This observational study evaluated the long-term clinical outcomes of adalimumab (ADA), etanercept (ETN), and infliximab (IFX) in biologic-naive patients with psoriatic arthritis (PsA) who began treatment with these drugs. The study included 420 patients and used Kaplan-Meier analysis to assess drug survival, with Cox regression analysis identifying baseline predictors of drug discontinuation. The frequency and dosage of concomitant glucocorticoids were also tracked over a four-year period. Results showed that ETN had the highest drug survival rate (58.9%) compared to ADA (43.9%) and IFX (44.0%), with a significant difference observed (p = 0.003). Female sex and disease duration were key predictors of drug discontinuation.

Over the four years, the average daily prednisone dose significantly decreased, from 5.6 ± 2.5 at baseline to 4.0 ± 1.8 by year 4 (p = 0.001). Additionally, the proportion of patients taking glucocorticoids dropped from 49.6% at baseline to 22.6% by year 4 (p < 0.01). The findings indicate that in real-world settings, TNF inhibitors like ETN, ADA, and IFX are effective for long-term management of PsA, with lower reliance on glucocorticoids over time.

Reference: Iannone F, Lopriore S, Bucci R, et al. Longterm Clinical Outcomes in 420 Patients with Psoriatic Arthritis Taking Anti-tumor Necrosis Factor Drugs in Real-world Settings. J Rheumatol. 2016 May;43(5):911-7. doi: 10.3899/jrheum.151042. Epub 2016 Mar 15. PMID: 26980583.