Comorbidities, disease characteristics, and socioeconomic factors were linked to failure to respond to disease-modifying antirheumatic drugs in patients with psoriatic arthritis.
Failure to respond to targeted disease-modifying antirheumatic drugs for psoriatic arthritis occurs at an incident rate of about 0.35 per person-year.An observational cohort of 591 individuals at the University of Toronto, Toronto, Ontario, Canada , with psoriatic arthritis who started advanced therapy between 2000 and 2023 was followed prospectively.
Primary failure was defined as inefficacy during treatment or failure to meet response criteria after 1 year.Therapies involved tumor necrosis factor inhibitors , etanercept , IL-17 inhibitors , IL-23 or IL-12/IL-23 inhibitors , and tsDMARDs . Treatment response occurred in 49.9% of participants, treatment failure in 35.4%, and therapy stoppage for other reasons in 14.7%. Treatment failure rates were 32.5% for TNF inhibitors, 50.7% for non-TNF inhibitor biologics, and 43.3% for tsDMARDs.
Greater risk for primary failure was linked to daily alcohol consumption , higher body mass index , and fibromyalgia . Higher educational level , higher damaged joint count , and HLA-B27 positivity conferred lower risk for primary failure. "We always try to look for clinical profiling of patients to know how a patient will respond to therapy. This helps in that," said presenting author Fadi Kharouf, MD, a clinical fellow at Toronto Western Hospital, Toronto, in an interview.The study was a retrospective analysis and cannot demonstrate causality.
Arthropathic Psoriasis Psoriatic Arthropathy Psa Arthritis Joint Inflammation Rheumatoid Arthritis RA - Rheumatoid Arthritis Rheumatoid Arthritis (RA) Disease-Modifying Antirheumatic Drugs Dmards DMARD Canada Canadian Socioeconomics Social Determinants Of Health SDOH Social Determinants Of Health (SDOH) Body Mass Index BMI Fellowship Fellows Hospitals
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