ArticleBMC rheumatology2025
Comparative effectiveness of cycling versus swapping to IL-17 inhibitors after first TNF inhibitor failure in Psoriatic Arthritis: A real-world multicenter study.
Article in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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64 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThe increase in biological disease-modifying antirheumatic drugs for psoriatic arthritis (PsA) made it possible to consider different mechanisms of action (MoA) after the failure of the first advanced-line therapy. However, there is still a lack of real-world evidence comparing the cycling (re-administration of a similar MoA) and the swap strategy. This retrospective observational study aims to evaluate the retention rate, as a proxy for effectiveness, of second-line therapeutic options after the failure of a TNF inhibitor (TNFi) by comparing cycling versus swap strategies.
methodsPsA patients who failed the first-line TNFi and subsequently received either a TNFi or IL-17i were retrospectively selected from 25 centers. We collected demographic and disease-related data (disease duration, clinical phenotype, Disease Activity in Psoriatic Arthritis score), concomitant use of conventional synthetic disease-modifying antirheumatic drugs. Patients were categorized into cycling (second TNFi) (CG) or swapping (switch to IL-17i) (SG) groups. Kaplan-Meier survival curves were used to evaluate the retention rate, and a Cox regression analysis was performed to identify risk factors influencing treatment retention.
resultsIn CG and SG there were 275 and 177 patients, respectively. Retention rate in SG was higher than in CG (p < 0.001). Treatment interruption predictors were cycling strategy (p < 0.001), Disease Activity in Psoriatic Arthritis (p = 0.013), prescription year (p = 0.016), axial (p = 0.013), mixed involvement (p = 0.001).
conclusionThe swap strategy showed higher treatment retention than cycling in PsA patients who failed the first-line TNFi. This finding supports the hypothesis that changing MoA may improve the chances of selecting the most effective PsA treatment. CLINICAL TRIAL NUMBER: Not applicable.
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