Impact of dactylitis and enthesitis resolution on disease control in guselkumab-treated psoriatic arthritis patients with TNFi-IR: COSMOS post hoc analysis
Rheumatology 2025;00:1–10 Doi: 10.1093/rheumatology/keaf490
Marzo-Ortega et al. report that dactylitis and enthesitis are associated with a greater disease burden and worse prognosis, highlighting the importance for physicians to identify these conditions and provide adequate treatment. Authors evaluated guselkumab’s efficacy on dactylitis resolution (DR) and enthesitis resolution (ER), and their impact on subsequent disease control, in patients with active PsA and prior inadequate response to tumour necrosis factor inhibitors (TNFi-IR).
Guselkumab treatment resulted in high DR/ER rates through Week 48 in TNFi-IR PsA patients; Week 24 DR/ER was associated with Week 48 disease control, providing valuable insights for clinical decision-making based on Week 24 treatment responses. These data, coupled with the key role of IL-23 in dactylitis and enthesitis pathogenesis, suggest guselkumab is a highly effective treatment option for resolving these disease domains.
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