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Antiarthritic agents

Psoriatic Arthritis Remains Difficult to Treat: Study

Strategic Insights

— 2 min read

Researchers at Hospital Clinic Barcelona have revealed new insights into the challenges of treating psoriatic arthritis, with nearly one-fourth of patients remaining active despite multiple treatments. The study, published in the journal Diagnostics, found that difficult-to-treat (D2T) psoriatic arthritis is associated with disease duration, comorbidities, activity, HLA-B27, and combined therapies. The findings suggest that achieving low disease activity or remission in psoriatic arthritis remains a significant hurdle.

Key Takeaways:

  • The study defines difficult-to-treat (D2T) psoriatic arthritis using three operational definitions: failure of 1 csDMARD plus 2 b/tsDMARDs with different mechanisms of action, failure of 2 b/tsDMARDs with different mechanisms of action within 12 months, or failure of 3 b/tsDMARDs with different mechanisms of action.
  • The study enrolled 72 patients with active psoriatic arthritis, with 54.2% female and median age 56, disease duration 84 months.
  • The patients had a median disease activity index (DAPSA) of 17, with 68% having comorbidities. Enthesitis, dactylitis, and nail disease were present in 20.8%, 45.8%, and 41.7%, respectively.
  • HLA-B27 positivity was present in 13.9%, with radiographic erosions and ultrasound paratenonitis present in 37.5% and 33.3%, respectively.
  • The GRAPPA D2T criteria were met by 23.6% of patients, linked to longer disease duration, higher activity, HLA-B27, comorbidities, and combined therapy.
  • The time-based D2T criteria showed higher DAPSA and nail involvement, with ultrasound paratenonitis and combined therapy independently associated with this subgroup.
  • Very refractory patients (11.1%) only correlated with combined therapy.

Statistics:

  • 72 patients were enrolled in the study, with 54.2% female and median age 56.
  • The median disease duration was 84 months, with a median DAPSA of 17.
  • 68% of patients had comorbidities, with enthesis, dactylitis, and nail disease present in 20.8%, 45.8%, and 41.7%, respectively.
  • HLA-B27 positivity was present in 13.9% of patients, with radiographic erosions and ultrasound paratenonitis present in 37.5% and 33.3%, respectively.
  • The GRAPPA D2T criteria were met by 23.6% of patients, with the time-based D2T criteria showing higher DAPSA and nail involvement.

Sources:

  • Clinical and Ultrasound Characteristics of a Difficult-to-Treat Psoriatic Arthritis Population. Diagnostics, 2025,15(19):2418. (Diagnostics - http://www.mdpi.com/journal/diagnostics)
  • MDPI AG, publisher of Diagnostics journal.
  • NewsRx. Study Findings on Psoriatic Arthritis Detailed by Researchers at Hospital Clinic Barcelona (Clinical and Ultrasound Characteristics of a Difficult-to-Treat Psoriatic Arthritis Population). Health & Medicine Week. October 31, 2025; p 8152.

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