Publications

Gollins et al. reported that within this cohort, the Psoriatic arthritis response criteria (PsARC) response to 4^th+ lines of b/tsDMARD was not significantly reduced compared with 2^nd/3^rd 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.

In this nationwide observational study, ixekuzumab was mainly used in patients with axSpA and PsA who had previously failed multiple b/tsDMARDs, including other IL-17 inhibitors. Although prior IL-17 treatment was associated with increased risk of withdrawal in both groups, the relatively high retention rates and improvements in all disease outcomes suggest ixekizumab as a viable option for challenging patients with multiple b/tsDMARD failures.

In more than 1500 patients from 13 European countries, Pons et al. demonstrated that secukinumab retention rates after four years were approximately 50% in both axSpA and PsA patients. Pons et al. aimed to assess retention rates and proportions of patients achieving remission and LDA, according to disease activity measures and patient-reported outcomes at 24 and 48 months, in axSpA and PsA patients initiating secukinumab. In this large real-world study, Pons et al., for the first time, report 48-month retention rates as well as rates of remission and LDA. Importantly, b/tsDMARD naïve patients demonstrated higher retention, remission and LDA rates than patients with prior b/tsDMARDs exposure, particularly in axSpA.  

Palsson et al. aimed to estimate the prevalence and predictors of ever achieving remission and sustained remission (SR) in PsA patients initiating b/tsDMARDs therapy in Sweden, using three different remission criteria (DAPSA28, DAS28CRP and EGA). Palsson et al. found that despite increased availability and a wider selection of b/tsDMARDs with different modes of action, a considerable proportion of PsA patients receiving such treatments never achieve remission and approximately half never achieve SR. Fewer swollen joints at baseline predicted a greater likelihood of SR according to all assessed remission definitions, while male sex predicted the likelihood of SR according to DAPSA28 and EGA.

Haberman et al. analysed prescribing patterns and characteristics of PsA patients with
multi-b/tsDMARD failure, defined as requiring ≥4 b/tsDMARDs. Among 960 patients at the NYU Psoriatic Arthritis Centre, 17% met this criterion. These patients were more likely to be female, obese, and have higher rates of axial involvement and depression. They also exhibited greater disease activity, suggesting that both inflammatory and non-inflammatory factors contribute to multiple treatment failures.

Kanda et al. investigated the efficacy of second-line b/tsDMARDs in RA patients unresponsive to first-line b/tsDMARDs. Using data from the FIRST registry, the study assessed 687 patients with RA treated with TNFis, IL-6 receptor inhibitors, cytotoxic T-lymphocyte-associated protein 4 immunoglobulin, or JAKis. After propensity score-based adjustment, JAKi showed the highest persistence rate, greatest improvement in CDAI, and highest remission rates at 24 weeks. Among JAKi, UPA was most effective in achieving remission, with a safety profile comparable to other b/tsDMARDs.

The authors found that there is a reduction in effectiveness of lines of bDMARDs after first-line in PsA, with inadequate data to determine response to tsDMARDs.

This multicentre, retrospective study by Hayashi, et al. found no significant differences in efficacy and safety between tofacitinib, baricitinib, peficitinib and upadacitinib in patients with RA. Predictive factors for resistance to LDA achievement included baseline CRP and CDAI for tofacitinib and baseline glucocorticoid dose, baseline CDAI and number of previous b/tsDMARDs for baricitinib.