VISIBLE: Guselkumab Provides Scalp Psoriasis Relief in Diverse Skin Tones
Key Takeaways
Guselkumab showed sustained scalp psoriasis improvement in a diverse patient cohort with skin of color.
Results at week 16 showed superior efficacy vs. placebo for all primary and key secondary endpoints.
Clinical and quality-of-life benefits were maintained through 48 weeks, according to researchers.
Guselkumab 100 mg demonstrated efficacy and sustained improvement through 48 weeks in a cohort of adults with moderate to severe scalp psoriasis and skin of color, new research suggests.
In the B cohort of the phase 3b, randomized VISIBILE clinical trial, researchers enrolled 108 participants with at least one nonscalp plaque, with ≥30% scalp surface area involvement, a Psoriasis Scalp Severity Index (PSSI) score ≥12, and Investigator’s Global Assessment (ss-IGA) score ≥3. All participants had at least one nonscalp plaque. They randomized study participants (3:1) to receive guselkumab at weeks 0, 4, and then every 8 weeks, or placebo through week 12 followed by guselkumab starting at week 16.
Patients on guselkumab achieved ss-IGA 0/1 (68.4% vs. 11.5%) and PSSI 90 (65.8% vs. 3.8%) vs. placebo (P < 0.001 for both) at week 16, according to the results. Secondary endpoints, including complete scalp clearance (ss-IGA 0) and PSSI 100, also favored guselkumab. Nearly 70% of guselkumab-treated patients with baseline Scalp Itch NRS scores ≥4 reported a ≥4-point reduction vs. 24.0% in the placebo group.
Mean percentage improvements in PSSI and SSA was 94.6% and 94.8%, respectively. Two-thirds of guselkumab recipients achieved ss-IGA 0, and patient-reported outcomes showed improvements in DLQI and PSSD scores.
“Cohort B of the VISIBLE randomized clinical trial provided important clinical results demonstrating that guselkumab is highly effective for the treatment of moderate to severe scalp psoriasis in individuals with skin of color across the spectrum of objectively measured skin tones," the authors wrote. "At week 48, mean SSA and PSSI improvements of more than 94% were observed and were associated with clinically meaningful reductions in psoriasis symptoms and quality-of-life improvements."
Source: McMichael A, et al. JAMA Dermatology. 2025. doi:10.1001/jamadermatol.2025.1849