{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:15:00Z","timestamp":1753877700592,"version":"3.41.2"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":318,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Biologic treatments have revolutionized the management of PsA by significantly improving clinical manifestations and preventing structural damage. Both result in better quality of life and improved physical functioning. Since the introduction of the first TNF inhibitor (TNFi) in the early 2000s, therapeutic options for PsA are increasing steadily, and a new generation of biologics, including anti-IL-17 and anti-IL-23 strategies, allows distinct targeted approaches. The purpose of this study was to investigate whether the demographic, clinical and disease characteristics of PsA patients who are selected for first-line biologic treatment has changed over time since the introduction of biologics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with a clinical diagnosis of PsA were included in the KU Leuven BioSPAR registry, a prospective cohort of SpA and PsA patients treated with biologics and targeted synthetic DMARDs (tsDMARDs), such as apremilast and Janus kinase inhibitors. Demographics, prior DMARD use, disease characteristics and disease activity parameters were recorded at the initiation of biologic treatment and subsequently every 3 months for the first 2 years and later every 6 months. The patient data were compared in three treatment periods, corresponding to availability of the first and second generation of TNFi and the third generation of biologics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Analysis of 185 Caucasian patients with PsA from our prospective cohort showed longer disease duration and higher disease activity, with higher tender joint count, swollen joint count and CRP in the first period compared with the later time periods. The demographic characteristics and prior DMARD use did not change over time. Skin and nail psoriasis were more frequent in earlier compared with the later treatment periods. The bio-DMARD survival rate was similar in the early and later treatment periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The population of patients selected for treatment escalation has changed over time since the introduction of biologics. Our results suggest that with years of experience, PsA patients might be considered earlier and for therapy intensification in patients with less active disease in comparison to profiles in the early days of biologic treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rap\/rkab085","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T04:19:02Z","timestamp":1637209142000},"source":"Crossref","is-referenced-by-count":2,"title":["Evolution of patient characteristics in the era of biologic treatment of psoriatic arthritis: 18-year Belgian experience from the Leuven Spondyloarthritis Biologics Cohort (BioSPAR)"],"prefix":"10.1093","volume":"5","author":[{"given":"Alla","family":"Ishchenko","sequence":"first","affiliation":[{"name":"Department of Rheumatology, University Hospitals Leuven"},{"name":"Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Joly","sequence":"additional","affiliation":[{"name":"Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Neerinckx","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospitals Leuven"},{"name":"Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rik","family":"Lories","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospitals Leuven"},{"name":"Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt","family":"de Vlam","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospitals Leuven"},{"name":"Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"2021120719170163500_rkab085-B1","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1136\/annrheumdis-2015-209068","article-title":"Efficacy and safety of ustekinumab in psoriatic arthritis patients with peripheral arthritis and physician-reported spondylitis: post-hoc analyses from two phase III, multicentre, double-blind, placebo-controlled studies (PSUMMIT-1\/PSUMMIT-2)","volume":"75","author":"Kavanaugh","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"2021120719170163500_rkab085-B2","first-page":"890","article-title":"Secukinumab improves active psoriatic arthritis symptoms and inhibits radiographic progression: primary results from the randomised, double-blind, phase III FUTURE 5 study","volume":"77","author":"Mease","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2021120719170163500_rkab085-B3","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.semarthrit.2018.05.011","article-title":"Effects of ustekinumab versus tumor necrosis factor inhibition on enthesitis: Results from the enthesial clearance in psoriatic arthritis (ECLIPSA) study","volume":"48","author":"Araujo","year":"2019","journal-title":"Semin Arthritis Rheum"},{"key":"2021120719170163500_rkab085-B4","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/S0140-6736(19)30952-3","article-title":"Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial","volume":"394","author":"Reich","year":"2019","journal-title":"Lancet"},{"issue":"Suppl 1","key":"2021120719170163500_rkab085-B5","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1186\/1478-6354-13-S1-S4","article-title":"Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future","volume":"13","author":"Schett","year":"2011","journal-title":"Arthritis Res Ther"},{"key":"2021120719170163500_rkab085-B6","doi-asserted-by":"crossref","first-page":"3172","DOI":"10.1093\/rheumatology\/keaa313","article-title":"Effect of biologics on radiographic progression of peripheral joint in patients with psoriatic arthritis: meta-analysis","volume":"59","author":"Wu","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2021120719170163500_rkab085-B7","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.berh.2019.03.001","article-title":"Opportunities and challenges in the treatment of psoriatic arthritis","volume":"32","author":"FitzGerald","year":"2018","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2021120719170163500_rkab085-B8","doi-asserted-by":"crossref","first-page":"e000779","DOI":"10.1136\/rmdopen-2018-000779","article-title":"Evolution of psoriatic arthritis study patient population characteristics in the era of biological treatments","volume":"5","author":"Vandendorpe","year":"2019","journal-title":"RMD Open"},{"key":"2021120719170163500_rkab085-B9","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1002\/art.20967","article-title":"Sustained benefits of infliximab therapy for dermatologic and articular manifestations of psoriatic arthritis: results from the infliximab multinational psoriatic arthritis controlled trial (IMPACT)","volume":"52","author":"Antoni","year":"2005","journal-title":"Arthritis Rheum"},{"key":"2021120719170163500_rkab085-B10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0140-6736(00)02530-7","article-title":"Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial","volume":"356","author":"Mease","year":"2000","journal-title":"Lancet"},{"key":"2021120719170163500_rkab085-B11","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/art.24403","article-title":"Golimumab, a new human tumor necrosis factor alpha antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: twenty-four-week efficacy and safety results of a randomized, placebo-controlled study","volume":"60","author":"Kavanaugh","year":"2009","journal-title":"Arthritis Rheum"},{"key":"2021120719170163500_rkab085-B12","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1136\/annrheumdis-2013-203696","article-title":"Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA)","volume":"73","author":"Mease","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"2021120719170163500_rkab085-B13","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1136\/annrheumdis-2013-204655","article-title":"Efficacy and safety of the anti-IL-12\/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial","volume":"73","author":"Ritchlin","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"2021120719170163500_rkab085-B14","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1093\/rheumatology\/keq091","article-title":"Time and predictors of response to tumour necrosis factor-\u03b1 blockers in psoriatic arthritis: an analysis of a longitudinal observational cohort","volume":"49","author":"Eder","year":"2010","journal-title":"Rheumatology (Oxford)"},{"key":"2021120719170163500_rkab085-B15","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.semarthrit.2016.09.005","article-title":"Effectiveness and drug survival of TNF-inhibitors in the treatment of psoriatic arthritis: A prospective cohort study","volume":"46","author":"Aaltonen","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2021120719170163500_rkab085-B16","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1002\/art.30117","article-title":"Treatment response, drug survival, and predictors thereof in 764 patients with psoriatic arthritis treated with anti-tumor necrosis factor \u03b1 therapy: results from the nationwide Danish DANBIO registry","volume":"63","author":"Glintborg","year":"2011","journal-title":"Arthritis Rheum"},{"key":"2021120719170163500_rkab085-B17","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.3346\/jkms.2018.33.e213","article-title":"Real-world evidence versus randomized controlled trial: clinical research based on electronic medical records","volume":"33","author":"Kim","year":"2018","journal-title":"J Korean Med Sci"},{"key":"2021120719170163500_rkab085-B18","first-page":"127","article-title":"Psoriatic arthritis (PSA) \u2013 an analysis of 220 patients","volume":"62","author":"Gladman","year":"1987","journal-title":"Q J Med"},{"key":"2021120719170163500_rkab085-B19","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1136\/annrheumdis-2013-205056","article-title":"Treatment of psoriatic arthritis in a phase 3 randomised, placebo-controlled trial with apremilast, an oral phosphodiesterase 4 inhibitor","volume":"73","author":"Kavanaugh","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"2021120719170163500_rkab085-B20","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/rheumatology\/keq262","article-title":"Observational cohort studies: lessons learnt from the University of Toronto Psoriatic Arthritis Program","volume":"50","author":"Gladman","year":"2011","journal-title":"Rheumatology (Oxford)"},{"key":"2021120719170163500_rkab085-B21","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2017-000596","article-title":"Long-term persistence of TNF-inhibitor treatment in patients with psoriatic arthritis. Data from the British Society for Rheumatology Biologics Register","volume":"4","author":"Fagerli","year":"2018","journal-title":"RMD open"},{"key":"2021120719170163500_rkab085-B22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jbspin.2014.08.001","article-title":"Treatment response, drug survival and safety of anti-tumour necrosis factor a therapy in 193 patients with psoriatic arthritis: a twelve-year \u201creal life\u201d experience","volume":"82","author":"Soubrier","year":"2015","journal-title":"Joint Bone Spine"}],"container-title":["Rheumatology Advances in Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rheumap\/advance-article-pdf\/doi\/10.1093\/rap\/rkab085\/41153972\/rkab085.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/5\/3\/rkab085\/41640829\/rkab085.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/5\/3\/rkab085\/41640829\/rkab085.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T19:17:29Z","timestamp":1638904649000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rheumap\/article\/doi\/10.1093\/rap\/rkab085\/6428673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,8,31]]}},"URL":"https:\/\/doi.org\/10.1093\/rap\/rkab085","relation":{},"ISSN":["2514-1775"],"issn-type":[{"type":"electronic","value":"2514-1775"}],"subject":[],"published-other":{"date-parts":[[2021]]},"published":{"date-parts":[[2021]]},"article-number":"rkab085"}}