Medication Review: What is the Efficacy of Guselkumab Across the GRAPPA Domains

In this expert breakdown, Cassie Dolecki, PharmD, a clinical pharmacy specialist in rheumatology at Allegheny Health Network in Pittsburgh, Pennsylvania, discusses the effectiveness of Guselkumab across the GRAPPA domains, drawing insights from the DISCOVER-2 trial and additional post-hoc analyses.

As a phase 3 clinical trial, DISCOVER-2 evaluated Guselkumab in biologic-naïve patients with active PsA over two years, comparing 100 mg every 4 weeks and 100 mg every 8 weeks to placebo. At week 24, significantly more patients on Guselkumab achieved ACR20 response rates, demonstrating its superior ability to control inflammation and joint symptoms.

A post-hoc analysis of DISCOVER-2 stratified patient responses across GRAPPA domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, and psoriasis, confirming early and sustained improvement through 100 weeks of therapy. While nail disease was not directly assessed in DISCOVER-2, pooled data from VOYAGE-1 and VOYAGE-2 trials revealed that Guselkumab significantly improved nail psoriasis, with patients achieving clearance or minimal disease activity by week 16.

With consistent results in long-term disease control, Guselkumab stands out as a comprehensive treatment choice for PsA patients, addressing multiple disease manifestations beyond joint inflammation. Its strong safety profile and efficacy in biologic-naïve patients further support its role as a go-to IL-23 inhibitor in PsA management.

For more expert insights on Guselkumab and its role in PsA treatment, visit RhAPP.org or explore the RhAPP ACE App for the latest educational content in rheumatology.