Evidence map›Paper›PMID 41830973›Full record

ArticleRheumatology and therapy2026

Does Prior Exposure Affect Retention? A Real-World, Multicentre Assessment of IL-17 Inhibitor Cycling in Psoriatic Arthritis.

Valentino Paci, Alarico Ariani, Eleonora Celletti, Olga Addimanda, Alberto Lo Gullo, Camilla Mazzanti, Myriam Di Penta, Emanuela Sabatini, Francesco Cipollone, Gianluca Santoboni and 71 more

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Article in Rheumatology and therapy, 2026. 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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1 · What the graph read from it

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5 · Who and what money

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81 authors.

Valentino Paci *Clinica Medica, Department of Internal Medicine, Marche University Hospital & Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
Alarico Ariani *Rheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Eleonora CellettiRheumatology Unit, "Clinica Medica" Institute, Ospedale SS. Annunziata Di Chieti, G.d'Annunzio University of Chieti, Chieti, Italy.
Olga AddimandaRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Alberto Lo GulloRheumatology Unit, ARNAS Garibaldi Di Catania, Catania, Italy.
Camilla MazzantiCenter for the Diagnosis and Therapy of Autoimmune Rheumagological Diseases, Ospedale Santa Rosa, ASL Viterbo, Viterbo, Italy.
Myriam Di PentaRheumatology Unit, "Clinica Medica" Institute, Ospedale SS. Annunziata Di Chieti, G.d'Annunzio University of Chieti, Chieti, Italy.
Emanuela SabatiniRheumatology Unit, "Clinica Medica" Institute, Ospedale SS. Annunziata Di Chieti, G.d'Annunzio University of Chieti, Chieti, Italy.
Francesco CipolloneRheumatology Unit, "Clinica Medica" Institute, Ospedale SS. Annunziata Di Chieti, G.d'Annunzio University of Chieti, Chieti, Italy.
Gianluca SantoboniCenter for the Diagnosis and Therapy of Autoimmune Rheumagological Diseases, Ospedale Santa Rosa, ASL Viterbo, Viterbo, Italy.
Claudio AngrisaniCenter for the Diagnosis and Therapy of Autoimmune Rheumagological Diseases, Ospedale Santa Rosa, ASL Viterbo, Viterbo, Italy.
Massimiliano De SimoneCenter for the Diagnosis and Therapy of Autoimmune Rheumagological Diseases, Ospedale Santa Rosa, ASL Viterbo, Viterbo, Italy.
Valeria NuceraRheumatology Outpatient Unit, ASL Novara, Novara, Italy.
Aurora IannielloRheumatology Outpatient Unit, ASL Novara, Novara, Italy.
Giulia VallifuocoRheumatology Outpatient Unit, ASL Novara, Novara, Italy.
Natalia MansuetoAmbulatori Di Reumatologia ASL1 Liguria, Imperia Hospital, Imperia, Italy.
Romina AndraccoAmbulatori Di Reumatologia ASL1 Liguria, Imperia Hospital, Imperia, Italy.
Giulio FerreroAmbulatori Di Reumatologia ASL1 Liguria, Imperia Hospital, Imperia, Italy.
Rosalba CaccavaleDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Polo Pontino, Rome, Italy.
Marino ParoliDepartment of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Polo Pontino, Rome, Italy.
Patrizia Del MedicoRheumatology Outpatient Clinic-Internal Medicine Unit, Civitanova Marche Hospital, Civitanova Marche, Italy.
Gianluca SmerilliRheumatology Outpatient Clinic-Internal Medicine Unit, Civitanova Marche Hospital, Civitanova Marche, Italy.
Antonella FarinaInternal Medicine Unit, Rheumatology Outpatient Clinic, Ospedale "A. Murri" Di Fermo, Fermo, Italy.
Palma ScolieriDepartment of Medical Specialties, "Nuovo Regina Margherita" Hospital, Rome, Italy.
Vincenzo BruzzeseDepartment of Medical Specialties, "Nuovo Regina Margherita" Hospital, Rome, Italy.
Cecilia GiampietroRheumatology Outpatient Clinic, Azienda ULSS 6 Euganea, Padua, Italy.
Francesca OmettoRheumatology Outpatient Clinic, Azienda ULSS 6 Euganea, Padua, Italy.
Gentiana VukatanaRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Marica TrevisaniRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Rita MulèRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Elisa RossiRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Enrica VandelliRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Riccardo BixioRheumatology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy.
Alessandro VolpeRheumatology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy.
Antonio MarchettaRheumatology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy.
Maddalena LarosaDivision of Rheumatology-Medical Specialties Department, Ospedale La Colletta-Azienda Sanitaria Locale 3, Genoa, Italy.
Dario CamellinoDivision of Rheumatology-Medical Specialties Department, Ospedale La Colletta-Azienda Sanitaria Locale 3, Genoa, Italy.
Gerolamo BianchiDivision of Rheumatology-Medical Specialties Department, Ospedale La Colletta-Azienda Sanitaria Locale 3, Genoa, Italy.
Viviana RavagnaniRheumatology Unit, Santa Chiara Hospital APSS Trento, Trento, Italy.
Federica LumettiRheumatology Unit, Azienda USL of Modena and University Hospital "Policlinico Di Modena", Modena, Italy.
Aldo Biagio Molica ColellaRheumatology Unit, Azienda Ospedaliera Papardo, Messina, Italy.
Veronica FranchinaRheumatology Unit, Azienda Ospedaliera Papardo, Messina, Italy.
Francesco Molica ColellaRheumatology Unit, Azienda Ospedaliera Papardo, Messina, Italy.
Elena BraviRheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy.
Ilaria PlatèRheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy.
Eugenio ArrigoniRheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy.
Rosetta VitettaUnit of Rheumatology, ASL VC Ospedale S. Andrea, Vercelli, Italy.
Francesca SeraleUnit of Rheumatology, ASL VC Ospedale S. Andrea, Vercelli, Italy.
Alessia FiorenzaUnit of Rheumatology, ASL VC Ospedale S. Andrea, Vercelli, Italy.
Davide MurgiaUnit of Rheumatology, ASL VC Ospedale S. Andrea, Vercelli, Italy.
Guido RoveraUnit of Rheumatology, ASL VC Ospedale S. Andrea, Vercelli, Italy.
Gabriele AmatiRheumatology Unit, University Hospital of Modena, Modena, Italy.
Elisa VisalliRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Giorgio AmatoRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Francesco De LuciaRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Ylenia Dal BoscoRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Roberta FotiRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Enrico FusaroRheumatology Department, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Turin, Italy.
Maria Chiara DittoRheumatology Department, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Turin, Italy.
Simone BernardiRheumatology Unit, Ospedale GB Morgagni - L Pierantoni, Forlì, Italy.
Francesco GirelliRheumatology Unit, Ospedale GB Morgagni - L Pierantoni, Forlì, Italy.
Marta PrioraRheumatology Day Hospital and Outpatient Clinic, ASL CN1, Mondovì, Italy.
Alessandra BezziInternal Medicine and Rheumatology Unit, ASL Romagna, Rimini, Italy.
Maria Cristina FocheriniInternal Medicine and Rheumatology Unit, ASL Romagna, Rimini, Italy.
Fabio MascellaInternal Medicine and Rheumatology Unit, ASL Romagna, Rimini, Italy.
Andrea BeccioliniInternal Medicine and Rheumatology Unit, University Hospital of Parma, Parma, Italy.
Eleonora Di DonatoInternal Medicine and Rheumatology Unit, University Hospital of Parma, Parma, Italy.
Giuditta AdorniInternal Medicine and Rheumatology Unit, University Hospital of Parma, Parma, Italy.
Gianluca LucchiniInternal Medicine and Rheumatology Unit, University Hospital of Parma, Parma, Italy.
Daniele SantilliInternal Medicine and Rheumatology Unit, University Hospital of Parma, Parma, Italy.
Beatrice GabrielliDepartment of Rheumatology, Teaching Hospital of the Paracelsius Medical University, Central Hospital of Bolzano (ASAA-SABES), Bolzano, Italy.
Dilia GiuggioliRheumatology Unit, University Hospital of Modena, Modena, Italy.
Bernd RaffeinerDepartment of Rheumatology, Teaching Hospital of the Paracelsius Medical University, Central Hospital of Bolzano (ASAA-SABES), Bolzano, Italy.
Massimo RetaRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Mirco MagnaniRheumatology Unit, Azienda Unità Sanitaria Locale Di Bologna, Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS Di Bologna, Bologna, Italy.
Luca IdolazziRheumatology Section - Department of Medicine, AOUI Verona, Verona, Italy.
Gilda SandriRheumatology Unit, University Hospital of Modena, Modena, Italy.
Rosario FotiRheumatology Unit, Policlinico San Marco Hospital, Catania, Italy.
Simone ParisiRheumatology Department, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Turin, Italy.
Michele Maria Luchetti Gentiloni *Clinica Medica, Department of Internal Medicine, Marche University Hospital & Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy. m.luchetti@staff.univpm.it.ORCID http://orcid.org/0000-0001-9132-7401
Gianluca Moroncini *Clinica Medica, Department of Internal Medicine, Marche University Hospital & Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInterleukin-17 inhibitors (IL-17i) represent a key therapeutic option for psoriatic arthritis (PsA), but real-world evidence regarding the effectiveness of cycling strategies within this class is lacking. This study evaluated the real-world retention of IL-17i in PsA, focusing on whether prior IL-17i exposure affects subsequent IL-17i persistence.

methodsThis multicentre, retrospective, observational study included consecutive patients with PsA treated with an IL-17i across 24 Italian rheumatology centres. The primary outcome was drug retention, analysed using Kaplan-Meier methods, with differences between IL-17i-naïve and IL-17i-experienced patients assessed with the log-rank test. Secondary outcomes included baseline clinical characteristics and predictors of discontinuation.

resultsA total of 868 patients were included (59.3% female, 40.7% male; median age 56 [48-63] years; 89.3% IL-17i-naïve). The overall median IL-17i retention rate was 90.7% [95% CI 88.7-92.8] at 6 months, 77.5% [95% CI 74.6-80.6] at 12 months, 60.9% [95% CI 57.3-64.8] at 24 months, and 52.1% [95% CI 48.1-56.4] at 36 months. Among IL-17i-naïve patients, retention rates were 90.5%, 77.6%, 61.7%, and 53.9% at 6, 12, 24, and 36 months, respectively. Among IL-17i-experienced patients, the corresponding retention rates were 92.2%, 77.0%, 54.0%, and 33.9%. In multivariable Cox regression, male sex and prior IL-17 inhibitor exposure were associated with a lower risk of discontinuation, whereas axial involvement, a higher number of previous biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs), and later calendar year of IL-17i initiation predicted poorer retention.

conclusionsIL-17i showed high long-term retention in real-world PsA, with no significant difference between naïve and previously exposed patients. These findings support the sustained effectiveness of IL-17i therapy and suggest that cycling within the class may remain a reasonable option for selected cases.

Indexed as

Biologic DMARDsClinical effectivenessCyclingInterleukin-17 inhibitorsPersistencePsoriatic arthritisReal-world evidencesRetention rate

Identifiers

PMID41830973
PMCPMC13198578

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