Guselkumab induces robust reduction in acute phase proteins and type 17 effector cytokines in active psoriatic arthritis: results from phase 3 trials

Objective To investigate serum protein expression in participants with psoriatic arthritis (PsA) and changes after guselkumab treatment. Methods Participants PsA were treated or placebo the DISCOVER-1 DISCOVER-2 studies. Serum levels of acute phase reactants C reactive (CRP) amyloid A (SAA) inflammatory cytokines/chemokines measured at weeks 0, 4 24 300 study 34 healthy controls (HCs). The PSUMMIT studies interleukin (IL)-17A, IL-17F CRP ustekinumab treatment versus compared. Results Baseline CRP, SAA, IL-6, IL-17A elevated active vs HCs (p<0.05, geometric mean (GM) ≥40% higher). T-helper cell 17 (Th17) effector cytokines significantly associated baseline psoriasis but not joint disease activity. Compared placebo, resulted decreases IL-17A, IL-22 as early week continued to decrease through GM from ≥33%). At 24, different HCs, suggesting normalisation peripheral IL-23/Th17 axis postguselkumab Reductions IL-17A/IL-17F greater guselkumab-treated ustekinumab-treated participants, whereas effects on similar. Conclusion Guselkumab reduced Th17 achieved comparable those HCs. In PsA, reductions magnitude than ustekinumab.