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  • Treatment of recalcitrant psoriasis and psoriatic arthritis with a combination of a biologic plus an oral JAK or TYK2 inhibitor: a case series

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Treatment of recalcitrant psoriasis and psoriatic arthritis with a combination of a biologic plus an oral JAK or TYK2 inhibitor: a case series
  1. M Grace Hren1,2,
  2. Saakshi Khattri1
  1. 1 Dermatology and Rheumatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2 Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, USA
  1. Correspondence to Dr Saakshi Khattri; saakshi.khattri{at}mountsinai.org

https://doi.org/10.1136/ard-2024-225800

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    Psoriasis (PSO) and psoriatic arthritis (PsA) are debilitating diseases that impact the life quality of those affected. One-third of patients with PSO develop PsA.1 PSO affects skin and PsA is a heterogeneous condition involving peripheral joints and/or axial skeleton, with extra-articular manifestations such as enthesitis, dactylitis and nail disease.1 Implicated in both PSO and PsA pathogenesis is the interleukin (IL)-23/T helper (Th) 17 pathway.1

    Injectable biologics (TNF-α, IL-12/IL-23, IL-17 and IL-23 inhibitors) are approved for the treatment of PSO and PsA. Oral molecules, TYK2 and JAK1 inhibitors, are approved for PSO and PsA, respectively. Here, we describe the use of JAK1 or TYK2 inhibitors combined with injectable biologics (IL-17 or IL-23 inhibitor) to treat six patients with recalcitrant PSO and PsA.

    Charts were retrospectively retrieved from a rheumatology-dermatology clinic for patients on JAK1 or TYK2 inhibition plus biological therapy for the treatment of PSO and PsA between 01 June 2018 - 01 December 2023. For PSO, remission was classified as body surface area <1%, …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors SK developed idea for research and treated patients described in this manuscript. MGH collected data, drafted the initial manuscript and created tables. SK and MGH edited the manuscript. MGH finalised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests SK is an employee of Mount Sinai and a consultant for AbbVie, Eli Lilly, Janssen and Novartis. She is on the speaker bureau for UCB, Janssen, Lilly, Regeneron and Abbvie. She receives research funding from Abbvie, Pfizer, Incyte and Takeda. MGH has no conflicts of interest to declare.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.