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Journal article
Effect of guselkumab on serum biomarkers in patients with active psoriatic arthritis and inadequate response to tumor necrosis factor inhibitors: results from the COSMOS phase 3b study
Arthritis research & therapy, v 25(1), pp 1-11
16 Aug 2023
PMID: 37587493
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Guselkumab is a selective interleukin (IL)-23 inhibitor targeting the IL-23p19 subunit. In the phase 3b COSMOS trial, guselkumab demonstrated efficacy in treating participants with active psoriatic arthritis (PsA) and inadequate response (IR; lack of efficacy or intolerance) to tumor necrosis factor inhibitors (TNFi).
Methods
Adults with active PsA (& GE; 3 swollen joints, & GE; 3 tender joints) and IR to one or two TNFi (TNFi-IR) were randomized 2:1 to guselkumab at Weeks 0, 4, then every 8 weeks (Q8W) or placebo ➔guselkumab Q8W at Week 24 with possible early escape at Week 16. Levels of serum cytokines, including interferon & Gamma; (IFN & Gamma;), IL-10, and tumor necrosis factor & alpha; (TNF & alpha;); T helper 17 (Th17) effector cytokines IL-17A, IL-17F, and IL-22; and acute phase proteins C-reactive protein (CRP), IL-6, and serum amyloid A (SAA), were assessed and compared with matched healthy controls; guselkumab pharmacodynamics through Week 24 were also assessed. Associations between baseline biomarker levels and 1) baseline disease activity (28-joint disease activity score using CRP [DAS28-CRP], psoriasis area and severity index [PASI], and % body surface area [BSA] affected by psoriasis) and 2) clinical response (including & GE; 20% improvement in American College of Rheumatology criteria [ACR20] response) at Week 24 were assessed.
Results
Baseline serum levels of IL-6, IL-10, IL-17A, IL-17F, IL-22, TNF & alpha;, and IFN & Gamma; were significantly higher in COSMOS TNFi-IR participants than in matched healthy controls. Baseline IL-6, CRP, and SAA levels were associated with baseline DAS28-CRP. IL-17A and IL-17F levels were associated with baseline PASI score and psoriasis BSA. Baseline swollen or tender joint counts did not associate with baseline biomarker levels. At Week 24, significant decreases from baseline in CRP, SAA, IL-17A, IL-17F, and IL-22 levels were seen in guselkumab, but not placebo-, treated participants. IL-17F and IL-22 levels at Week 24 in guselkumab-treated participants did not significantly differ from those of matched healthy controls. Guselkumab-treated participants achieving ACR20 response at Week 24 exhibited higher baseline IL-22 and IFN & Gamma; levels versus nonresponders.
Conclusions
Results from COSMOS participants with active, TNFi-IR PsA suggest guselkumab reduces levels of effector cytokines associated with the IL-23/IL-17 pathway, including those associated with baseline arthritis and skin disease activity.
Metrics
Details
- Title
- Effect of guselkumab on serum biomarkers in patients with active psoriatic arthritis and inadequate response to tumor necrosis factor inhibitors: results from the COSMOS phase 3b study
- Creators
- Georg Schett (Corresponding Author) - Friedrich-Alexander-Universität Erlangen-NürnbergWarner Chen - JanssenSheng Gao - JanssenSoumya D. Chakravarty - Drexel University, General Internal MedicineMay Shawi - JanssenFrederic Lavie - JanssenMiriam Zimmermann - JanssenMohamed Sharaf - Johnson & JohnsonLaura C. Coates - Nuffield Orthopaedic CentreStefan Siebert - University of Glasgow
- Publication Details
- Arthritis research & therapy, v 25(1), pp 1-11
- Publisher
- Springer Nature
- Number of pages
- 11
- Grant note
- Janssen Research amp; Development, LLC, Spring House, PA, USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Rheumatology; General Internal Medicine
- Web of Science ID
- WOS:001049220700001
- Scopus ID
- 2-s2.0-85168238155
- Other Identifier
- 991021860618404721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology