THE IMPACT OF SECOND LINE THERAPEUTIC ON DISEASE CONTROL AFTER DISCONTINUATION OF FIRST LINE TNF INHIBITOR IN PATIENTS WITH PSA: ANALYSIS FROM THE COREVITAS PSORIATIC ARTHRITIS/SPONDYLARTHRITIS REGISTRY
Authors: Ogdie A et al.
There is good evidence in patients with RA that switching treatment to a biologic with a different mode of action is more effective than cycling to another biologic of the same class. It is currently unknown whether this is also true for patients with PsA who fail to a first TNF inhibitor. Patients with PsA enrolled in the CorEvitas registry who initiated a second line advanced therapy after discontinuation of a TNF inhibitor between May 2013 and January 2022 were analysed. Patients had to have an at least 6 months follow-up. 394 patients started a 2nd advanced therapy with 52% cyclers and 48% switchers. Cyclers had the first TNF inhibitor for a shorter time period compared to switchers (11.4 versus 14.7 months). Switchers had higher baseline skin involvement and a lower proportion of patients in minimal (MDA) or low disease activity. After 6 months, switchers had a 70% higher chance of achieving MDA, a greater likelihood of achieving a HAQ-DI < 0.5 and a pain score of < 15 among other parameters.
There is limited data on whether switching versus cycling is better in PsA patients who initiate a second biologic after a first TNF inhibitor. This analysis is based on real world patients that were followed in the CorEvitas registry and suggests that switching results in comparable or better outcomes compared to cycling among TNF inhibitors.