A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report

Monotherapy may not be sufficient for the complete control of the psoriatic disease in selected patients. In refractory patients, combining two drugs with different mechanisms of action may result in improved efficacy. Data regarding the combination of biologics and Janus kinase inhibitors are lacki...

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Main Authors: Sofia Antolini, Giorgia Scagliosi, Olta Veliaj, Antonio Carletto, Elena Fracassi, Paolo Gisondi
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251352160
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author Sofia Antolini
Giorgia Scagliosi
Olta Veliaj
Antonio Carletto
Elena Fracassi
Paolo Gisondi
author_facet Sofia Antolini
Giorgia Scagliosi
Olta Veliaj
Antonio Carletto
Elena Fracassi
Paolo Gisondi
author_sort Sofia Antolini
collection DOAJ
description Monotherapy may not be sufficient for the complete control of the psoriatic disease in selected patients. In refractory patients, combining two drugs with different mechanisms of action may result in improved efficacy. Data regarding the combination of biologics and Janus kinase inhibitors are lacking. A 61-year-old man affected by severe chronic plaque psoriasis and peripheral psoriatic arthritis affecting hands and feet, dactylitis, and enthesitis was successfully treated with a combination of upadacitinib and guselkumab. The combination of the two drugs was needed because upadacitinib was effective on psoriatic arthritis, but not on the skin lesions, while responding to guselkumab, which, vice versa, was not effective on psoriatic arthritis. Notably, the patients failed different conventional synthetic and biologic drugs. At a follow-up of 12 months, he had not experienced adverse events or laboratory alterations. Other studies are necessary to confirm the efficacy and safety profile of upadacitinib associated with guselkumab.
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spelling doaj-art-d6dad8ec75aa4153aa511b91ea38ec1a2025-08-20T03:28:37ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-06-011310.1177/2050313X251352160A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case reportSofia Antolini0Giorgia Scagliosi1Olta Veliaj2Antonio Carletto3Elena Fracassi4Paolo Gisondi5Section of Rheumatology, Department of Medicine, University of Verona, ItalySection of Rheumatology, Department of Medicine, University of Verona, ItalySection of Rheumatology, Department of Medicine, University of Verona, ItalySection of Rheumatology, Department of Medicine, University of Verona, ItalySection of Rheumatology, Department of Medicine, University of Verona, ItalySection of Dermatology and Venereology, Department of Medicine, University of Verona, ItalyMonotherapy may not be sufficient for the complete control of the psoriatic disease in selected patients. In refractory patients, combining two drugs with different mechanisms of action may result in improved efficacy. Data regarding the combination of biologics and Janus kinase inhibitors are lacking. A 61-year-old man affected by severe chronic plaque psoriasis and peripheral psoriatic arthritis affecting hands and feet, dactylitis, and enthesitis was successfully treated with a combination of upadacitinib and guselkumab. The combination of the two drugs was needed because upadacitinib was effective on psoriatic arthritis, but not on the skin lesions, while responding to guselkumab, which, vice versa, was not effective on psoriatic arthritis. Notably, the patients failed different conventional synthetic and biologic drugs. At a follow-up of 12 months, he had not experienced adverse events or laboratory alterations. Other studies are necessary to confirm the efficacy and safety profile of upadacitinib associated with guselkumab.https://doi.org/10.1177/2050313X251352160
spellingShingle Sofia Antolini
Giorgia Scagliosi
Olta Veliaj
Antonio Carletto
Elena Fracassi
Paolo Gisondi
A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
SAGE Open Medical Case Reports
title A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
title_full A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
title_fullStr A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
title_full_unstemmed A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
title_short A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report
title_sort successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis a case report
url https://doi.org/10.1177/2050313X251352160
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