Upadacitinib in psoriatic arthritis with prior TNF-inhibitor failure: a 56-week real-world study

Clin Exp Rheumatol. 2025; Advance online publication Epub ahead of print Doi: 10.55563/clinexprheumatol/gniy9i

Bakay et al. report  that upadacitinib (UPA) demonstrated sustained efficacy across musculoskeletal and skin domains in PsA patients with prior inadequate response to TNF inhibitors, with a safety profile consistent with previous reports.  Authors conducted a retrospective, single-centre observational study evaluating musculoskeletal disease activity, psoriasis, and patient-reported outcomes following initiation of UPA.

Gollins et al. reported that within this cohort, the Psoriatic arthritis response criteria (PsARC) response to 4th+ lines of b/tsDMARD was not significantly reduced compared with 2nd/3rd line in participants who had failed at least 3 b/tsDMARDs. Authors evaluated the primary clinical response to sequential lines of b/tsDMARD therapy in PsA, focusing on the effectiveness of later line treatments.

October 2025

Bai et al. reported that JAKi therapy was associated with a reduced risk of incident uveitis compared with TNF inhibitors among patients with AS, PsO, or PsA. Authors conducted a large-scale, real world comparative study which evaluated the risk of incident uveitis among patients with psoriatic disease and AS treated with either TNFi or JAKi.

In this first global clinical study of a nanobody in inflammatory arthritis, sonelokimab, an
IL-17A- and IL-17F-inhibiting nanobody demonstrated strong efficacy across multiple domains including high-hurdle composite joint and skin responses. McInnes et al. reported on the Phase 2, randomized, double-blind, PBO-controlled ARGO trial which evaluated the efficacy and safety of sonelokimab in patients with active PsA.

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.

September 2025

Marzo-Ortega et al. report that dactylitis and enthesitis are associated with a greater disease burden and worse prognosis, highlighting the importance for physicians to identify these conditions and provide adequate treatment. Authors evaluated guselkumab’s efficacy on dactylitis resolution (DR) and enthesitis resolution (ER), and their impact on subsequent disease control, in patients with active PsA and prior inadequate response to tumour necrosis factor inhibitors (TNFi-IR).

August 2025

Results from the Phase 3 GRAVTI study by Hart et al. showed that SC induction followed by SC maintenance treatment with guselkumab resulted in superior clinical and endoscopic improvements in participants with moderately to severely active CD through 48 weeks compared with placebo. Hart et al. evaluated efficacy and safety of guselkumab SC induction followed by SC maintenance in participants with moderately to severely active CD in a    treat-through design.

In this nationwide observational study, ixekuzumab was mainly used in patients with axSpA and PsA who had previously failed multiple b/tsDMARDs, including other IL-17 inhibitors. Although prior IL-17 treatment was associated with increased risk of withdrawal in both groups, the relatively high retention rates and improvements in all disease outcomes suggest ixekizumab as a viable option for challenging patients with multiple b/tsDMARD failures.

This descriptive analysis indicates a long-term safety profile of UPA consistent with previous reports, further supporting long-term treatment of chronic diseases with UPA. Burmester at al. characterized the safety profile of UPA across multiple approved indications and offer insights into its long-term use to help inform clinical decision-making.

Treatment with risankizumab provides durable improvement in the signs and symptoms of PsA across all the GRAPPA disease domains and related conditions. This post hoc analysis by Coates et al. aimed to assess the efficacy of long-term treatment with risankizumab across the updated GRAPPA domains and key related conditions of PsA.