Short-term effectiveness of guselkumab in psoriatic arthritis patients and suggestive features of axial involvement: results from a real-life multicentre cohort

Objective To evaluate the short-term effectiveness of guselkumab in patients with psoriatic arthritis (PsA) and suggestive features of axial involvement in a prospective 'real-life' multicentre cohort.Methods Between June 2022 and June 2023, PsA patients with axial involvement were evaluated if treated at least for 4 months with guselkumab. The effectiveness was evaluated by BASDAI, ASDAS, DAPSA, and achievement of BASDAI <= 4, also exploiting predictive factors. In a group of patients, MRI findings on sacroiliac joints were assessed before and after guselkumab administration.Results Sixty-seven patients with PsA and suggestive features of axial involvement (age 53.4 +/- 11.2 years, male sex 26.9%) were treated with guselkumab. After 4 months, a significant reduction of BASDAI, ASDAS, and DAPSA was observed. A Delta BASDAI of -2.11 +/- 0.43 was estimated assessing the mean difference values before and after guselkumab administration and 52.2% of patients reached a BASDAI <= 4. In 27 patients, MRI findings on sacroiliac joints were assessed before and after guselkumab administration. A reduction of 0.80 or larger in the sacroiliac joint lesion score was observed in the majority of patients (70.3%) based on MRI improvements, paralleling with the clinical response. No life-threatening side effects were recorded; 17.9% of patients reported minor adverse events mainly injection site reactions.Conclusions The short-term effectiveness of guselkumab in patients with PsA and suggestive features of axial involvement were shown. Although further studies are needed, our multicentre 'real-life' study may suggest the clinical usability of guselkumab in this context.