{ "abstract": "Background/Objectives: Individualising guselkumab maintenance is increasingly considered in clinical practice, but the characteristics associated with clinicians’ decisions to modify dosing intervals remain poorly defined. We investigated the clinical profiles of patients undergoing interval extension or reduction and assessed drug survival after interval reduction in patients with psoriatic arthritis (PsA). Methods: This retrospective study included patients receiving guselkumab for psoriasis across eight Italian centres. Patients undergoing interval extension beyond every eight weeks (q8w; n = 39) were compared with those without interval extension (n = 951). Separately, patients with PsA undergoing interval reduction from q8w to every four weeks (q4w; n = 39) were compared with patients with PsA maintained on q8w (n = 184). Between-group comparisons were exploratory and unadjusted. Post-interval reduction drug survival was estimated using the Kaplan–Meier method. Results: Patients undergoing extension had less frequent palmoplantar involvement (2.6% versus 14.7%; p = 0.033), nail involvement (0% versus 13.6%; p = 0.014), and PsA (7.7% versus 23.1%; p = 0.023), and more frequent previous anti-IL-12/23 treatment (35.9% versus 18.2%; p = 0.006). Within the PsA population, interval reduction was associated with younger age (56.9 versus 62.8 years; p = 0.023) and obesity (41.0% versus 23.4%; p = 0.023). Five patients subsequently returned to standard q8w dosing following clinical improvement. All 39 patients undergoing interval reduction were included in the survival analysis, with six guselkumab discontinuations. Estimated drug survival was 97.1% at 52 weeks (95% CI 81.4–99.6%) and 84.2% at 104 weeks (95% CI 62.7–93.9%). Conclusions: Guselkumab interval modification was associated with distinct clinical profiles, suggesting that disease phenotype, joint involvement, and treatment history contribute to individualised maintenance decisions. These findings describe clinical selection in routine practice and support prospective evaluation of patient selection criteria and long-term outcomes.", "abstract_shown": true, "affiliations": [ "Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy", "Dermatology Unit, Azienda Ospedaliera Universitaria Policlinico “Tor Vergata”, 00133 Rome, Italy", "Department of Medicine Surgery and Dentistry, ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy", "Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy", "Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy", "Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy", "Dermatology Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy", "Dermatology Unit, University of Campania Luigi Vanvitelli, 801380 Naples, Italy", "Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy", "Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy" ], "article_type": null, "arxiv": null, "author_total": 20, "authors": [ { "affs": [ 0 ], "name": "Edoardo Mortato", "orcid": "0009-0008-3763-6922" }, { "affs": [ 1 ], "name": "Marina Talamonti" }, { "affs": [ 2 ], "name": "Annunziata Raimondo", "orcid": "0000-0002-0849-715X" }, { "affs": [ 3 ], "name": "Viviana Lora" }, { "affs": [ 4 ], "name": "Matteo Megna", "orcid": "0000-0003-1803-2046" }, { "affs": [ 5 ], "name": "Cristina Mugheddu", "orcid": "0000-0001-7500-4178" }, { "affs": [ 6 ], "name": "Gabriele Biondi", "orcid": "0000-0003-0507-0633" }, { "affs": [ 7 ], "name": "Anna Balato" }, { "affs": [ 8, 9 ], "name": "Giacomo Caldarola", "orcid": "0000-0002-8837-9232" }, { "affs": [ 0 ], "name": "Lorenzo Marcelli" }, { "affs": [ 2 ], "name": "Serena Lembo" }, { "affs": [ 3 ], "name": "Dario Graceffa" }, { "affs": [ 4 ], "name": "Luca Potestio", "orcid": "0000-0001-5940-0592" }, { "affs": [ 5 ], "name": "Laura Atzori" }, { "affs": [ 6 ], "name": "Maria Antonia Montesu" }, { "affs": [ 7 ], "name": "Eugenia Veronica Di Brizzi", "orcid": "0000-0002-0278-2443" }, { "affs": [ 8, 9 ], "name": "Eleonora De Luca", "orcid": "0000-0003-3893-2869" }, { "affs": [ 2 ], "name": "Lucia Bufano", "orcid": "0009-0004-6805-3595" }, { "affs": [ 0, 1 ], "name": "Luca Bianchi", "orcid": "0000-0001-8697-6896" }, { "affs": [ 0, 1 ], "name": "Marco Galluzzo", "orcid": "0000-0002-3424-5175" } ], "bibtex": "https://research.draconitic.com/paper/44yha0hfc0hhg.bib", "cited_by": 0, "doi": "10.3390/jcm15218567", "fulltext_url": null, "id": "44yha0hfc0hhg", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/21/8567", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [], "openalex": null, "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-11-03", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/44yha0hfc0hhg.ris", "sources": [ { "first_seen": "2026-11-04T12:21:42Z", "native_id": "10.3390/jcm15218567", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/21/8567" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Individualising Guselkumab Maintenance in Psoriatic Disease: Clinical Profiles Associated with Dosing-Interval Modification in a Multicentre Cohort", "title_text": "Individualising Guselkumab Maintenance in Psoriatic Disease: Clinical Profiles Associated with Dosing-Interval Modification in a Multicentre Cohort", "type": "peer-reviewed", "updated_at": "2026-11-06T00:21:25Z", "url": "https://research.draconitic.com/paper/44yha0hfc0hhg", "venue": "Journal of Clinical Medicine", "versions": [] }