Guselkumab,
does it really help with PASI90 and IGA 0 or 1 skin-lesion response in moderate-to-severe plaque psoriasis?
research showsGuselkumab is rated C for plaque-psoriasis skin clearance. VOYAGE 1 randomized and analyzed 837 participants by intention to treat. At week 16, coprimary IGA 0 or 1 response was 85.1% versus 6.9% with placebo, and PASI90 was 73.3% versus 2.9%; both succeeded at P<0.001. VOYAGE 2 reproduced the result in 992 intention-to-treat participants, at 84.1% versus 8.5% and 70.0% versus 2.4%. Effects were very large, but the confirmatory coprimary outcomes were PASI and IGA lesion-score surrogates, S, and both trials belonged to the Janssen development program, I0. Each feature independently caps the grade at C.
ads claimMarketing can expand high PASI90 and IGA response into a permanent cure or prevention of every long-term complication. Strong 16-week skin response is true; permanent remission, cardiovascular-event prevention, and cure go beyond that evidence.
Useful facts when choosing a product
- Guselkumab is a subcutaneous monoclonal antibody targeting the p19 subunit of IL-23. VOYAGE used 100 mg at weeks 0 and 4 and every eight weeks thereafter.
- verdict 1814, which is C with 58 points, asks whether home narrowband UV-B is noninferior to office phototherapy; this verdict asks about placebo-controlled efficacy of a biologic drug.
- verdict 1342, which is B with 76 points, concerns secukinumab, while verdict 1796, which is C with 55 points, concerns deucravacitinib. The same surrogate logic applied to PASI and static PGA in verdict 1796 is applied to PASI and IGA here.
What the research actually shows
Blauvelt's VOYAGE 1 assigned 837 participants to guselkumab, 329, placebo, 174, or adalimumab, 334, and analyzed all 837 by intention to treat. At week 16, coprimary IGA 0 or 1 was 85.1% versus 6.9%, and PASI90 was 73.3% versus 2.9%, both P<0.001. Reich's VOYAGE 2 assigned 992 to guselkumab, 496, placebo, 248, or adalimumab, 248, and analyzed all 992. The same coprimary outcomes were 84.1% versus 8.5% and 70.0% versus 2.4%, both P<0.001. Janssen Research & Development sponsored both trials and participated in design and analysis.
Why this is classified as C (58)
The profile is S, R1, I0, E+, and B0. Both large primary endpoints succeeded, but the same Janssen development program is not independent replication, and the R1, surrogate, and manufacturer-only ceilings produce C with 58 points.
Counterpoint. Patient-reported itch and quality-of-life benefits were also reported, but PASI and IGA were the confirmatory coprimary endpoints. Secondary patient-reported outcomes do not change the representative axis to P.
Rejudgment record. Cross-check applied — Accepted large successful intention-to-treat effects in VOYAGE 1 and 2 while consistently applying C ceilings for PASI and IGA surrogates and Janssen-only evidence
| Endpoint | S | Surrogate marker - laboratory or imaging measures |
| Replication | R1 | Single confirmatory trial |
| Independence | I0 | Evidence comes only from manufacturer studies |
| Effect size | E+ | Meets the clinically important threshold |
The scoring table and the verdict agree (C).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Achievement of PASI90 at week 16 | C | Two large manufacturer trials repeatedly succeeded, but PASI90 is a surrogate. |
| Achievement of IGA 0 or 1 at week 16 | C | Both coprimary endpoints were strongly positive, but evidence is manufacturer-only. |
| Achievement of complete skin clearance with PASI100 | C | A large effect occurred on this secondary lesion scale, but the same S and I0 ceilings apply. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Blauvelt A et al. 2017 VOYAGE 1 | Phase 3 double-blind randomized placebo- and active-controlled trial | 837 | Manufacturer sponsorship, design, and analysis by Janssen Research & Development | Coprimary week-16 IGA 0 or 1 and PASI90 | 85.1% versus 6.9% and 73.3% versus 2.9%, both P<0.001; both coprimary endpoints met. | Pivotal manufacturer confirmatory trial |
| Reich K et al. 2017 VOYAGE 2 | Phase 3 double-blind randomized placebo- and active-controlled withdrawal and retreatment trial | 992 | Manufacturer sponsorship, design, and analysis by Janssen Research & Development | Coprimary week-16 IGA 0 or 1 and PASI90 | 84.1% versus 8.5% and 70.0% versus 2.4%, both P<0.001; both coprimary endpoints met. | Large replication within the same manufacturer program |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-07-24).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-24 · Corrections: none
Cite this verdict
[Chamgap] Guselkumab x skin clearance in moderate-to-severe plaque psoriasis — Evidence Grade C·58. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/skin-hair/guselkumab-plaque-psoriasis-skin-clearance/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.