The SELECT-MONOTHERAPY study evaluated the safety and efficacy of UPA monotherapy through 260 weeks of treatment, in patients with RA who had prior inadequate response to MTX. No new safety signals were observed with long-term exposure to UPA, and results were consistent with prior findings and the established safety profile of UPA across indications. These data support the potential of UPA as a treatment option for patients with moderate to severe active RA who have responded inadequately to MTX.

May 2025

Lin et al. compared the risk of CVD in patients with psoriasis who were prescribed biologics or oral therapies and assessed the association between different classes of biologics and CVD risk. Patients with psoriasis-prescribed biologics exhibited a reduced risk of incident CVDs compared with those receiving oral antipsoriatic drugs.

Poddubnyy et al. identified no apparent increase in the risk of developing extramusculoskeletal manifestations (EMMs) in patients with PsA, r-axSpA, and nr-axSpA receiving 15mg UPA in the SELECT trials. Majority of patients did not report a history of EMMs at baseline, regardless of disease indication or study treatment.

Maksymowych et al. evaluated the effect of ixekizumab and adalimumab versus placebo over 52 weeks on structural lesions in sacroiliac joints assessed by MRI in patients naive to biological DMARDs with radiographic axSpA from the COAST-V study. The authors reported a decrease in erosion and increase in backfill at Week 16 with further reductions in erosion and increases in backfill occurring at Week 52 in patients receiving ixekizumab.

Biologic switching in psoriatic arthritis: Insights from real-world data and key risk factors

Semin Arthritis Rheum. 2025;73:152737 doi: 10.1016/j.semarthrit.2025.152737

Haddad et al. used real-world data from Israel’s largest health maintenance organisation to investigate predictors and patterns of biologic therapy switching in PsA, reporting that nearly half of biologic users switched therapy at least once. Cross-class switching, particularly from anti-TNF to IL-17 therapies, was frequent and consistent across two decades of treatment data.

Phase 2 study data show that zimlovisertib + tofacitinib was more effective than tofacitinib alone, in patients with moderate-to-severe RA and an inadequate response to MTX.

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.

Mariette et al. investigated the long-term safety of filgotinib with regard to MACE, VTE and malignancy across RA and UC clinical trial populations. Rates of these events remained low overall, with some increases observed in patients aged 65 years and older.

March 2025

Floris et al. conducted a monocentric cohort study to assess the impact of biologic treatment on the development of PsA in patients with PsO. Treatment with biologics significantly reduced the likelihood of PsA development, with lower prevalence observed across different biologic classes and patterns of joint involvement.

Zavoriti and Miossec explored the impact of tofacitinib on inflammation and coagulation in RA. Tofacitinib reduced synovial and vascular inflammation by inhibiting IFNɣ, IL-17A, and IL-6 production but failed to prevent the prothrombotic effects of inflammatory cytokines on endothelial cells. These findings suggest that while tofacitinib reduces inflammation, it does not mitigate associated thrombotic risk.