Morning Symposium 5

Objectives:

The APEX study evaluated guselkumab in adults with active, erosive psoriatic arthritis and demonstrated meaningful clinical and radiographic benefits through Week 48. Participants met predefined activity and erosive criteria and were randomized to two guselkumab dosing regimens or placebo with crossover at Week 24. By Week 48, both guselkumab schedules showed sustained improvements in ACR20 and ACR50 responses, along with continued suppression of radiographic progression, while patients switched from placebo also improved after initiating treatment. Safety findings through 48 weeks showed stable incidence rates of adverse events without signals of increased risk over time. Overall, guselkumab maintained consistent disease‑activity improvements and limited structural progression in biologic‑naïve patients.

Axial spondyloarthritis is a systemic condition influenced by immune, microbial, and mechanical pathways, with extra‑musculoskeletal manifestations—such as acute anterior uveitis and inflammatory bowel disease—playing an important role in therapeutic decision‑making. Current guidelines recommend monoclonal TNF inhibitors when these manifestations are present. Real‑world data for AS patients from Korean and the Go-EASY study describe differing risks of uveitis among biologics, with some TNF inhibitors including golimumab showing lower observed rates. Long‑term observations also describe favorable treatment persistence with monthly dosing regimens. These findings collectively support an evidence‑informed approach to biologic selection in axSpA.