Marzo-Ortega et al. report that dactylitis and enthesitis are associated with a greater disease burden and worse prognosis, highlighting the importance for physicians to identify these conditions and provide adequate treatment. Authors evaluated guselkumab’s efficacy on dactylitis resolution (DR) and enthesitis resolution (ER), and their impact on subsequent disease control, in patients with active PsA and prior inadequate response to tumour necrosis factor inhibitors (TNFi-IR).

In this first global clinical study of a nanobody in inflammatory arthritis, sonelokimab, an
IL-17A- and IL-17F-inhibiting nanobody demonstrated strong efficacy across multiple domains including high-hurdle composite joint and skin responses. McInnes et al. reported on the Phase 2, randomized, double-blind, PBO-controlled ARGO trial which evaluated the efficacy and safety of sonelokimab in patients with active PsA.

April 2025

The concept of difficult-to-treat disease in rheumatology: where next?

Lancet Rheumatol. 2025;7:e274–89 doi: 10.1016/S2665-9913(24)00340-0

Nagy et al. propose a unifying and holistic framework for understanding and addressing the concept of difficult-to-treat (D2T) disease across rheumatology, integrating cross-disciplinary evidence and recommending its incorporation into future disease management strategies. The D2T state requires a comprehensive, holistic, multidisciplinary approach that considers the specific characteristics of each disease and the personalised needs of the patient.