PT  - JOURNAL ARTICLE
AU  - Bente Glintborg
AU  - Daniela Di Giuseppe
AU  - Johan Karlsson Wallman
AU  - Dan C Nordström
AU  - Bjorn Gudbjornsson
AU  - Merete Lund Hetland
AU  - Johan Askling
AU  - Gerdur Grondal
AU  - Tuulikki Sokka
AU  - Sella A Provan
AU  - Brigitte Michelsen
AU  - Eirik Klami Kristianslund
AU  - Lene Dreyer
AU  - Thorvardur Jon Love
AU  - Ulf Lindström
TI  - Uptake and effectiveness of newer biologic and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis: results from five Nordic biologics registries
AID  - 10.1136/ard-2022-223650
DP  - 2023 Jun 01
TA  - Annals of the Rheumatic Diseases
PG  - 820--828
VI  - 82
IP  - 6
4099  - http://ard.bmj.com/content/82/6/820.short
4100  - http://ard.bmj.com/content/82/6/820.full
SO  - Ann Rheum Dis2023 Jun 01; 82
AB  - Background We aimed to describe the uptake of newer biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in psoriatic arthritis (PsA) in the Nordic countries and to compare their retention and effectiveness.Methods Patients with PsA starting a b/tsDMARD in 2012–2020 in five Nordic rheumatology registers were included. Uptake and patient characteristics were described, with comorbidities identified from linkages to national patient registries. One-year retention and 6-month effectiveness (proportions achieving low disease activity (LDA) on the Disease Activity Index for PSoriatic Arthritis based on 28-joint evaluation) for the newer b/tsDMARDs (abatacept/apremilast/ixekizumab/secukinumab/tofacitinib/ustekinumab) were compared with adalimumab through adjusted regression models stratified by treatment course (first, second/third, and fourth or more).Results In total, 5659 treatment courses with adalimumab (56% biologic-naïve) and 4767 courses with a newer b/tsDMARD (21% biologic-naïve) were included. The uptake of newer b/tsDMARDs increased from 2014 and plateaued in 2018. Patient characteristics appeared similar across treatments at treatment start. Adalimumab was more often used as the first course and newer b/tsDMARDs more often in biologic-experienced patients. Used as a second/third b/tsDMARD, the retention rate and the proportion achieving LDA were significantly better for adalimumab (rate 65%, proportion 59%) compared with abatacept (45%, 37%), apremilast (43%, 35%), ixekizumab (LDA only, 40%) and ustekinumab (LDA only, 40%), but not significantly different from other b/tsDMARDs.Conclusion Uptake of newer b/tsDMARDs occurred mainly in biologic-experienced patients. Regardless of mode of action, only a minority of patients starting a second or later b/tsDMARD course remained on drug and achieved LDA. Superior outcomes for adalimumab indicate that the positioning of newer b/tsDMARDs in the PsA treatment algorithm remains to be established.Due to privacy and ethical concerns any raw data can not be shared. Aggregated data can be shared upon reasonable request