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.

April 2025

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.

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.

Di Napoli et al. conducted a global pharmacovigilance analysis comparing MACE between JAKis and anti-TNFα therapies in patients with RA. JAKis were more frequently associated with reported MACE, particularly stroke, and had a shorter median time to onset than
anti-TNFα therapy.

March 2025

Eberhard et al. investigated the effectiveness of JAKi versus bDMARDs on pain reduction in RA patients, using Swedish national register data. JAKi treatment resulted in a significantly greater reduction in pain at three months compared with TNFis, with a higher proportion achieving low pain at 12 months, particularly in those previously treated with multiple bDMARDs.

February 2025

IL23is are associated with a lower risk of PsA incidence compared to IL17is in PsO patients, particularly in specific age, sex, and ethnic groups according to the latest real-world research from Yu S, et al.

Zhao et al. found that among patients with PsA or axSpA, JAKi were not associated with increased risk of CVD or common cancers compared to TNFi or IL-17i.

December 2024

Integrated safety analysis of tofacitinib from Phase 2 and 3 trials of patients with ankylosing spondylitis

Journal Reference: Adv Rheumatol. 2024 Dec 18;64:87 doi: 10.1186/s42358-024-00402-x

Deodhar et al. conducted a pooled analysis of Phase 2 and 3 RCT data to assess the safety of tofacitinib in AS. The results showed that tofacitinib 5 mg BID had a tolerable safety profile over 48 weeks, consistent with its use in other inflammatory conditions such as RA and PsA.

November 2024

Tsai et al. observed no significant difference in the incidence of psoriatic arthritis among psoriasis patients treated with IL-23 inhibitors compared to IL-12/23 inhibitors, although there was a numerically lower PsA risk with IL-23 inhibitors. Results indicate both therapies are similarly effective for PsO management.