Where in the sequence of biologics would you consider guselkumab for patients with active psoriatic arthritis despite standard DMARD therapy?   

This is an extremely important question and one that is likely to change as new data becomes available. It is important to remember that psoriatic arthritis (PsA) is a complex and heterogeneous disease and a single approach does not work for every patient. Based on the ACR/NPF 2019 PsA treatment gui...

In patients that failed standard conventional synthetic DMARD therapy and still have active disease, the start of a biological DMARD would be the next step. The choice is between anti-TNF therapy, anti-IL-12/23 therapy (guselkumab), and anti-IL-17 therapy. In patients with significant skin psoriasis...

Although not head-to-head data with TNFi, the absolute outcome measure data in musculoskeletal domains, the strong results in the skin domain, the benign safety profile, and data from a recent Network Metaanalysis which evaluated all approved therapies for PsA, suggest that guselkumab musculoskeleta...