Wang et al. validated the effectiveness and safety of UPA in this real-world study of Chinese PsA patients. UPA demonstrated comparable effectiveness to secukinumab (SEC) in psoriatic lesion improvement while showing comparable joint symptom relief compared with adalimumab (ADA), coupled with a favourable safety profile.

August 2025

Baraliakos et al. compared real-world effectiveness of upadacitinib, TNF inhibitors, or IL-17 inhibitors following inadequate response to an initial TNF inhibitor in patients with axSpA. Upadacitinib was associated with greater reductions in pain and fewer affected joints compared with switching to a second TNF inhibitor or IL-17 inhibitor.

June 2025

Heiting et al. investigated whether the initiation of IL-17 blockade with secukinumab improves bone turnover, bone mineral density, and microarchitecture in axSpA patients. Despite symptomatic benefits of therapy with secukinumab, with improvements in pain and function, there were few biochemical, densitometric, or microarchitectural changes in skeletal health over two years of treatment with secukinumab. Larger, longer-term controlled studies using sensitive metrics such as HR-pQCT to follow bone quality are needed to improve our understanding of bone health in axSpA and the relation to disease activity and therapy.

Merola et al. undertook a post hoc analysis of prospective cohorts that compared the effects of deucravacitinib vs placebo and vs apremilast on joint pain, and the impact of musculoskeletal symptoms, at Weeks 16 and 24 in the pooled POETYK PSO-1 and PSO-2 populations who self-reported joint symptoms on the PASE questionnaire. Patients who screened positively for PsA reported greater improvements in joint pain and peripheral joint disease with deucravacitinib vs placebo at Week 16 and vs apremilast at Week 24. Findings from this pooled analysis suggest that deucravacitinib may be used to treat both dermatologic and joint symptoms effectively in patients with psoriasis and probable arthritis.

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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.

March 2025

Van den Bosch et al. reported that upadacitinib 15 mg once daily led to sustained improvement in nr-axSpA over two years, including disease activity, pain, and quality of life. The study reports that 57.1% achieved ASAS40 response at week 104, with no new safety signals identified.

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

Gladman et al. assessed the impact of bimekizumab over 1 year on patient-reported symptoms, HRQoL, and work productivity in patients with PsA who were bDMARD-naïve or TNF-IR. The study showed that bimekizumab treatment resulted in sustained improvements across multiple domains, including pain, fatigue, physical function, and work impairment.

June 2024

The 1-year results of the SELECT-AXIS 2 study showed significant improvements in ASAS40 achievement in patients with nr-axSpA that were treated with upadacitinib 15mg QD versus placebo. Improvements in ASDAS endpoints, back pain, BASFI, and hsCRP from baseline were also observed.

April 2024

Deucravacitinib improved physical and social functioning, mental health, fatigue, and pain in a
Phase 2 trial in patients with active PsA. Here, investigators aimed to report the impact of deucravacitinib in a Phase 2 study in patients with active PsA from a patient perspective.