Background and Importance Guselkumab is a monoclonal antibody that selectively binds to interleukin 23 protein with a label indication in plaque psoriasis and psoriatic arthritis (PsA). Little information about real-world persistence with guselkumab therapy for PsA is known.

Aim and Objectives The aim was to evaluate persistence with guselkumab therapy in PsA.

Material and Methods Retrospective observational study was conducted in a tertiary level hospital. Patients who started treatment with guselkumab between 01/05/2020–01/09/2023 were included. Those with less than 9 months’ treatment duration were excluded. The variables collected were sex, age, underlying pathology and comorbidities, previous treatments, and start-end date of treatment. Data analysis was performed using SPSS® version 24 statistical software. A descriptive analysis of the data was performed, comparative statistical tests, as well as a Kaplan-Meier survival analysis.

Results Among the 69 patients in the database who initiated guselkumab during the study period, 50 met the study inclusion criteria. The mean (SD) age was 53.3 (12.7) years and 58% were female. 44% (22/50) had been treated with four or more PsA drugs before guselkumab and 74% used an anti-TNF drug.

The median drug survival (SD) was 20.6 (2.7) months. 52% of patients experienced the event (discontinuation of treatment) within 30 months of treatment. Persistence was 69.3% (ES:0.07) at 1 year of treatment and it decreased to 43.7% (ES:0.08) at 2 years of treatment.

There were no statistical differences between patients who had been treated with more or less than four previous treatments nor patients with and without comorbidities. However, we found some differences between patients with previous anti-TNF treatments and the ones who didn’t use them. 30.8% of patients without Anti-TNF discontinued treatment vs 59.5% who used Anti-TNF before (p=0,075), mean drug survival in the first group (no anti-TNF) (SD) was 26.0(2.0) vs 16.4 (1.8) in the second group (p=0.02). The reason for these results may be because guselkumab is used in initial stages of the disease due to contraindications to anti-TNF.

Conclusion and Relevance As in clinical trials and another real-world study, high persistence rates were observed with guselkumab during the first year. Further real-world research should be conducted to correlate the differences found between patients with previous anti-TNF treatment, as no such differences were found in clinical trials.

Conflict of Interest No conflict of interest.