Individualising Guselkumab Maintenance in Psoriatic Disease: Clinical Profiles Associated with Dosing-Interval Modification in a Multicentre Cohort
10 affiliations
- 1Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
- 2Dermatology Unit, Azienda Ospedaliera Universitaria Policlinico “Tor Vergata”, 00133 Rome, Italy
- 3Department of Medicine Surgery and Dentistry, ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy
- 4Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
- 5Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
- 6Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- 7Dermatology Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- 8Dermatology Unit, University of Campania Luigi Vanvitelli, 801380 Naples, Italy
- 9Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- 10Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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.
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BibTeX
@article{mortato2026individualising,
title = {{Individualising Guselkumab Maintenance in Psoriatic Disease: Clinical Profiles Associated with Dosing-Interval Modification in a Multicentre Cohort}},
author = {Edoardo Mortato and Marina Talamonti and Annunziata Raimondo and Viviana Lora and Matteo Megna and Cristina Mugheddu and Gabriele Biondi and Anna Balato and Giacomo Caldarola and Lorenzo Marcelli and Serena Lembo and Dario Graceffa and Luca Potestio and Laura Atzori and Maria Antonia Montesu and Eugenia Veronica Di Brizzi and Eleonora De Luca and Lucia Bufano and Luca Bianchi and Marco Galluzzo},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218567},
url = {https://www.mdpi.com/2077-0383/15/21/8567},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Individualising Guselkumab Maintenance in Psoriatic Disease: Clinical Profiles Associated with Dosing-Interval Modification in a Multicentre Cohort
AU - Edoardo Mortato
AU - Marina Talamonti
AU - Annunziata Raimondo
AU - Viviana Lora
AU - Matteo Megna
AU - Cristina Mugheddu
AU - Gabriele Biondi
AU - Anna Balato
AU - Giacomo Caldarola
AU - Lorenzo Marcelli
AU - Serena Lembo
AU - Dario Graceffa
AU - Luca Potestio
AU - Laura Atzori
AU - Maria Antonia Montesu
AU - Eugenia Veronica Di Brizzi
AU - Eleonora De Luca
AU - Lucia Bufano
AU - Luca Bianchi
AU - Marco Galluzzo
PY - 2026
DA - 2026/11/03
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218567
UR - https://www.mdpi.com/2077-0383/15/21/8567
AB - 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.
SN - 2077-0383
ER -