Spondyloarthritis & psoriatic arthritis
Effectiveness of sequential lines of biologic and targeted small-molecule drugs in psoriatic arthritis: a systematic review
Authors' conclusion
Predominantly observational studies, inherently at high risk of bias, indicate bDMARDs can be effective to third-line in PsA, but that response is reduced after first line. There is very limited data for more advanced lines of b/tsDMARD.
Study context
- Population
- Adults with psoriatic arthritis (PsA) receiving b/tsDMARDs beyond first-line12 manuscripts (11 observational, 1 RCT sub-analysis)
- Participants
- 16,081 adults
- Comparison
- First-line vs second-line vs third-line b/tsDMARDs
- Outcome
- Effectiveness of sequential lines of b/tsDMARDs beyond first-line
Methodological detailsrisk of bias assessment (ROBINS-I/Cochrane RoB2), Two abstracts (n = 7186) also included, Average age 49.5 years, female 53.3%, 2666 abstracts identified; 177 full texts reviewed; 12 manuscripts and 2 abstracts eligible
- Risk of bias assessment (ROBINS-I/Cochrane RoB2)
- Two abstracts (n = 7186) also included
- Average age 49.5 years, female 53.3%
- 2666 abstracts identified; 177 full texts reviewed; 12 manuscripts and 2 abstracts eligible
Pooled result
As reported in the abstract
DAPSA remission (most reported outcome, 8 studies), average
Further pooled results
Response to third-line bDMARDs
- Studies finding comparable second- and third-line responses
- 4
- Studies finding diminishing responses in sequential lines
- 5
Original publication
Effectiveness of sequential lines of biologic and targeted small-molecule drugs in psoriatic arthritis: a systematic review. Rheumatology (Oxford). Published 18 January 2024. doi:10.
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