Background and Importance Guselkumab is anti-interleukin-23 monoclonal antibody used for moderate to severe psoriasis (msPs) and psoriatic arthritis (PsA) in patients refractory to other biological agents in clinical practice.

Aim and Objectives To analyse the profile of use and persistence of guselkumab in patients diagnosed with msPs and PsA.

Material and Methods An observational, descriptive and retrospective study (May 2019 to August 2023) in which we included all patients who initiated treatment with guselkumab. Data of sex, age, diagnostic, comorbidities, previous biological, start date, last dispensation date and the reasons for treatment discontinuation were collected from the medical records and prescription medications program.

Categorical variables were summarised as percentage (N) and as median for continuous variables. The cumulative probability of treatment persistence was analysed by Kaplan-Meier method and log-rank test to compare the survival along diagnostic, line of treatment and comorbidities using SPSS Statistics, considering a p-value <0.05.

Results Guselkumab was initiated by 40 patients, 57.5%(23) with PsA and 42.5%(17) with msPs. Median age was 54 years, and 57.3% (23) were female. All patients had prior exposure to biologic therapy except one, 87.5% (35) anti-TNF-a (adalimumab, infliximab, etanercept), 47.5% (19) anti-IL-17 (ixekizumab, secukinumab) and 30% (12) ustekinumab. The exposed patients 97.5% (39) had used 1–5 biologic therapies before guselkumab initiation, 40% (16) of patients received three or more therapies. 22.5% (9) of patients had no comorbidities, 35% (14) had at least one comorbidity and 42.5% (17) showed two or more.

The cumulative probability of guselkumab treatment persistence was 74.8% at 1 year and 67.3% at 2 years. Median persistence of guselkumab was 31.2 months (95% CI: 21.2–41.2). 32.5% (13) discontinued treatment during the study, the main cause of discontinuation was secondary failure (46.1%). Comparing groups, there were statistical differences in guselkumab’s persistence in msPs vs PsA (14–36.7 months, p=0.059), however, patients with or without prior anti-IL-17 therapy, with or without comorbidities, or according to the number of prior biologics did not show any statistical differences.

Conclusion and Relevance Drug survival of guselkumab in this study is acceptable but main limitation is short follow-up time in some of the patients due to their recent coverage by the Spanish health system in PsA. More studies with larger sample sizes are needed to establish the factors that play a key role in the persistence of treatment.

Conflict of Interest No conflict of interest.