Effects of previous csDMARDs exposure and csDMARDs co-medication on psoriatic arthritis refractory to bDMARDs

While new targeted therapies are approved and available for patients with psoriatic arthritis (PsA), complete remission remains an area of unmet need. Importantly, a proportion of patients are refractory to one or more biologic disease-modifying antirheumatic drugs (bDMARDs), resulting a significant clinical challenge. Although conventional synthetic disease-modifying antirheumatic drug (csDMARD) has been one of the most widely used medications for PsA, very few studies have investigated the impact of the previous csDMARDs exposure on the risk of development of PsA refractory to bDMARDs. Moreover, there is no conclusive recommendation on the comedication with csDMARDs during bDMARDs therapy. To elucidate the impact of previous csDMARDs exposure and csDMARDs co-medication on the treatment outcome of PsA refractory to bDMARDs, a retrospective study was performed at the Department of Dermatology of Xiangya Hospital.