Spondyloarthritis & psoriatic arthritis
Impact of dactylitis and enthesitis resolution on disease control in guselkumab-treated psoriatic arthritis patients with TNFi-IR: COSMOS post hoc analysis
Authors' conclusion
Guselkumab treatment resulted in high DR/ER rates through W48 in TNFi-IR PsA patients. W24 DR/ER was associated with W48 disease control
Study context
- Population
- Adults with active psoriatic arthritis (PsA) and prior inadequate response to TNFi (TNFi-IR)
- Participants
- 285 adults
- Comparison
- Guselkumab 100 mg vs placebo
- Primary endpoint
- Dactylitis resolution (DSS) and enthesitis resolution (LEI); association of W24 DR or ER with W48 stringent disease control measures
- Follow-up
- W24
Methodological detailsPhase IIIb, randomized (2:1), logistic regression
- Phase IIIb
- Randomized (2:1)
- Logistic regression
Primary result
As reported in the abstract
Dactylitis resolution / enthesitis resolution
Guselkumab
44.8%/39.7%
Placebo
25.0%/18.8%
Further findings
- Dactylitis resolution (DR)/enthesitis resolution (ER) among guselkumab-randomized patients · W48
- 67.2%/55.6%
Association of W24 resolution with W48 stringent measures (ACR50/70, DAPSA LDA/remission, PASI100, PASDAS LDA/VLDA, MDA/VLDA)
- OR, DR
- 3.28-13.38
- OR, ER
- 2.88-6.09
Baseline prevalence of dactylitis (Dactylitis Severity Score (DSS) ≥ 1) and enthesitis (Leeds Enthesitis Index (LEI) ≥ 1)
- Dactylitis, 103/285
- 36.1%
- Enthesitis, 190/285
- 66.7%
Original publication
Impact of dactylitis and enthesitis resolution on disease control in guselkumab-treated psoriatic arthritis patients with TNFi-IR: COSMOS post hoc analysis. Rheumatology (Oxford). Published 14 September 2025. doi:10.
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