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Psoriatic Arthritis — SCE Rheumatology MCQ

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HardSpondyloarthropathyPsoriatic ArthritisSCE Rheumatology

A patient with psoriatic arthritis is considering guselkumab after primary non-response to a TNF inhibitor. Which molecular target explains guselkumab’s mechanism?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Selective antibody blockade of the interleukin-23 p19 subunit

Guselkumab is a monoclonal antibody directed against the p19 subunit of IL-23. This separates it from IL-17 inhibitors, TNF inhibitors, JAK inhibitors and CTLA4-Ig therapy.

Reference: NICE TA711: guselkumab for active psoriatic arthritis (Published June 2021): https://www.nice.org.uk/guidance/ta711/chapter/1-Recommendations; 2022 BSR guideline for psoriatic arthritis with biologic and targeted synthetic DMARDs (Published May 2022; corrected January 2023): https://academic.oup.com/rheumatology/article/61/9/e255/6594139