Evidence map›Paper›PMID 39177870›Full record

ArticleDermatology and therapy2024

Direct and Indirect Effect of Guselkumab on Anxiety, Depression, and Quality of Life in Patients with Moderate-to-Severe Plaque Psoriasis: A Mediation Analysis.

April W Armstrong, Peter Foley, Yan Liu, Megan Miller, Rachel E Teneralli, Anthony Bewley, Kenneth B Gordon, Kim A Papp, Chenglong Han

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In one paragraph

Article in Dermatology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Molecular Link Between Psoriasis and Depression-Update on Pathophysiology.International journal of molecular sciences · 2025
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

April W ArmstrongUniversity of California Los Angeles, Los Angeles, CA, USA.
Peter FoleyThe University of Melbourne, St. Vincent's Hospital Melbourne and Probity Medical Research, Skin Health Institute, Carlton, VIC, Australia.
Yan LiuJanssen Global Services, LLC, Horsham/Malvern, 200 Great Valley Pkwy, Malvern, PA, USA.
Megan MillerJanssen Research & Development, LLC, Spring House, PA, USA.
Rachel E TeneralliJanssen Global Services, LLC, Horsham/Malvern, 200 Great Valley Pkwy, Malvern, PA, USA.
Anthony BewleyBarts Health NHS Trust and QMUL, London, UK.
Kenneth B GordonMedical College of Wisconsin, Milwaukee, WI, USA.
Kim A PappAlliance Clinical Trials and Probity Medical Research Inc, Waterloo, ON, Canada.
Chenglong HanJanssen Global Services, LLC, Horsham/Malvern, 200 Great Valley Pkwy, Malvern, PA, USA. chan3@its.jnj.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTreating plaque psoriasis (PsO) with guselkumab (GUS) promotes skin clearance and is associated with improvements in health-related quality of life (HRQoL), anxiety, and depression. It is unclear whether improvements in patient-reported outcomes are due to resolution of skin symptoms or the direct result of GUS treatment.

methodsTwo phase 3, placebo- and active-comparator-controlled studies randomized patients with moderate-to-severe PsO to GUS, placebo (crossing over to GUS at week 16), or adalimumab. Post hoc mediation analyses examined direct and indirect effects of GUS, versus adalimumab, on Dermatology Life Quality Index (DLQI) or Hospital Anxiety and Depression Scale (HADS) after adjusting for indirect effects mediated by skin clearance, evaluated via Psoriasis Area and Severity Index (PASI), to determine the direct effect of GUS on dermatology HRQoL, depression, and anxiety.

resultsCompared with adalimumab, the natural direct effect (NDE) of GUS on change in DLQI from baseline was - 2.04 (P < 0.001), using PASI improvement as a mediator, indicating 89.2% of the total treatment effect was due to direct effects of GUS; using PASI 90 as a mediator, NDE of GUS was - 1.43 (P < 0.001), with 62.2% of the total treatment effect attributed to direct effects of GUS. Compared with adalimumab, 25.5% of change in HADS anxiety score was mediated through PASI improvement (NDE - 0.74; P = 0.002), indicating 74.5% of the total effect was independent of PASI improvement. Similarly, 24% of treatment effect was mediated through PASI 90 (NDE - 0.76; P = 0.002). Comparable proportions of the total improvement in HADS depression scores were due to direct and indirect effects of GUS mediated through PASI improvement (direct, 50.2%; indirect, 49.8%) or PASI 90 (direct, 59.5%; indirect, 40.5%).

conclusionsGUS-mediated improvements in anxiety, depression, and overall HRQoL are not solely mediated by resolution of PsO signs, suggesting GUS use has a potential direct effect on anxiety and depression.

Indexed as

AnxietyDepressionGuselkumabHealth-related quality of lifeMediation analysisPsoriasis

Identifiers

PMID39177870
PMCPMC11393263

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