Spondyloarthritis & psoriatic arthritis
Real‑world assessment of the effectiveness and response profiles of biologic DMARDs in psoriatic arthritis: findings from an emulated multicentre clinical trial
Authors' conclusion
In this real-world emulated multicentre clinical trial, bDMARDs showed comparable overall trajectories of short-term effectiveness and long-term treatment persistence in PsA. The identification of partially distinct response patterns may support a more individualised approach to bDMARD selection.
Study context
- Population
- Consecutive patients with moderate-to-high psoriatic arthritis (PsA) disease activity initiating a bDMARD, multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale study, January 2022 to June 2025patients included
- Participants
- 990 patients
- Comparison
- Comparing tumour necrosis factor (TNF) inhibitors, interleukin (IL)-17 inhibitors, and IL-23-pathway inhibitors
- TNF INHIBITORSn = 342
- IL-17 INHIBITORSn = 313
- IL-23-PATHWAY INHIBITORSn = 335
- Outcome
- DAPSA, longitudinal change
- Follow-up
- 6 months
Methodological detailstarget trial emulation framework, prospectively enrolled, consecutive patients, propensity score weighting, 6-month landmark analysis
- Target trial emulation framework
- Prospectively enrolled
- Consecutive patients
- Propensity score weighting
- 6-month landmark analysis
Main finding
As reported in the abstract
- DAPSA decreased significantly over 6 months in all 3 treatment groups, with no statistically significant between-class differences in adjusted longitudinal trajectories
- Propensity score weighting
Secondary outcomes
Long-term drug retention (6-month landmark, patients on index bDMARD through month 6)
- The adjusted analyses did not identify statistically significant between-class differences in subsequent long-term drug retention
Predictors of outcome (exploratory)
- Shorter disease duration was associated with more favourable outcomes in selected exploratory analyses
- Associations with previous bDMARD exposure were inconsistent
- Additional class-specific associations were identified but should be considered exploratory and hypothesis-generating
Original publication
Real‑world assessment of the effectiveness and response profiles of biologic DMARDs in psoriatic arthritis: findings from an emulated multicentre clinical trial. Ann Rheum Dis. Published 28 October 2026. doi:10.
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