Medication Review: What Is the Evidence For Guselkumab Efficacy In Inhibiting The Progression of Structural Damage?

October 2025

In this medication review, Wendy Simmons, PA-C, from Carolina Arthritis Associates in Wilmington, North Carolina, draws on nearly three decades of rheumatology experience to explore the clinical efficacy of guselkumab in inhibiting the progression of structural damage in psoriatic arthritis. Referencing the APEX Phase 3B Trial presented at the 2025 EULAR Congress, Wendy reviews key data on guselkumab's dual IL-23 mechanism of action—targeting both the p19 subunit and the CD64 receptor on IL-23–producing myeloid cells. She highlights significant findings in joint space narrowing, bone erosion, and radiographic progression, demonstrating the therapy’s ability to slow disease progression compared to placebo. With efficacy shown across both Q4 and Q8 week dosing intervals, this medication represents a meaningful advancement in psoriatic arthritis management. For a deeper dive into the data and additional resources, visit the RhAPP website to access full clinical insights and educational materials for advanced practice providers.