Drives Pathogenic IL-17-Producing CD8+ T Cells. J Immunol 2009;182:5296–305.
Lin AM, Rubin CJ, Khandpur R, Wang JY, Riblett M, Yalavarthi S, et al. Mast Cells and Neutrophils Release IL-17 through Extracellular Trap Formation in Psoriasis. The Journal of Immunology 2011;187:490–500.
Gooderham MJ, Papp KA, Lynde CW. Shifting the focus – the primary role of IL ‐23 in psoriasis and other inflammatory disorders. J Eur Acad Dermatol Venereol 2018;32:1111–9.
Hawkes JE, Yan BY, Chan TC, Krueger JG. Discovery of the IL-23/IL-17 Signaling Pathway and the Treatment of Psoriasis. J Immunol 2018;201:1605–13.
Chan TC, Hawkes JE, Krueger JG. Interleukin 23 in the skin: role in psoriasis pathogenesis and selective interleukin 23 blockade as treatment. Ther Adv Chron Dis 2018;9:111–9.
Yang K, Oak ASW, Elewski BE. Use of IL-23 Inhibitors for the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review. Am J Clin Dermatol 2021;22:173–92.
Sofen H, Smith S, Matheson RT, Leonardi CL, Calderon C, Brodmerkel C, et al. Guselkumab (an IL-23–specific mAb) demonstrates clinical and molecular response in patients with moderate-to-severe psoriasis. J Allerg Clin Immunol 2014;133:1032–40.
Martini E, Wikén M, Cheuk S, Gallais Sérézal I, Baharom F, Ståhle M, et al. Dynamic Changes in Resident and Infiltrating Epidermal Dendritic Cells in Active and Resolved Psoriasis. J Investig Dermatol 2017;137:865–73.
Fotiadou C, Lazaridou E, Sotiriou E, Ioannides D. Targeting IL-23 in psoriasis: current perspectives. Psoriasis (Auckl). 2018;8:1-5.
Blauvelt A, Papp KA, Griffiths CEM, Randazzo B, Wasfi Y, Shen YK, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator–controlled VOYAGE 1 trial. J Amer Acad Dermatol 2017;76:405–17.
Langley RG, Tsai T ‐F., Flavin S, Song M, Randazzo B, Wasfi Y, et al. Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, double‐blind, phase III NAVIGATE trial. Br J Dermatol 2018;178:114–23.
Reich K, Armstrong AW, Langley RG, Flavin S, Randazzo B, Li S, et al. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial. Lancet 2019;394(10201):831–9.
Du Jardin K, Lopez P, Lange M, McCool R, Naval S, Quickert S. A Systematic Literature Review and Bucher Indirect Comparison: Tildrakizumab versus Guselkumab. J Health Econ Outcomes Res 2020;123–9.
Griffiths CEM, Papp KA, Song M, Miller M, You Y, Shen YK, et al. Continuous treatment with guselkumab maintains clinical responses through 4 years in patients with moderate-to-severe psoriasis: results from VOYAGE 1. J Dermatolog Treat 2022;33:848–56.
Ohtsuki M, Kubo H, Morishima H, Goto R, Zheng R, Nakagawa H. Guselkumab, an anti‐interleukin‐23 monoclonal antibody, for the treatment of moderate to severe plaque‐type psoriasis in Japanese patients: Efficacy and safety results from a phase 3, randomized, double‐blind, placebo‐controlled study. The Journal of Dermatology 2018;45:1053–62.
Hall SL, Haidari W, Feldman SR. Resolution of Guttate Psoriasis Plaques After One-time Administration of Guselkumab. J Drugs Dermatol 2019;18(8):822–3.
Bartholomew E, Chung BY, Davis M, Yeroushalmi S, Chung M, Hakimi M, et al. Rapid Remission of Sunburn-Induced Guttate Psoriasis with Guselkumab. Dermatol Ther (Heidelb) 2023;13:2473–8.
Schwarz A, Bhardwaj R, Aragane Y, Mahnke K, Riemann H, Metze D, et al. Ultraviolet-B-Induced Apoptosis of Keratinocytes: Evidence for Partial Involvement of Tumor Necrosis Factor-α in the Formation of Sunburn Cells. J Investig Dermatol 1995;104:922–7.
McGonagle D, Tan AL, Benjamin M. The Nail as a Musculoskeletal Appendage – Implications for an Improved Understanding of the Link between Psoriasis and Arthritis. Dermatology 2009;218:97–102.
Kassir M, Kircik L, Weinberg J, Fatima F, Yamauchi P, Lotti T, et al. Treatment of Nail Psoriasis. J Drugs Dermatol 2022;21:146–50.
Egeberg A, See K, Garrelts A, Burge R. Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort. BMC Dermatol 2020;20:3.
Langley RG, Daudén E. Treatment and Management of Psoriasis with Nail Involvement: A Focus on Biologic Therapy. Dermatology 2010;221(Suppl. 1):29–42.
Kaeley GS, Eder L, Aydin SZ, Rich P, Bakewell CJ. Nail Psoriasis: Diagnosis, Assessment, Treatment Options, and Unmet Clinical Needs. J Rheumatol 2021;48(8):1208–20.
Temiz SA, Özer İ, Ataseven A, Dursun R, Uyar M. The effect of smoking on the psoriasis: Is it related to nail involvement? Dermatol Ther 2020;33:e13960.
Schwarz CW, Loft N, Rasmussen MK, Nissen CV, Dam TN, Ajgeiy KK, et al. Predictors of Response to Biologics in Patients with Moderate-to-severe Psoriasis: A Danish Nationwide Cohort Study. Acta Derm Venereol 2021;101:adv00579.
Pirro F, Caldarola G, Chiricozzi A, Burlando M, Mariani M, Parodi A, et al. Impact of Body Mass Index on the Efficacy of Biological Therapies in Patients with Psoriasis: A Real-World Study. Clin Drug Investig 2021;41:917–25.
Gerdes S, Bräu B, Hoffmann M, Korge B, Mortazawi D, Wiemers F, et al. Real‐world effectiveness of guselkumab in patients with psoriasis: Health‐related quality of life and efficacy data from the noninterventional, prospective, German multicenter PERSIST trial. J Dermatol 2021;48:1854–62.
Foley P, Gordon K, Griffiths CEM, Wasfi Y, Randazzo B, Song M, et al. Efficacy of Guselkumab Compared With Adalimumab and Placebo for Psoriasis in Specific Body Regions: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Dermatol 2018;154:676.
Blauvelt A, Leonardi C, Elewski B, Crowley JJ, Guenther LC, Gooderham M, et al. A head‐to‐head comparison of ixekizumab vs. guselkumab in patients with moderate‐to‐severe plaque psoriasis: 24‐week efficacy and safety results from a randomized, double‐blinded trial. Br J Dermatol 2021;184:1047–58.
Gerdes S, Hoffman M, Asadullah K, Korge B, Mortazawi D, Kruger N et al. Effectiveness, safety and quality of life effects of guselkumab and ustekinumab in patients with psoriasis: week 104 results from the non-interventional, prospective German multicentre PERSIST study. J Eur Acad Dermatol Venereol. 2023. doi: 10.1111/jdv.19296. Epub ahead of print. PMID: 37462295.
Jo SJ, Huang Y, Tsai T, Kim BS, Reich K, Saadoun C, et al. Efficacy of guselkumab in difficult‐to‐treat psoriasis regions: Data from VOYAGE 1 and VOYAGE 2 Asian subpopulations. J Dermatol 2023;50:1180–9.
Farley E, Masrour S, McKey J, Menter A. Palmoplantar psoriasis: A phenotypical and clinical review with introduction of a new quality-of-life assessment tool. J Am Acad Dermatol 2009;60:1024–31.
Raposo I, Torres T. Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects. Am J Clin Dermatol 2016;17:349–58.
Passeron T, Carrascosa JM, Warren RB, Pinter A, Romanelli M, Gorecki P, et al. A Phase IIIb, Multicentre, Interventional, Randomised, Placebo-Controlled Clinical Trial Investigating the Efficacy and Safety of Guselkumab for the Treatment of Nonpustular Palmoplantar Psoriasis (G-PLUS). Dermatol Ther 2023; 2023:1–14.
Brunasso AMG, Massone C. Psoriasis and palmoplantar pustulosis: an endless debate? J Eur Acad Dermatol Venereol 2017; 31:e335-337.
Terui T, Kobayashi S, Okubo Y, Murakami M, Hirose K, Kubo H. Efficacy and Safety of Guselkumab, an Anti–interleukin 23 Monoclonal Antibody, for Palmoplantar Pustulosis: A Randomized Clinical Trial. JAMA Dermatol 2018;154:309-316.
Terui T, Kobayashi S, Okubo Y, Murakami M, Zheng R, Morishima H, et al. Efficacy and Safety of Guselkumab in Japanese Patients with Palmoplantar Pustulosis: A Phase 3 Randomized Clinical Trial. JAMA Dermatol 2019;155:1153-1161.
Okubo Y, Morishima H, Zheng R, Terui T. Sustained efficacy and safety of guselkumab in patients with palmoplantar pustulosis through 1.5 years in a randomized phase 3 study. The Journal of Dermatology 2021;48:1838–53.
Morita A, Chen Y, Leung MWL, Kawashima N, Terui T. Effect of guselkumab on serum biomarkers in Japanese palmoplantar pustulosis patients in a randomized phase 3 study. JEADV Clin Pract. 2023;2:59–72.
Girolomoni G, Strohal R, Puig L, Bachelez H, Barker J, Boehncke WH, et al. The role of IL ‐23 and the IL ‐23/ T H 17 immune axis in the pathogenesis and treatment of psoriasis. J Eur Acad Dermatol Venereol 2017;31:1616–26.
Bridgewood C, Watad A, Russell T, Palmer TM, Marzo-Ortega H, Khan A, et al. Identification of myeloid cells in the human enthesis as the main source of local IL-23 production. Ann Rheum Dis 2019;78:929–33.
Lee Y. The role of interleukin-17 in bone metabolism and inflammatory skeletal diseases. BMB Rep 2013;46:479–83.
Murphy CA, Langrish CL, Chen Y, Blumenschein W, McClanahan T, Kastelein RA, et al. Divergent Pro- and Antiinflammatory Roles for IL-23 and IL-12 in Joint Autoimmune Inflammation. J Exp Med 2003;198:1951–7.
Schurich A, Raine C, Morris V, Ciurtin C. The role of IL-12/23 in T cell–related chronic inflammation: implications of immunodeficiency and therapeutic blockade. Rheumatology 2018;57:246–54.
Kopp T, Lenz P, Bello-Fernandez C, Kastelein RA, Kupper TS, Stingl G. IL-23 Production by Cosecretion of Endogenous p19 and Transgenic p40 in Keratin 14/p40 Transgenic Mice: Evidence for Enhanced Cutaneous Immunity. J Immunol 2003;170:5438–44.
Deodhar A, Gottlieb AB, Boehncke WH, Dong B, Wang Y, Zhuang Y, et al. Efficacy and safety of guselkumab in patients with active psoriatic arthritis: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet 2018;391:2213–24.
Mease PJ, Gladman DD, Deodhar A, McGonagle DG, Nash P, Boehncke WH, et al. Impact of guselkumab, an interleukin-23 p19 subunit inhibitor, on enthesitis and dactylitis in patients with moderate to severe psoriatic arthritis: results from a randomised, placebo-controlled, phase II study. RMD Open 2020;6:e001217.
Mease PJ, Rahman P, Gottlieb AB, Kollmeier AP, Hsia EC, Xu XL, et al. Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020;395:1126–36.
Deodhar A, Helliwell PS, Boehncke WH, Kollmeier AP, Hsia EC, Subramanian RA, et al. Guselkumab in patients with active psoriatic arthritis who were biologic-naive or had previously received TNFα inhibitor treatment (DISCOVER-1): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020;395:1115–25.
Kelly G, Sweeney CM, Tobin A, Kirby B. Hidradenitis suppurativa: the role of immune dysregulation. Int J Dermatol 2014;53:1186–96.
Schlapbach C, Hänni T, Yawalkar N, Hunger RE. Expression of the IL-23/Th17 pathway in lesions of hidradenitis suppurativa. J Am Acad Dermatol 2011;65:790–8.
Littman DR, Rudensky AY. Th17 and Regulatory T Cells in Mediating and Restraining Inflammation. Cell 2010;140:845–58.
Cole S, Murray J, Simpson C, Okoye R, Tyson K, Griffiths M, et al. Interleukin (IL)-12 and IL-18 Synergize to Promote MAIT Cell IL-17A and IL-17F Production Independently of IL-23 Signaling. Front Immunol 2020;11:585134.
Dudink K, Bouwman K, Chen Y, DePrimo SE, Munoz-Elias EJ, Aarts P, et al. Guselkumab for hidradenitis suppurativa: a phase II, open-label, mode-of-action study. Br J Dermatol 2023;188:601–9.
Kimball AB, Podda M, Alavi A, Miller M, Shen Y, Li S, et al. Guselkumab for the treatment of patients with moderate‐to‐severe hidradenitis suppurativa: A phase 2 randomized study. J Eur Acad Dermatol Venereol 2023;37:2098–108.
Casseres RG, Kahn JS, Her MJ, Rosmarin D. Guselkumab in the treatment of hidradenitis suppurativa: A retrospective chart review. J Am Acad Dermatol 2019;81:265–7.
Montero‐Vilchez T, Martinez‐Lopez A, Salvador‐Rodriguez L, Arias‐Santiago S, Molina‐Leyva A. The use of guselkumab 100 mg every 4 weeks on patients with hidradenitis suppurativa and a literature review. Dermatol Ther 2020;33:e13456.
Kearney N, Byrne N, Kirby B, Hughes R. Successful use of guselkumab in the treatment of severe hidradenitis suppurativa. Clin Exp Dermatol 2020;45:618–9.
Kovacs M, Podda M. Guselkumab in the treatment of severe hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2019;33:e140-e141.
Martora F, Fabbrocini G, Marasca C, Battista T, Megna M. Paradoxical hidradenitis suppurativa induced by adalimumab biosimilar successfully treated with guselkumab in a patient with psoriasis. Comment on ‘Paradoxical hidradenitis suppurativa due to anti-interleukin-1 agents for mevalonate kinase deficiency successfully treated with the addition of ustekinumab.’ Clin Exp Dermatol 2023;48:701–3.
Garcia‐Melendo C, Vilarrasa E, Cubiró X, Bittencourt F, Puig L. Sequential paradoxical psoriasiform reaction and sacroiliitis following adalimumab treatment of hidradenitis suppurativa, successfully treated with guselkumab. Dermatol Ther 2020;33:e14180.
Burzi L, Repetto F, Ramondetta A, Rozzo G, Licciardello M, Ribero S, et al. Guselkumab in the treatment of severe hidradenitis suppurativa, a promising role? Dermatol Ther 2021;34:e14930.
Croitoru DO, Seigel K, Nathanielsz N, Elsawi R, Silverberg MS, Piguet V, et al. Treatment of severe hidradenitis Suppurativa and Fistulizing Crohn’s disease with Guselkumab. J Eur Acad Dermatol Venereol 2022;36:e563-65.
Berman HS, Villa NM, Shi VY, Hsiao JL. Guselkumab in the treatment of concomitant hidradenitis suppurativa, psoriasis, and Crohn’s disease. J Dermatol Treat 2021;32:261–3.
Jørgensen AR, Holm JG, Thomsen SF. Guselkumab for hidradenitis suppurativa in a patient with concomitant Crohn’s disease: Report and systematic literature review of effectiveness and safety. Clin Case Rep 2020;8:2873–6.
George C, Deroide F, Rustin M. Pyoderma gangrenosum - a guide to diagnosis and management. Clin Med (Lond) 2019;19:224–8.
Yamanaka K. New treatment of pyoderma gangrenosum and hidradenitis suppurativa: A review. J of Dermatol 2023;1346-8138.17031.
Baier C, Barak O. Guselkumab as a treatment option for recalcitrant pyoderma gangrenosum. JAAD Case Rep 2021;8:43–6.
Reese AM, Erickson K, Reed KB, Ortega-Loayza AG. Modified dose of guselkumab for treatment of pyoderma gangrenosum. JAAD Case Rep 2022;21:38–42.
Villaverde Piñeiro L, Loureiro Martínez M, Cachafeiro Pin AI. Tratamiento del pioderma gangrenoso con guselkumab en condiciones diferentes a las autorizadas en la ficha técnica. Med Clín 2023;161:226–7.
Wang D, Chong VCL, Chong WS, Oon HH. A Review on Pityriasis Rubra Pilaris. Am J Clin Dermatol 2018;19:377–90.
Feldmeyer L, Mylonas A, Demaria O, Mennella A, Yawalkar N, Laffitte E, et al. Interleukin 23–Helper T Cell 17 Axis as a Treatment Target for Pityriasis Rubra Pilaris. JAMA Dermatol 2017;153:304-308.
Kannan AK, Su Z, Gauvin DM, Paulsboe SE, Duggan R, Lasko LM, et al. IL-23 induces regulatory T cell plasticity with implications for inflammatory skin diseases. Sci Rep 2019;9:17675.
Pilz AC, Seiringer P, Biedermann T, Eyerich K. Treatment of Pityriasis Rubra Pilaris With Guselkumab. JAMA Dermatol 2019;155:1424-1426.
Nagai H, Jimbo H, Matsuura S, Tatsuoka S, Shiraki E, Nishigori C. Successful treatment of pityriasis rubra pilaris with guselkumab: Serum CCL20 as a potential marker for the disease activity. Dermatol Ther 2020;33:e14403.
Nishimura M, Kondo M, Habe K, Hayashi A, Yamanaka K. Successful treatment with cyclosporine and guselkumab for pityriasis rubra pilaris. Clin Case Rep 2022;10:e6413.
Langrish CL, Chen Y, Blumenschein WM, Mattson J, Basham B, Sedgwick JD, et al. IL-23 drives a pathogenic T cell population that induces autoimmune inflammation. J Exp Med 2005;201:233–40.
McGeachy MJ, Chen Y, Tato CM, Laurence A, Joyce-Shaikh B, Blumenschein WM, et al. The interleukin 23 receptor is essential for the terminal differentiation of interleukin 17–producing effector T helper cells in vivo. Nat Immunol 2009;10:314–24.
Wang R, Hasnain SZ, Tong H, Das I, Che-Hao Chen A, Oancea I, et al. Neutralizing IL-23 Is Superior to Blocking IL-17 in Suppressing Intestinal Inflammation in a Spontaneous Murine Colitis Model: Inflamm Bowel Dis 2015;21:973–84.
Solimani F, Pollmann R, Schmidt T, Schmidt A, Zheng X, Savai R, et al. Therapeutic Targeting of Th17/Tc17 Cells Leads to Clinical Improvement of Lichen Planus. Front Immunol 2019;10:1808.
Murgia RD, Gross GP. Stewart-Treves Syndrome [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Dec 27]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507833/
Nardinocchi L, Sonego G, Passarelli F, Avitabile S, Scarponi C, Failla CM, et al. Interleukin‐17 and interleukin‐22 promote tumor progression in human nonmelanoma skin cancer. Eur J Immunol 2015;45(3):922–31.
Sheng S, Zhang J, Ai J, Hao X, Luan R. Aberrant expression of IL-23/IL-23R in patients with breast cancer and its clinical significance. Mol Med Rep 2018;17:4639-4644.
Nie W, Yu T, Sang Y, Gao X. Tumor-promoting effect of IL-23 in mammary cancer mediated by infiltration of M2 macrophages and neutrophils in tumor microenvironment. Biochem Biophys Res Commun 2017;482:1400–6.
Van Esbeen L, Roquet-Gravy PP. Improvement of Stewart-Treves angiosarcoma through interleukin 23p19 inhibition. JAAD Case Rep 2021;17:84–6.
Product Information: Tremfya (guselkumab) solution for injection. Janssen Inc. Toronto, ON. Accessed November 10, 2017. https://pdf.hres.ca/dpd_pm/00042101.PDF.
Burlando M, Capurro N, Herzum A, Cozzani E, Parodi A. Guselkumab‐associated bullous pemphigoid in a psoriasis patient: A case report and review of the literature. Dermatol Ther 2022;35:e15207.
Martora F, Annunziata MC, Guerriero L, Battista T, Potestio L, Megna M. Guselkumab-induced vitiligo in a patient with psoriatic arthritis. JAAD Case Rep 2023;41:46–8.
Le Guern A, Alkeraye S, Vermersch-Langlin A, Coupe P, Vonarx M. Bullous pemphigoid during ustekinumab therapy. JAAD Case Rep 2015;1:359–60.
Frisoli ML, Essien K, Harris JE. Vitiligo: Mechanisms of Pathogenesis and Treatment. Ann Rev Immunol 2020;38:621–48.
Guselkumab (Tremfya®) [Internet]. In: Mother To Baby | Fact Sheets. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994 [cited 2023 Dec 27]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK582737/
Stratigakis A, Paty D, Zou P, Zhao Z, Li Y, Zhang T. A regression approach for assessing large molecular drug concentration in breast milk. Reprod Breed 2023;3:199–207.
Anderson PO. Monoclonal Antibodies During Breastfeeding. Breastfeed Med 2021;16:591–3.
Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, et al. Family planning considerations in people with multiple sclerosis. Lancet Neurol 2023;22:350–66.
Kim SR, Kibbi N, Craiglow BG. Guselkumab for the treatment of severe refractory psoriasis in a pediatric patient. JAAD Case Rep 2019;5:552–4.
Song EJ, Whitman P, Samsel J. The use of ustekinumab and guselkumab in a pediatric psoriasis patient with active hepatitis B infection. JAAD Case Rep 2021;8:37–9.
Ruggiero A, Fabbrocini G, Cinelli E, Ocampo Garza SS, Camela E, Megna M. Anti‐interleukin‐23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real‐world practice. Clin Exp Dermatol 2022;47:561–7.
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