A study of U.S. patients with psoriatic arthritis found that >40% were treated with a biologic disease-modifying anti-rheumatic drug (bDMARD). Findings from the study were published in Arthritis Care & Research. 

Researchers used claims data between 2004–2015 from a large commercial database to identify patients with psoriatic arthritis who were initiated on DMARDs. After analyzing baseline patient characteristics and initial treatment patterns, they evaluated changes in the DMARD treatment regimen during the 1-year period after starting the first DMARD.

A total of 9,222 patients initiated on DMARDs were identified: 42.8% biologic and 57.2% conventional synthetic. Patients started on bDMARDs were younger vs. conventional synthetic DMARDs (csDMARDs). Also, bDMARD initiators tended to have less comorbidities but a greater proportion received non-systemic treatments for psoriasis at baseline. 

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The most common DMARD used was methotrexate, comprising about 80% of csDMARD initiation. The most common bDMARD was etanercept (49.1%) followed by adalimumab (34.4%). During the 1-year follow-up after starting DMARD treatment, changes to the regimen were made in 20.1% of bDMARD and 31.1% of csDMARD initiators; an increase in regimen modification was generally seen over the 11-year study period (P=0.03). Treatment discontinuation was seen in 5.3% of patients, but this decreased over time (P<0.001). 

“We found an increasing trend in treatment modification after the initial DMARD use and a decreasing trend in complete DMARD discontinuation over the past decade,” concluded study authors. 

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