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.

October 2025

Gold et al. showed that icotrokinra showed superior clinical response rates versus PBO and deucravacitinib in Phase 3 moderate-to-severe plaque PsO trials. Authors evaluated the efficacy and safety of icotrokinra, a targeted oral peptide that selectively binds the IL-23 receptor, compared with both PBO and deucravacitinib in adults with moderate-to-severe plaque PsO.

Danese et al. report that in the TUSCANY-2 study, afimkibart showed a favourable
benefit–risk profile with clinically meaningful improvements and early onset of response during induction, sustained through maintenance, and an acceptable safety profile with no safety signals. Danese et al. describe results from the Phase 2b TUSCANY-2 trial that evaluated the safety and efficacy of 50mg, 150mg, and 450mg doses of afimkibart in adults with moderately-to-severely active UC.

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.

September 2025

This study by Olivares-Guerrero et al. provides comparative safety data from a clinical practice point of view, potentially contributing to facilitate the drug selection process for clinicians. New biologic treatments have a superior safety profile in real-world practice compared to adalimumab and its biosimilars. Olivares-Guerrero et al. used data from the BIOBADADERM registry of AEs to analyse the long-term safety profile of systemic treatments, including biological agents as well as new small oral molecules approved for the treatment of moderate-to-severe PsO, using adalimumab and its biosimilars as comparators.

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.

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.

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.

July 2025

Merola et al. showed that the safety profile of ixekizumab (IXE) supports its long-term use in patients with PsO, PsA, or axSpA, without an increased risk for malignant neoplasm development. Merola et al. investigated the incidence rates of malignant neoplasms among patients with PsO, PsA, or axSpA who underwent long-term treatment with IXE, an IL- 17A antagonist.

June 2025

The SELECT-MONOTHERAPY study evaluated the safety and efficacy of UPA monotherapy through 260 weeks of treatment, in patients with RA who had prior inadequate response to MTX. No new safety signals were observed with long-term exposure to UPA, and results were consistent with prior findings and the established safety profile of UPA across indications. These data support the potential of UPA as a treatment option for patients with moderate to severe active RA who have responded inadequately to MTX.