Guselkumab is in clinical development for the treatment of adults with active psoriatic arthritis. Psoriatic arthritis is a type of chronic inflammatory arthritis affecting the joints and connective tissue and is associated with psoriasis of the skin or nails. Although the exact cause of the disease still remains unknown, it is thought to occur as a result of the immune system mistakenly attacking healthy tissues around the joint and bones. Psoriatic arthritis can get progressively worse and may lead to the joints becoming permanently damaged or deformed.
Guselkumab is a type of biologic medicine that has been designed to suppress immune response associated with psoriasis. It works by specifically targeting a chemical messenger (known as a cytokine) in the body called interleukin-23 (IL-23). The IL-23 are produced by leucocytes (mainly by lymphocytes T, macrophages and eosinophils) in response to mechanical stress, and has an important role in the pathogenesis of psoriasis and psoriatic arthritis. Guselkumab is already licensed in the EU/UK for the treatment of moderate to severe plaque psoriasis and may offer an additional treatment option for patients with active psoriatic arthritis.
Tofacitinib works by blocking the action of enzymes known as Janus kinases. These enzymes play an important role in the inflammatory process. By blocking the enzymes’ action, tofacitinib helps reduce the inflammation and other symptoms of these diseases. Tofacitinib is an oral alternative to the available biological medicines for children with JIA, most of which are administered by injection. If licensed, tofacitinib may offer an additional treatment option for polyarticular JIA with the potential advantage of improving the quality of life of children due to its oral formulation.