Quantifying Disease Activity Despite Treatment with Tumor Necrosis Factor Inhibitors Among Patients with Psoriatic Arthritis and Axial Spondyloarthritis: Real-World Results from the PPD CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.
Publication Title
Rheumatol Ther
Document Type
Article
Publication Date
1-7-2026
Keywords
washington; swedish
Abstract
INTRODUCTION: Although tumor necrosis factor inhibitors (TNFis) have improved management of psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA); many patients experience suboptimal disease control. We quantified achievement of varying degrees of disease activity in patients with PsA and axSpA who initiated and maintained TNFi treatment for 12 months.
METHODS: Patients with PsA or axSpA enrolled in the PPD™ CorEvitas™ PsA/Spondyloarthritis Registry were included in the study. Varying degrees of disease control were quantified based on minimal disease activity (MDA) status for PsA and BASDAI50 (≥ 50% improvement in Bath Ankylosing Spondylitis Disease Activity Index) status for axSpA at 6 and 12 months. Patients were categorized into four groups: sustained (MDA/BASDAI50 at 6 and 12 months), improved (MDA/BASDAI50 at 12 months only), worsened (MDA/BASDAI50 at 6 months only), and never achieved (no MDA/BASDAI50 at 6 or 12 months).
RESULTS: For PsA, 338 patients initiated and persisted on TNFis. At 6 months, the majority (65%, n = 221) did not achieve MDA status; of these, 86% (n = 189) still did not achieve MDA at 12 months. For axSpA, 152 patients initiated and persisted on TNFis. At 6 months, 80% (n = 121) did not achieve BASDAI50; among these patients, 91% (n = 110) still did not achieve BASDAI50 status at 12 months. For both PsA and axSpA initiators, the risk of not achieving clinical or quality of life outcomes was two- to threefold lower in patients who never achieved versus patients who achieved and sustained MDA/BASDAI50.
CONCLUSION: More than 80% of patients with PsA or axSpA who did not achieve low disease activity at 6 months still did not achieve low disease activity by 12 months even though they persisted on TNFi treatment. These findings underscore the importance for physicians to consider modifying therapy if treatment targets with TNFi have not been achieved in the first 6 months.
Area of Special Interest
Orthopedics & Sports Medicine
Specialty/Research Institute
Orthopedics
Specialty/Research Institute
Rheumatology
Specialty/Research Institute
Epidemiology
DOI
10.1007/s40744-025-00813-2
