Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: a real-world multicenter experience from Spain

Dual targeted therapy (DTT) has emerged as a promising approach in patients with refractory spondyloarthritis (SpA) or psoriatic arthritis (PsA) and extra-musculoskeletal manifestations of both diseases, but its effectiveness/safety ratio still remains unclear. This is a retrospective, real-world mu...

Full description

Bibliographic Details
Authors: Valero-Martínez, Cristina, Urgelles, Judit Font, Salles Lizarzaburu, Meritxell, Joven-Ibáñez, Beatriz E, de Juanes, Alexia, Ramírez, Julio, Juanola, Xavier, Almodovar, Raquel, Laiz, Ana, Moreno, Mireia, Pujol, José Manuel, Beltrán, Emma, Pinto-Tasende, José Antonio, Crespí, Laura, Sala-Icardo, Luis, Castañeda, Santos, García-Vicuña, Rosario
Format: article
Publication Date:2023
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/20012
Online Access:https://hdl.handle.net/20.500.13003/20012
Access Level:Open access
Keyword:Tumor Necrosis Factor Inhibitors
Spain
Spondylarthritis
Humans
Arthritis, Psoriatic
Retrospective Studies
Espondiloartritis
Inhibidores del Factor de Necrosis Tumoral
Humanos
Artritis Psoriásica
Estudios Retrospectivos
España
Description
Summary:Dual targeted therapy (DTT) has emerged as a promising approach in patients with refractory spondyloarthritis (SpA) or psoriatic arthritis (PsA) and extra-musculoskeletal manifestations of both diseases, but its effectiveness/safety ratio still remains unclear. This is a retrospective, real-world multicenter study in refractory SpA and PsA patients with simultaneous use of two biological or synthetic targeted agents. Effectiveness was assessed using Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) and Disease Activity in Psoriatic Arthritis (DAPSA) Score. We identified 39 different DTT combinations in 36 patients (22 SpA; 14 PsA), 25 of them with concomitant inflammatory bowel disease. The most commonly used combinations were TNF inhibitor plus antagonist of the IL12/23 pathway, followed by TNF inhibitor plus IL-17 antagonist. During a median exposure of 14.86 months (IQR 8-20.2), DTT retention rate was 69.4% (n=25/36; 19 SpA, 6 PsA). Major clinical improvement (change in ASDAS-CRP > 2 or improvement > 85% in DAPSA) was achieved in 69.4% of patients (n=25/36 therapeutical combinations; 17/21 SpA, 8/15 PsA), with a 58.3% (n=21/36 combinations; 15/20 SpA, 6/13 PsA) low-activity/remission rate. Of the patients who were receiving glucocorticoids, 55% managed to withdraw them during follow-up. Interestingly, only four serious adverse events in three patients were observed, leading to DTT discontinuation.

Similar Items