Guselkumab, a Novel Monoclonal Antibody Inhibitor of the p19 Subunit of IL-23, for Psoriatic Arthritis and Plaque Psoriasis: A Review of Its Mechanism, Use, and Clinical Effectiveness

Authors

Christian K. Kerut, LSU Health Sciences Center - New OrleansFollow
Maxwell J. Wagner, Louisiana State University Health Sciences Center, Shreveport, LA
Charles P. Daniel, Louisiana State University Health Sciences Center, Shreveport, LA
Claire Fisher, Louisiana State University Health Sciences Center, Shreveport, LA
Emmilee J. Henderson, Louisiana State University Health Sciences Center, Shreveport, LA
Caroline R. Burroughs, Louisiana State University Health Sciences Center, Shreveport, LA
Sam Amarasinghe, Louisiana State University Health Sciences Center, Shreveport, LA
Olga Willett, Louisiana State University Health Sciences Center, Shreveport, LA
Shahab Ahmadzadeh, Louisiana State University Health Sciences Center, Shreveport, LA
Giustino Varrassi, Paolo Procacci Foundation, Rome, ITA
Sahar Shekoohi, Louisiana State University Health Sciences Center, Shreveport, LA
Alan D. Kaye, Louisiana State University Health Sciences Center, Shreveport, LA

Document Type

Article

Publication Date

12-31-2023

Publication Title

Cureus

Abstract

Psoriatic arthritis and plaque psoriasis are autoimmune conditions affecting multiple organs, including the skin. The pathophysiology and etiology of these conditions are not fully understood; however, numerous factors are believed to play a critical role, including genetics and environmental risk factors. Furthermore, research suggests the IL-23/IL-17 pathway partially mediates these diseases. Once the IL-23 receptor is bound and activated, two subunits, p19, and p40, act through different signaling pathways. Ultimately, inflammation is produced through the effector molecule, IL-17, other cytokines, and tumor necrosis factor (TNF). Traditionally, these chronic conditions have been treated with TNF-α inhibitors and methotrexate, a dihydrofolate reductase inhibitor. Although successful in inhibiting the immune system, these drugs can have many adverse effects due to their broad targets. In recent years, more targeted therapy has become popular. Guselkumab is a monoclonal antibody that inhibits the p19 subunit of IL-23. It has been FDA-approved to treat both plaque psoriasis and psoriatic arthritis. Clinical trials showing guselkumab's efficacy have been promising, even showing improvement in symptoms of plaque psoriasis patients resistant to adalimumab, a TNF-α inhibitor. Guselkumab has also been shown to be well tolerated with a similar safety profile as other biologics inhibiting the immune system. In addition to its efficacy in treating plaque psoriasis and psoriatic arthritis, the mechanism of action offers a targeted approach that may minimize the broad immunosuppressive effects often associated with traditional therapies, providing a potential advantage in the long-term management of these autoimmune conditions.

First Page

e51405

PubMed ID

38292958

Volume

15

Issue

12

Recommended Citation

Kerut, Christian K.; Wagner, Maxwell J.; Daniel, Charles P.; Fisher, Claire; Henderson, Emmilee J.; Burroughs, Caroline R.; Amarasinghe, Sam; Willett, Olga; Ahmadzadeh, Shahab; Varrassi, Giustino; Shekoohi, Sahar; and Kaye, Alan D., "Guselkumab, a Novel Monoclonal Antibody Inhibitor of the p19 Subunit of IL-23, for Psoriatic Arthritis and Plaque Psoriasis: A Review of Its Mechanism, Use, and Clinical Effectiveness" (2023). School of Medicine Faculty Publications. 2140.
https://digitalscholar.lsuhsc.edu/som_facpubs/2140
10.7759/cureus.51405