Comparing Guselkumab and Golimumab Treatments for Psoriatic Arthritis in Patients Not Responding to TNF Inhibitors

What this Trial Is About

Researchers are evaluating treatments for patients with psoriatic arthritis PsA who have not responded well to tumor necrosis factor inhibitors TNFi. The trial aims to find out if switching to guselkumab, a selective interleukin 23 inhibitor IL23i, is more effective than switching to a second TNFi, golimumab. This is the first study to compare these treatment switches in PsA patients and will focus on those who have an inadequate response to TNFi in a real-world clinical setting. Participants will be randomly assigned to one of three treatment groups guselkumab 100mg every 4 weeks, guselkumab 100mg every 8 weeks, or golimumab 50mg every 4 weeks. Both medications are given as subcutaneous injections. The study is open-label, meaning both patients and researchers know which treatment is given. The trial will continue for 12 months to assess treatment effectiveness. Throughout the study, participants will be monitored for disease activity using measures like cDAPSA low disease activity and Investigator Global Assessment of Psoriasis. Additional assessments include minimal disease activity, quality of life questionnaires, fatigue, and resolution of symptoms such as dactylitis and enthesitis. Safety and treatment response will be evaluated regularly, with the main outcomes measured at 6 and 12 months.

Guselkumab vs Golimumab in PsA TNF Inadequate Responder Patients