Data by Flouri et al. support greater drug persistence with secukinumab than with TNF inhibitors in patients with axSpA and peripheral spondyloarthritis, both with respect to efficacy- and safety-related discontinuations, while the achievement of 6-month treatment targets was comparable. Flouri et al. compared long term treatment persistence, efficacy and safety between secukinumab and TNF inhibitors in a cohort of patients with SpA treated in real life.

Nozaki et al. showed that JAK inhibitor treatment provided sustained disease control (especially in high-risk RA patients) and promoted GC reduction, although TNF inhibitors remain a standard option. Nozaki et al. evaluated the clinical efficacy and continuation rates of JAK inhibitors and TNF inhibitors in RA patients with poor-prognosis factors (PPFs).

Hernández-Hernández et al. showed that in a real-world clinical settings, UPA persistence is lower among RA patients who have received prior IL-6i treatment; and that treatment strategies to avoid UPA in patients with cardiovascular risk (CVR) appear to be primarily driven by pivotal safety studies rather than regulatory guidance.

October 2025

Lindner et al. report that their findings underscore the need for sex-specific treatment strategies and more comprehensive research into biological and sociocultural factors influencing therapy persistence and reasons for discontinuation in real-world settings. Authors investigated sex differences in treatment outcomes, persistence, discontinuation reasons, and adverse events during first-line b/tsDMARD therapy.

April 2025

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.

March 2025

Burden and determinants of multi-b/tsDMARD failure in psoriatic arthritis

Arthritis Research & Therapy 2025;27:46 doi: 10.1186/s13075-025-03518-7

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.