The AFFINITY Study: Combination Treatment in PsA Save
Dr. Antoni Chan reports on abstract OP0186 in London at EULAR 2026
Transcription
Hi, I'm Anthony Chan reporting for RheumNow here in London at EULAR 2026. One of the areas that have been discussed in this conference is the use of combination treatment or dual targeted therapy in the field of both psoriatic arthritis and also axial spondyloarthritis.
One of the presentations was the AFFINITY study, which is OP0186, which is the study of guselkumab in addition to golimumab in patients who had failed one or two TNF inhibitors. This was a phase 2a study which tested the IL-23 inhibitor guselkumab combined with golimumab, which is a TNF alpha inhibitor, versus guselkumab monotherapy in patients who had failed one or two prior TNF inhibitors. 91 PsA patients were studied in the study and this early report is about the MRI findings as an exploratory outcome.
The key findings: the combination therapy patients who had received both guselkumab in addition to golimumab did better with regards to some of the MRI findings compared to patients who had just received the TNF inhibitor alone or with the guselkumab monotherapy. The combination therapy produced numerically greater reductions in the hand inflammation compared to the monotherapy group, and also the foot MRI showed a statistically significant reduction in the total inflammation versus the monotherapy group. The structural damage was stable in both arms. The combination did not accelerate any damage. There was no obvious difference in the enthesitis data that was seen.
So the question is, what is the significance of this? This is very early data. It's looking at MRI changes, so it's very much looking at the imaging outcomes, and the MRI data certainly in the hands and feet would support the clinical signals. The dual pathway, the dual blockade of IL-23 and TNF, may actually raise the ceiling with regards to reducing joint inflammation in patients who had failed TNF, or TNF inadequate responders, particularly as seen in the foot, and it does not appear to increase structural risk.
So this I thought was interesting because it's using in the exploratory phase the MRI result rather than the typical outcome measures that we would use in standard reporting. Obviously we'll await further data as the study is carried out in the longer term, but we are increasingly seeing in patients who had failed one or two TNFs that we are going for more combination treatment in these patients to try to get the treatment refractory patients into a better clinical state and also hopefully reduce structural damage in the long term.
I'm Anthony Chan reporting here in London at EULAR 2026.
One of the presentations was the AFFINITY study, which is OP0186, which is the study of guselkumab in addition to golimumab in patients who had failed one or two TNF inhibitors. This was a phase 2a study which tested the IL-23 inhibitor guselkumab combined with golimumab, which is a TNF alpha inhibitor, versus guselkumab monotherapy in patients who had failed one or two prior TNF inhibitors. 91 PsA patients were studied in the study and this early report is about the MRI findings as an exploratory outcome.
The key findings: the combination therapy patients who had received both guselkumab in addition to golimumab did better with regards to some of the MRI findings compared to patients who had just received the TNF inhibitor alone or with the guselkumab monotherapy. The combination therapy produced numerically greater reductions in the hand inflammation compared to the monotherapy group, and also the foot MRI showed a statistically significant reduction in the total inflammation versus the monotherapy group. The structural damage was stable in both arms. The combination did not accelerate any damage. There was no obvious difference in the enthesitis data that was seen.
So the question is, what is the significance of this? This is very early data. It's looking at MRI changes, so it's very much looking at the imaging outcomes, and the MRI data certainly in the hands and feet would support the clinical signals. The dual pathway, the dual blockade of IL-23 and TNF, may actually raise the ceiling with regards to reducing joint inflammation in patients who had failed TNF, or TNF inadequate responders, particularly as seen in the foot, and it does not appear to increase structural risk.
So this I thought was interesting because it's using in the exploratory phase the MRI result rather than the typical outcome measures that we would use in standard reporting. Obviously we'll await further data as the study is carried out in the longer term, but we are increasingly seeing in patients who had failed one or two TNFs that we are going for more combination treatment in these patients to try to get the treatment refractory patients into a better clinical state and also hopefully reduce structural damage in the long term.
I'm Anthony Chan reporting here in London at EULAR 2026.
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