Short-Term Response to Biologic Therapy in Psoriatic Arthritis Is Not Influenced by Disease Duration at Initiation of...

We aimed to determine whether the short-term response to biologics in biologic-naive psoriatic arthritis (PsA) is better in patients initiating biologic treatment early in the disease course.

Patients with PsA who started on biologic therapy from the year 2000 to 2025 were included for analysis. Patients were considered in the early treatment group if they had started on biologic therapy within two years of PsA diagnosis; otherwise, they were considered in the delayed treatment group. The primary outcome was ≥50% reduction in the Disease Activity Index for Psoriatic Arthritis (DAPSA) score at six months. The secondary outcome was Psoriasis Area and Severity Index (PASI) 75, defined as ≥75% improvement in the PASI score at six months. Logistic regression was used to examine the association between early treatment and disease outcomes at six months. Propensity scores were used to account for differences between the groups at the baseline visit.

Of the 228 included patients, 71 patients were in the early treatment group, and 157 patients were in the delayed treatment group. There were significant differences in the time from PsA diagnosis to biologic treatments over the decades. The propensity score regression adjusted analysis did not suggest a difference in response at six months between those treated within two years of diagnosis and those treated later.

Short-term response to biologic therapy in patients with PsA does not appear to differ between those treated early or later in the disease course. It remains to be determined whether early treatment prevents progression of joint damage in the longer-term.