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

The efficacy and safety of tildrakizumab for the treatment of scalp psoriasis are maintained for up to 52 weeks of treatment in a clinical trial setting.

Real-world effectiveness and safety data suggest that deucravacitinib is a valuable long-term treatment option for PsO.

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.

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.

Mease et al. found that bimekizumab demonstrated a favourable long-term safety profile in patients with axSpA and PsA.

Reinisch W, et al. report that the efficacy of RZB induction therapy is independent of CS use, with high rates of CS-free outcomes observed in the overall population and among patients with baseline CS use.

Kaya et al. reported that switching to secukinumab or cycling to another TNFi after first TNFi failure in axSpA led to comparable drug survival, with predictive factors differing by treatment. The study reports that smoking and Achilles enthesitis were associated with higher SEC discontinuation, while high CRP and primary TNFi failure predicted TNFi discontinuation.

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.