guselkumab

Overview

Guselkumab is a therapeutic monoclonal antibody used in immune-mediated inflammatory disease research and treatment. It is best known as an interleukin-23 (IL-23) pathway inhibitor and has been studied extensively in conditions driven by dysregulated inflammatory signaling, including psoriatic arthritis, plaque psoriasis, and ulcerative colitis. By targeting the IL-23 axis, guselkumab is intended to reduce downstream inflammatory activity that contributes to chronic tissue inflammation and clinical disease activity.

In biomedical research, guselkumab is of particular interest because it is being evaluated across both dermatologic and rheumatologic disease domains, as well as in inflammatory bowel disease. Recent studies have focused on its effectiveness, persistence, and safety in real-world psoriatic arthritis cohorts, and on its induction efficacy in moderately to severely active ulcerative colitis. These investigations position guselkumab as a clinically relevant biologic therapy with expanding translational significance.

Focus of Latest Publications

Recent publications have examined guselkumab in several clinical contexts, primarily as a treatment for psoriatic arthritis and ulcerative colitis.

A multicenter real-world study in psoriatic arthritis investigated predictors of 12-month DAPSA remission among patients treated with guselkumab. The study specifically aimed to identify which baseline or early-treatment factors were associated with remission at 12 months. The extracted variables indicate that the analysis considered articular response, cutaneous response, Dapsa, disease duration, number of prior advanced therapies, axial involvement, smoking status, and pre-pregnancy BMI, reflecting a broad clinical assessment of factors that may influence treatment response in psoriatic arthritis. The publication context suggests that guselkumab was evaluated in routine care, with remission defined using DAPSA-based outcomes.

Another multicenter retrospective real-world study from Argentina assessed the persistence and effectiveness of IL-23 inhibitors in psoriatic arthritis, including guselkumab and risankizumab. In this setting, adults with rheumatologist-diagnosed psoriatic arthritis initiating IL-23 inhibitors in routine care were included. The study emphasized 12-month persistence and effectiveness, indicating that guselkumab was analyzed as part of a class-level comparison in everyday clinical practice rather than in a controlled trial setting.

A case report described granulomatous prostatitis masquerading as suspected prostate cancer in a young patient receiving guselkumab immunotherapy for psoriasis. This report is notable as a rare clinical observation in a patient on guselkumab, highlighting the importance of considering inflammatory or treatment-associated diagnostic confounders in patients receiving biologic therapy for plaque psoriasis.

Guselkumab was also evaluated in ulcerative colitis in a phase 3 randomized, placebo-controlled trial (ASTRO). This study assessed the efficacy and safety of subcutaneous guselkumab induction therapy in adults with moderately to severely active ulcerative colitis. The trial design indicates a rigorous interventional evaluation of guselkumab beyond dermatologic and rheumatologic indications, supporting its investigation as an anti-inflammatory biologic in gastrointestinal disease.

Complementing the clinical trial, a multiomic characterisation study examined the cellular and molecular changes associated with guselkumab treatment in ulcerative colitis from the QUASAR Phase IIb induction study. This work aimed to define the biological effects of guselkumab at a systems level, linking clinical efficacy with underlying immune and molecular changes. Together, these ulcerative colitis studies suggest that guselkumab is being explored not only for symptom control but also for mechanistic insight into IL-23 blockade in intestinal inflammation.

Key Publications

Jun Biparatopic targeting of IL-23 enables dual-epitope engagement and enhanced neutralization potency. (mAbs, 2026, PMID 42304980): "Herewithin, we engineered and characterized biparatopic antibodies targeting human interleukin-23 (IL-23) by combining the clinically validated variable regions of ustekinumab and guselkumab into 1 + 1 IgG-like and 2 + 2 Fab-IgG extended biparatopic formats."
Jun Six months predictors of DAPSA Remission With Guselkumab in Psoriatic Arthritis in a Multicenter Real-World Study. (Scientific reports, 2026, PMID 42230809): "This multicenter observational study aimed to identify predictors of 12-month DAPSA remission in patients with PsA treated with GUS."
May High 12-month persistence and effectiveness of IL-23 inhibitors in psoriatic arthritis: a multicenter retrospective real-world study from Argentina. (Rheumatology international, 2026, PMID 42154041): "Adults with rheumatologist-diagnosed PsA initiating IL-23i (guselkumab or risankizumab) in routine care were included."
Apr Granulomatous prostatitis masquerading as suspected prostate cancer in a young patient on immunotherapy for psoriasis. (BMJ case reports, 2026, PMID 42031391): "...the only reported case of a patient on guselkumab immunotherapy."
Apr Multiomic characterisation of the clinical efficacy of guselkumab induction therapy in ulcerative colitis. (BMJ open gastroenterology, 2026, PMID 41871904): "Here, we provide a detailed evaluation of the cellular and molecular changes associated with guselkumab treatment in patients with moderately to severely active ulcerative colitis (UC) from the QUASAR Phase IIb induction study."
Apr Efficacy and safety of subcutaneous guselkumab induction therapy in participants with moderately to severely active ulcerative colitis (ASTRO): a double-blind, treat-through, randomised, placebo-controlled, phase 3 trial. (The lancet. Gastroenterology & hepatology, 2026, PMID 41544637): "We aimed to evaluate the efficacy and safety of subcutaneous guselkumab induction in adults with moderately to severely active ulcerative colitis."