Frédéric Lavie, MD, PhD: Efficacy of Guselkumab Across Multiple Disease Domains of Psoriatic Arthritis

New data from the DISCOVER-1, DISCOVER-2, and COSMOS trials evaluating guslekumab, a monoclonal antibody that inhibits interleukin-23 (IL-23), were presented at European Alliance of Associations for Rheumatology (EULAR) 2022 conference. Rheumatology Network interviewed Frédéric Lavie, MD, PhD, Senior Global Medical Affairs Lead Rheumatology at Janssen, to discuss these findings.

“Psoriatic arthritis (PsA) is a very diverse disease with a lot of features,” Lavie stated. “It’s very debilitating for patients and requires advanced therapies [as well as] new advanced therapies because the unmet need is so important.”

In DISCOVER-2, guselkumab demonstrated its efficacy in preventing structural damage, joint destruction, and inhibited radiographic progression. Investigators were also able to identify predictors of inhibition of radiographic progression in patients who had clinical response as early as week 8.

Another key finding was that guselkumab was effective in patients who had a previous inadequate response (IR) to tumor necrosis factor (TNF) blockers. Results from the COSMOS studies reported that at week 48, 80% of patients who were TNF-IR were able to achieve complete resolution of dactylitis symptoms.

“I think what is most exciting for us was that we were able to release new data at the molecular level to better understand how guselkumab works, binding to both IL-23 and also to something new, called CD64, which may have some clinical relevance for patients,” Lavie added.

Lavie and his team hope that moving forward, similar experiments will help to better understand how guselkumab works in patients with PsA who often present different symptoms, such as psoriasis, back pain, joint inflammation and involvement, dactylitis, and enthesitis. While patients may fall under the umbrella of PsA, it is often difficult for patients to find the right treatment to manage their condition.

“The data seems a little bit complex, but they are really resonating with healthcare providers,” Lavie concluded. “I think it's a first step to better understand how it works. It doesn’t explain everything, but it shows Janssen’s willingness to [continually] push further the understanding of the pathogenesis of the disease and how the new and advanced drugs that we are delivering can work.”