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.
Filgotinib is a new Janus Kinase (JAK) inhibitor. JAK pathways are involved in the inflammatory process in RA. Filgotinib is highly selective for JAK1. By blocking the JAK1 pathway, filgotinib may help ease the RA symptoms. Filgotinib can be taken orally as a tablet once a day and it has shown to be safe. Filgotinib may be taken as monotherapy or in combination with methotrexate or other non-biologic DMARDs. If approved for the treatment of moderate to severe RA, filgotinib will offer an additional front line or a later line treatment option for this population group.