Observational studyArthritis research & therapy2025
Burden and determinants of multi-b/tsDMARD failure in psoriatic arthritis.
Observational study in Arthritis research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- Psychological Aspects of Rheumatic Diseases: Psychorheumatology in Clinical Practice.Rheumatology and therapy · 2026Review
- Article
- The obesity-inflammation axis in psoriatic disease: mechanisms and therapeutic strategies.Nature reviews. Rheumatology · 2026Review
- Sex Differences in Response and Persistence to Biologic Therapy in Psoriatic Arthritis: A 52-Week Analysis With Extended Long-Term Outcomes.The Journal of dermatology · 2026Article
- Clinical and Ultrasound Characteristics of a Difficult-to-Treat Psoriatic Arthritis Population.Diagnostics (Basel, Switzerland) · 2025Article
- A successful combination of upadacitinib and guselkumab in refractory psoriasis and psoriatic arthritis: A case report.SAGE open medical case reports · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
objectivesDespite significant therapeutic advances in psoriatic arthritis (PsA), many patients do not achieve remission and cycle through multiple biologic (b)- or targeted synthetic (ts)- DMARDs. Identifying the underlying reasons for repetitive therapeutic failure remains a knowledge gap. Here we describe prescribing patterns and characteristics of PsA patients with multi-b/tsDMARD failure at the NYU Psoriatic Arthritis Center.
methodsNine hundred sixty PsA patients were enrolled in an observational, longitudinal registry. Demographics, medical history, medication use, and psoriatic disease phenotype were collected. Multi-b/tsDMARD failure was defined as requiring ≥ 4 b/tsDMARDs.
resultsSeven hundred twenty-five patients (75%) used ≥ 1 b/tsDMARD during their disease course. The initial b/tsDMARDs prescribed were predominately anti-TNF agents. 166 (17%) patients had multi-b/tsDMARD failure. Compared to those requiring 1 b/tsDMARD, female sex (OR 2.3; 95%CI 1.4-3.8), axial disease (OR 2.1; 95% CI 1.2-3.6), depression (OR 2.0; 95%CI 1.1-3.7), and obesity (OR 1.7; 95%CI 1.0-2.8) were risk factors for multi-b/tsDMARD failure disease after adjustment for age, disease duration, sex, depression, smoking, obesity, and skin severity. Patients with multi-b/tsDMARD failure PsA also had increased disease activity at their clinical visit (i.e., swollen joint count, p = 0.005).
conclusionIn this cohort, 17% patients with PsA experienced multi-b/tsDMARD failure. These patients were more likely to be female, obese, and have higher rates of axial involvement and depression, along with higher active disease activity. This highlights the inflammatory and non-inflammatory drivers of multiple therapeutic failures, underscoring the need for precision medicine strategies and potential non-pharmacologic adjuvant therapies for patients with PsA to improve outcomes and quality of life.
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