Psoriatic Arthritis

Long-term safety of bimekizumab in adult patients with axial spondyloarthritis or psoriatic arthritis: pooled results from integrated phase IIb/III clinical studies.

Mease PJ, Gensler LS, Orbai AM, Warren RB, Bajracharya R, Ink B · RMD open · 2025 · n=1407

To assess the long-term safety profile of bimekizumab (BKZ) in patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Safety data pooled from six integrated phase IIb/III studies in axSpA and PsA are reported (to the July 2022 data-cut for phase III) for patients who received ≥1 dose of BKZ 160 mg every 4 weeks. Treatment-emergent adverse events (TEAEs) are reported using exposure-adjusted incidence rate per 100 patient-years (EAIR/100 PY). The axSpA and PsA safety pools included 848 (total BKZ exposure: 2034.4 PY) and 1407 patients (2590.8 PY), respectively. TEAEs occurred at an EAIR/100 PY of 136.9 in axSpA and 139.6 in PsA; study discontinuation due to TEAEs was low (axSpA: 2.7/100 PY; PsA: 3.1/100 PY). The three most frequently reported TEAEs were SARS-CoV-2 (COVID-19) infection (axSpA: 7.8/100 PY; PsA: 8.8/100 PY), nasopharyngitis (axSpA: 8.2/100 PY; PsA: 7.7/100 PY) and upper respiratory tract infection (axSpA: 5.0/100 PY; PsA: 5.6/100 PY). E

Efficacy and safety of upadacitinib for patients with immune-mediated inflammatory diseases: a systematic review and meta-analysis.

Chai R, Li X, Shen W, Jin Z, Yao G, Tang X · Frontiers in immunology · 2025

There is a growing array of options for the treatment of immune-mediated inflammatory diseases (IMIDs). To explore upadacitinib's efficacy and safety in autoimmune disease treatment, we conducted this study. Pubmed, Web of Science and Embase were searched for randomized controlled trials related to the treatment of upadacitinib from the databases' inception to May 31, 2024. After literature screening, data extraction and bias assessment by two investigators, RevMan 5.3 or Stata 17.0 software was used for meta-analysis. 45 records across the following five types of IMIDs were obtained. For rheumatoid arthritis (RA), upadacitinib 15 mg outperformed placebo, methotrexate and adalimumab (ADA) in 20% improvement according to ACR criteria (ACR20) and 28-joint disease activity score (DAS28) (P < 0.05). It also improved quality of daily life based on pain relief, morning stiffness and 36-Item Short Form Health Survey, etc. For axial spondyloarthritis (axSpA), upadacitinib 15 mg enhanced 2

Efficacy and safety of IL-17, IL-12/23, and IL-23 inhibitors for psoriatic arthritis: a network meta-analysis of randomized controlled trials.

Gao S, Xie X, Fan L, Yu L · Frontiers in immunology · 2025 · n=241

Psoriatic arthritis (PsA) is a chronic inflammatory disease that impacts both the skin and joints. Currently, interleukin (IL)-17, IL-12/23, and IL-23 inhibitors have become integral components of PsA treatment regimens. Nevertheless, the comparative effectiveness of these IL-targeted therapies remains a subject of ongoing debate. This study employs a network meta-analysis (NMA) approach to systematically evaluate the therapeutic efficacy and safety profiles of various IL-17, IL-12/23, and IL-23 inhibitors. We searched PubMed, Web of Science, and Embase for randomized controlled trials (RCTs) to identify eligible research articles. This NMA was implemented by Stata 14.0 software, with odds ratios (ORs) and 95% confidence intervals (CIs) serving as effect and safety measures to evaluate clinical efficacy and safety profiles. Drugs were ranked based on their efficacy and safety profiles using the surface under the cumulative ranking curve values, enabling a comprehensive comparative ass

EULAR points to consider and consensus definitions for difficult-to-manage and treatment-refractory psoriatic arthritis.

Marzo-Ortega H, Harrison SR, Fragoulis GE, Michelena X, Macía-Villa C, Aydin SZ · Annals of the rheumatic diseases · 2026

This study aimed to develop evidence-based points to consider (PtC) and consensus definitions of difficult-to-manage (D2M) and treatment-refractory (TR) psoriatic arthritis (PsA). A multidisciplinary international European Alliance of Associations for Rheumatology (EULAR) task force (TF) of 27 members, including rheumatologists, dermatologists, health practitioners, and patient partners, was established, and the EULAR standardised operating procedures, including a systematic literature review and a consensus process, were followed. The TF formulated 4 overarching principles addressing the proportion of patients with PsA with an unsatisfactory treatment response despite the best standard of care, and for which the causes are likely multifactorial. Six PtC highlight criterion relevant for subsequent definitions including failure to achieve or maintain response to ≥2 biological/targeted synthetic disease-modifying antirheumatic drugs with ≥2 different mechanisms of action;

Emerging biological therapies for psoriatic arthritis: A systematic review.

Firdous S, Amjad H, Choudhary MU, Afzal MW, Tayyab RH, Parveen A · Medicine · 2025 · n=124

Psoriatic arthritis (PsA) is a chronic inflammatory condition characterized by joint involvement, enthesitis, dactylitis, and skin psoriasis. The pathophysiology of PsA is complex, driven by dysregulated immune responses, making targeted therapies essential for managing symptoms. Despite the success of biologic disease-modifying anti-rheumatic drugs (bDMARDs) like tumor necrosis factor (TNF) inhibitors, many patients experience suboptimal responses or adverse effects, necessitating the development of new therapies. Emerging biologics targeting interleukin (IL)-17, IL-23, and Janus kinase (JAK) pathways offer promising alternatives. This review aims to evaluate the efficacy and safety of emerging biologics for PsA. A systematic review of studies published from 2000 to December 2024 was conducted. Randomized controlled trials (RCTs), cohort studies, and clinical trials were included to assess the efficacy, safety, and adverse effects of bDMARDs and targeted synthetic DMARDs (tsDMARDs) f

Psoriasis treatments in the stabilization of atherosclerosis: a systematic review.

Ji L, Ravi S, Wright L, Nguyen V, Wiley J, Vukelic M · Archives of dermatological research · 2024

This systematic review explores the relationship between achieving minimal disease activity in psoriasis and the progression of atherosclerosis. It investigates how biologic therapies and other treatments impact atherosclerosis markers, offering insights into therapeutic strategies. A comprehensive search of PubMed, Embase, and Web of Science was conducted from January 1, 2000, to April 1, 2023, using terms such as psoriasis, psoriatic arthritis, atherosclerosis, biologic therapy, vascular stiffness, carotid intima-media thickness (CIMT), and coronary computed tomography angiography (CCTA). Eligible studies were those involving human subjects over 18, written in English, that provided quantitative atherosclerosis markers, including CIMT, CCTA, arterial pulse wave velocity (aPWV), fat attenuation index (FAI), and augmentation index (Aix). From an initial pool of 217 studies, 21 were included, grouped by treatments, including TNF-α inhibitors, IL-12/23 inhibitors, IL-17 inhibitors,

The APLAR Recommendations for the Management of Psoriatic Arthritis.

Leung YY, Bird P, Haroon M, Kishimoto M, Shin K, Mathew AJ · International journal of rheumatic diseases · 2025

Under the auspices of the Asia-Pacific League of Associations for Rheumatology (APLAR), we aimed to develop broad, evidence- and consensus-based guidelines to aid health professionals managing patients with psoriatic arthritis (PsA) in the region. A working group of 35 members comprising rheumatologists, dermatologists, and patient research partners from 18 APLAR countries was convened. The working group conducted systematic literature reviews to derive the quality of evidence via GRADE methods in supporting the efficacy and safety of classes of therapeutic agents for the management of active PsA, its comorbidities, and screening for specific infection concerns in the region. Recommendation statements on the principles of management and the best use of therapeutic drugs were developed. Consensus within the working group was achieved. An external voting panel, five from each of the 18 APLAR countries, was convened to confirm further agreement on the recommendation statements. The main

Clinical practice guideline on the treatment of axial spondyloarthritis and psoriatic arthritis. ESPOGUÍA 2024.

Cañete JD, Díaz Del Campo Fontecha P, ESPOGUÍA Development Group · Reumatologia clinica · 2025

The important advances in the area of therapeutic interventions and the time elapsed have justified the complete update of the Clinical practice guideline on the treatment of axial spondyloarthritis and psoriatic arthritis (ESPOGUIA2017). Methodologically, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system has been incorporated, which allows the quality or certainty of the evidence to be assessed for each outcome of interest, previously prioritized by the drafting group and which structures the process of formulating recommendations explicitly. Thus, an updated clinical practice guideline has been developed to serve as a reference in the management of spondyloarthritis, to contribute to reduce unjustified variability, and to reinforce the importance of bringing clinical practice closer to the best available scientific evidence.

Proactive therapeutic drug monitoring of biologic drugs in adult patients with inflammatory bowel disease, inflammatory arthritis, or psoriasis: a clinical practice guideline.

Kawano-Dourado L, Kristianslund EK, Zeraatkar D, Jani M, Makharia G, Hazlewood G · BMJ (Clinical research ed.) · 2024

In adult patients with inflammatory bowel disease, inflammatory arthritis (rheumatoid arthritis, spondyloarthritis, psoriatic arthritis), or psoriasis taking biologic drugs, does proactive therapeutic drug monitoring (TDM) improve outcomes as compared with standard care? Standard care for immune mediated inflammatory diseases includes prescribing biologic drugs at pre-determined doses. Dosing may be adjusted reactively, for example with increased disease activity. In proactive TDM, serum drug levels and anti-drug antibodies are measured irrespective of disease activity, and the drug dosing is adjusted to achieve target serum drug levels, usually within pre-specified therapeutic ranges. The role of proactive TDM in clinical practice remains unclear, with conflicting guideline recommendations and emerging evidence from randomised controlled trials. Linked systematic review and pairwise meta-analysis which identified 10 trials including 2383 participants. Inflammatory bowel disease, inf

Highly selective tyrosine kinase 2 inhibition with zasocitinib (TAK-279) improves outcomes in patients with active psoriatic arthritis: a randomised phase 2b study.

Kivitz A, Baraliakos X, Muensterman ET, Kavanaugh A, van der Heijde D, Klimiuk PA · Annals of the rheumatic diseases · 2025 · n=290

To assess the efficacy, safety, and tolerability of the investigational, oral, allosteric, highly selective, and potent tyrosine kinase 2 inhibitor zasocitinib (TAK-279) in patients with active psoriatic arthritis (PsA). In this phase 2b, randomised, multicentre, double-blind, placebo-controlled, multiple-dose study, patients (≥18 years, with PsA symptoms for ≥6 months) received 30 mg, 15 mg, or 5 mg zasocitinib or placebo (1:1:1:1) once daily for 12 weeks, with a 4-week safety follow-up. The primary endpoint was American College of Rheumatology (ACR)20 response at week 12. Secondary efficacy endpoints included ACR50 response, ACR70 response, Psoriasis Area and Severity Index (PASI) 75 response among those with ≥3% body surface area at baseline and minimal disease activity (MDA) at week 12. Overall, 290 patients (mean [SD] age, 49.9 [11.6] years; 57.2% female) received treatment. At week 12, 30 mg or 15 mg zasocitinib treatment resulted in significantly higher AC

Long-Term Safety of Guselkumab in Patients with Psoriatic Disease: An Integrated Analysis of Eleven Phase II/III Clinical Studies in Psoriasis and Psoriatic Arthritis.

Strober B, Coates LC, Lebwohl MG, Deodhar A, Leibowitz E, Rowland K · Drug safety · 2024 · n=1061

The benefit/risk profiles of biologics can be affected by comorbidities, certain demographic characteristics, and concomitant medications; therefore, it is important to evaluate the long-term safety profiles of biologics across broad patient populations. Guselkumab was well tolerated and efficacious across individual pivotal clinical studies in adults with moderate-to-severe psoriasis and/or active psoriatic arthritis (PsA). The objective of the current analysis was to evaluate guselkumab safety in a large population of patients with psoriatic disease by pooling adverse event (AE) data from 11 phase II/III studies (seven in psoriasis; four in PsA). Guselkumab was generally administered as 100 mg subcutaneous injections at Week 0, Week 4, then every 8 weeks (Q8W) in psoriasis studies and at Week 0, Week 4, then every 4 weeks (Q4W) or Q8W in PsA studies. Safety data were summarized for the placebo-controlled period (Weeks 0-16 in psoriasis; Weeks 0-24 in PsA) and through the end o

Effect of Therapeutic Drug Monitoring vs Standard Therapy During Maintenance Infliximab Therapy on Disease Control in Patients With Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial.

Syversen SW, Jørgensen KK, Goll GL, Brun MK, Sandanger Ø, Bjørlykke KH · JAMA · 2021 · n=458

Proactive therapeutic drug monitoring (TDM), consisting of individualized treatment based on scheduled assessments of serum drug levels, has been proposed as an alternative to standard therapy to optimize efficacy and safety of infliximab and other biologic drugs. However, it remains unclear whether proactive TDM improves clinical outcomes during maintenance therapy. To assess whether proactive TDM during maintenance therapy with infliximab improves treatment efficacy by preventing disease worsening compared with standard infliximab therapy without TDM. Randomized, parallel-group, open-label clinical trial including 458 adults with rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, ulcerative colitis, Crohn disease, or psoriasis undergoing maintenance therapy with infliximab in 20 Norwegian hospitals. Patients were recruited from June 7, 2017, to December 12, 2019. Final follow-up took place on December 14, 2020. Patients were randomized 1:1 to proactive TDM with dose and

Composite and pragmatic measures in psoriatic arthritis: bridging trials and clinical feasibility.

Kang JH, Coates LC · Current opinion in immunology · 2026

Psoriatic arthritis (PsA) is a multidomain inflammatory disease where no instrument captures the full spectrum of activity or its impact on patients' lives. Accurate outcome measurement is essential for research and personalized care. This review summarizes advances in PsA outcome-measure refinement and harmonization, with emphasis on psychometric validation, clinical feasibility, and treat-to-target (T2T) strategies. Multidomain composites such as the Psoriatic Arthritis Disease Activity Score (PASDAS) remain the most comprehensive OMERACT measures, but their complexity limits clinical use. Disease Activity Index for Psoriatic Arthritis (DAPSA) and minimal disease activity (MDA) are practical but limited: DAPSA evaluates fewer domains, while MDA's binary format can miss meaningful partial improvements. The Psoriatic Arthritis Impact of Disease-12 (PsAID-12) has undergone renewed validation with context-specific thresholds, reinforcing its value for assessing the lived burden of

Sleep patterns and the risk of psoriatic disease: genetic predisposition and metabonomics.

Guo Z, Luo Z, Zhang S, Yu Y, Wu Z, Chen Y · The British journal of dermatology · 2026 · n=912

The longitudinal impact of comprehensive sleep patterns on incident psoriatic disease (PsD) and the potential mediating effects are unclear. To investigate the associations of sleep patterns with PsD risk, alongside the role of genetic predisposition and the potential mediating effects of serum metabolites. This prospective cohort study included 399 912 participants without PsD registered in UK Biobank. Cox proportional hazard models were used to examine the association between sleep patterns, genetic risk of PsD and the overall risk of PsD. Cross-product interaction terms between polygenic risk score (PRS) categories and sleep patterns were incorporated into the fully adjusted models, and the relative excess risk due to interaction (RERI) was calculated to examine additive interaction. Mediation analyses were used to identify specific metabolites as potential mediators of PsD. During a mean follow-up of 14.7 years, 4001 new cases of PsD were identified. Compared with those w

Risk of major adverse cardiovascular events and venous thromboembolic events between patients with psoriasis or psoriatic arthritis on tumor necrosis factor inhibitors, interleukin 17 inhibitors, interleukin 12/23 inhibitors, and interleukin 23 inhibitors: An emulated target trial analysis.

Chen TL, Huang JY, Lin HY, Chang YT, Li CY, Wei JC · Journal of the American Academy of Dermatology · 2025

The risk of major adverse cardiovascular events (MACEs) and venous thromboembolic events (VTEs) in patients with psoriatic disease receiving biologics is not fully understood. This study aimed to investigate whether novel biologic therapies (interleukin 17 inhibitor [IL-17i], interleukin 12/23 inhibitor [IL-12/23i], and interleukin 23 inhibitor [IL-23i]) for biologic-naïve patients with psoriasis or psoriatic arthritis (PsA) are associated with differences in the risks of MACE and VTE compared with those with tumor necrosis factor inhibitors (TNFis). An emulated target trial was designed by a nationwide cohort using data from the TriNetX Research Network. Biologic-naïve patients with psoriasis or PsA receiving biologics between 2014 and 2022 were enrolled. Treatment groups were determined by patients' first prescription of biologics. Three propensity-matched cohorts were established, namely, IL-17i versus TNFi, IL-12/23i versus TNFi, and IL-23i versus TNFi. The incidence ra

Validation of Handheld Ultrasound Devices for Point of Care Use in Rheumatology

n=30 · NCT06580886 · COMPLETED · COMPLETED

The goal of this clinical trial is to test the concurrent validity of the Clarius handheld ultrasound devices versus gold-standard device to detect characteristic features of healthy and rheumatic joints in adults Psoriatic Arthtritis patients (i.e. anatomical structures and vascular flow).

A Multicenter, Double-blind, Randomized, Parallel-group Study to Compare the Efficacy and Safety of BAT2506 Versus Simponi® in Participants With Active Psoriatic Arthritis

n=704 · NCT05046431 · COMPLETED · COMPLETED

This is a multicenter, double-blind, randomized, parallel-group study to compare the efficacy,pharmacodynamics (PD), pharmacokinetics (PK), safety, and immunogenicity of BAT2506 versus Simponi® in participants with active PsA. The study will consist of up to 4-week Screening Period, a 52-week Treatment Period, and a 8-week Safety Follow-up Period.

Routine Clinical Practice in Spain: Evaluation of the Use of Apremilast in Patients With Psoriatic Arthritis, Naïve to Biological Treatment (PREVAIL Study)

n=119 · NCT03828045 · COMPLETED · COMPLETED

Observational, prospective and multicenter study in approximately 25 sites nationwide. The investigators participating in this study will be rheumatologists specializing in this pathology. The study will include patients diagnosed with PsA (according to the CASPAR diagnosis criteria), naïve to biological treatments, who have - following the routine practice in their centers - initiated treatment with apremilast 6 months (±1 months) before their inclusion in the study, irrespective of treatment duration. Recruitment will be consecutive and the reason for not including a potential candidate patient will be registered. The decision to prescribe apremilast treatment should be clearly dissociated from the inclusion of the patient in the study, which will not occur earlier than 6 months (± 4 weeks after treatment start). Therefore, the choice of the therapeutic strategy will be made independently by the physician. Before entering the study, all patients shall sign an informed consent to participate in the study, including permission to retrieve data from their medical records and to complete questionnaires regarding their quality of life. To avoid recruitment biases and obtain a homogeneous cohort regarding treatment duration, all consecutive patients who attend to a routine follow-up visit and have been prescribed apremilast 6 months (+/- 4 weeks) before the baseline visit, will be offered to enter the study. All consecutive patients who can be contacted 6 months (+/- 4 weeks) following initiation of treatment with apremilast will be approached for entry to minimize bias in patient selection

Cochrane reviews on Psoriatic arthritis

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Cochrane Library provides systematic reviews and meta-analyses on various interventions for psoriatic arthritis. It synthesizes the best available evidence to inform healthcare decisions.

Psoriatic Arthritis

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TRIP is a clinical search engine that allows users to quickly find high-quality research evidence, including guidelines, systematic reviews, and primary research, on psoriatic arthritis.