Research from Nordic countries reveals increased uptake of newer biologic and targeted synthetic DMARDs in psoriatic arthritis patients

Results from five Nordic biologics registries highlighted the increased uptake of newer biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) among biologic-experienced psoriatic arthritis (PsA) patients. The study has been published in the recent issue of Annals of the Rheumatic Diseases.

Glintborg and co-researchers described the effectiveness of newer b/tsDMARDs in PsA patients among 10,000 treatment courses given in Norway, Iceland, Finland, Sweden, and Denmark. There was an increase in the uptake of newer b/tsDMARDs from 2014 to 2018. About 59% of patients achieved low disease activity and 65% continued the adalimumab when given as a second or third-line treatment. Adalimumab, a tumor necrosis factor inhibitor (TNFi), showed a better retention rate and low disease activity than the other non-TNFi such as abatacept, apremilast, ixekizumab, and ustekinumab.

A 2019 review stated that TNF-alfa inhibitors, the first biologicals approved for the management of PsA, are being substituted by newer bDMARDs with diverse modes of action. The use of ustekinumab, secukinumab, ixekizumab, and abatacept has been proven to be safe and effective.  Newer targeted synthetic molecules with oral administration open the possibility of targeting numerous distinct immune pathways.

Though there is an increase in therapeutic options for the management of PsA, challenges around treatment selection remain to be ambiguous. Newer studies revealing the superior outcomes of adalimumab treatment warrant appropriate positioning of the novel b/tsDMARDs in the PsA treatment algorithm.

References

  1. Glintborg B, Giuseppe DD, Wallman JK, Nordstr├Âm DC, Gudbjornsson B, Hetland ML, et al. Uptake and effectiveness of newer biologic and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis: results from five Nordic biologics registries. Annals of the Rheumatic Diseases. 2023 Feb 22; Available from: https://ard.bmj.com/content/early/2023/02/22/ard-2022-223650
  2. Silvagni E, Bortoluzzi A, Ciancio G, Govoni M. Biological and synthetic target DMARDs in psoriatic arthritis. Pharmacological Research. 2019 Nov 1;149:104473. Available from: https://doi.org/10.1016/j.phrs.2019.104473