Spondyloarthritis & psoriatic arthritis
Understanding difficult-to-treat psoriatic arthritis: Data from the Rheumatic Diseases Portuguese Registry
Authors' conclusion
D2T PsA proportions varied between 0.9% and 3.7%. D2T PsA patients had higher disease activity scores before the initiation of their first b/tsDMARDs and higher rates of treatment discontinuation.
Study context
- Population
- Patients with psoriatic arthritis (PsA) registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt)
- Participants
- 1,873 patients
- Exposure
- Difficult-to-treat (D2T) PsA vs non-D2T PsA
- D2T PsA (first definition)n = 70
- D2T PsA (second definition)n = 17
- Outcome
- Proportion of D2T PsA and its predictors
Methodological detailsmulticentre, observational, registry-based (Reuma.pt)
- Multicentre
- Observational
- Registry-based (Reuma.pt)
Main finding
As reported in the abstract
Proportion classified as D2T PsA
- Predictor of D2T PsA: polyarticular disease
- OR: 3.09
- Predictor of D2T PsA: increased baseline swollen joint count
- OR: 1.12
- Predictor of D2T PsA: treatment duration on the first b/tsDMARDs
- P < 0.01
Observational data: associations, not effects.
Further findings
Characteristics associated with D2T PsA (D2T vs non-D2T) · baseline
- Age at symptom onset
- 37.5±11.0 vs. 41.4±12.8; P<0.01
- Age at diagnosis
- 40.7±10.5 vs. 44.7±12.3; P<0.01
- Polyarticular phenotype
- 77.6% vs. 53.6%; P<0.001
- Depression
- 10.9% vs. 5%; P<0.05
- Enthesitis
- 47.1% vs. 33.5%; P<0.05
- BMI (lower in D2T)
- 26.5[6.1] vs. 27.7[6.1]; P<0.01
- Tender joint count
- 13.4[14.5] vs. 6[8]; P<0.001
- Swollen joint count
- 9[9] vs. 4[6]; P<0.001
- DAPSA
- 38.2[31.6] vs. 25.4[15.6]; P<0.001
Original publication
Understanding difficult-to-treat psoriatic arthritis: Data from the Rheumatic Diseases Portuguese Registry. Joint Bone Spine. Published 24 July 2025. doi:10.
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