Upadacitinib in psoriatic arthritis with prior TNF-inhibitor failure: a 56-week real-world study

Clin Exp Rheumatol. 2025; Advance online publication Epub ahead of print Doi: 10.55563/clinexprheumatol/gniy9i

Bakay et al. report  that upadacitinib (UPA) demonstrated sustained efficacy across musculoskeletal and skin domains in PsA patients with prior inadequate response to TNF inhibitors, with a safety profile consistent with previous reports.  Authors conducted a retrospective, single-centre observational study evaluating musculoskeletal disease activity, psoriasis, and patient-reported outcomes following initiation of UPA.

November 2025

Xu et al. showed that elevated BMI, BSA, body weight, and basal metabolic rate are associated with more severe PsO and diminished treatment efficacy, especially for those treated with biologics. Authors investigated the associations of BMI, basal metabolic rate, BSA, and body weight with baseline PsO severity and therapeutic response across different treatment modalities.

Qiao et al. showed that ixekizumab demonstrated superior efficacy in mild-moderate versus severe PsO, suggesting greater benefit with early biologic intervention. Authors compared clinical efficacy, relapse rates, and drug retention between mild-to-moderate and severe plaque PsO cohorts with different severity levels treated with Ixekizumab.

Gollins et al. reported that within this cohort, the Psoriatic arthritis response criteria (PsARC) response to 4th+ lines of b/tsDMARD was not significantly reduced compared with 2nd/3rd line in participants who had failed at least 3 b/tsDMARDs. Authors evaluated the primary clinical response to sequential lines of b/tsDMARD therapy in PsA, focusing on the effectiveness of later line treatments.

Bai et al. reported that JAKi therapy was associated with a reduced risk of incident uveitis compared with TNF inhibitors among patients with AS, PsO, or PsA. Authors conducted a large-scale, real world comparative study which evaluated the risk of incident uveitis among patients with psoriatic disease and AS treated with either TNFi or JAKi.

October 2025

Gold et al. showed that icotrokinra showed superior clinical response rates versus PBO and deucravacitinib in Phase 3 moderate-to-severe plaque PsO trials. Authors evaluated the efficacy and safety of icotrokinra, a targeted oral peptide that selectively binds the IL-23 receptor, compared with both PBO and deucravacitinib in adults with moderate-to-severe plaque PsO.

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).

Lindner et al. report that their findings underscore the need for sex-specific treatment strategies and more comprehensive research into biological and sociocultural factors influencing therapy persistence and reasons for discontinuation in real-world settings. Authors investigated sex differences in treatment outcomes, persistence, discontinuation reasons, and adverse events during first-line b/tsDMARD therapy.

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.

September 2025

This study by Olivares-Guerrero et al. provides comparative safety data from a clinical practice point of view, potentially contributing to facilitate the drug selection process for clinicians. New biologic treatments have a superior safety profile in real-world practice compared to adalimumab and its biosimilars. Olivares-Guerrero et al. used data from the BIOBADADERM registry of AEs to analyse the long-term safety profile of systemic treatments, including biological agents as well as new small oral molecules approved for the treatment of moderate-to-severe PsO, using adalimumab and its biosimilars as comparators.