Spondyloarthritis & psoriatic arthritis
Tolerability and comparative effectiveness of TNF, IL-17 and IL-23(p19) inhibitors in psoriatic arthritis: a target trial emulation study
Authors' conclusion
No decisive differences between drugs were observed at group level regarding drug survival and clinical outcomes after 12 months.
Study context
- Population
- Patients with PsA in the Parker Institute's PsA cohort (PIPA) initiating a bDMARDintention-to-monitor population
- Participants
- 109 patients
- Exposure
- IL-17i and IL-23i vs TNF inhibitors (TNFi)
- TNFin = 75reference
- IL-17in = 26
- IL-23(p19)in = 8
- Outcome
- Drug survival
- Follow-up
- Up to 12 months from baseline
Methodological detailsobservational data from a prospective cohort (PIPA cohort), propensity score adjustment, proportional hazards model, Interview and clinical examination at baseline and at 4 and 12 months
- Observational data from a prospective cohort (PIPA cohort)
- Propensity score adjustment
- Proportional hazards model
- Interview and clinical examination at baseline and at 4 and 12 months
Main finding
As reported in the abstract
Drug survival (time to stopping the drug) · up to 12 months
Each group vs TNFiHR for drug discontinuation (95% CI)
IL-17i
1.36(0.59–3.14)
IL-23(p19)i
0.56(0.10–3.24)
Observational data: associations, not effects.
Further findings
Response rates and changes in clinical outcomes · up to 12 months
- TNFi and IL-17i had comparable effects; IL-23(p19)i tended to perform better overall
Original publication
Tolerability and comparative effectiveness of TNF, IL-17 and IL-23(p19) inhibitors in psoriatic arthritis: a target trial emulation study. Rheumatology (Oxford). Published 15 September 2023. doi:10.
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