{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:56:50Z","timestamp":1791633410425,"version":"4.3.4"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2021,1,4]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To quantify comparative effectiveness of interleukin (IL)\u221212\/23 antagonist (ustekinumab), IL-17A antagonists (secukinumab and ixekizumab), PDE4 inhibitor (apremilast) and tumour necrosis factor-alpha (TNF-\u03b1) inhibitors (infliximab, etanercept, adalimumab, certolizumab pegol and golimumab) for psoriatic arthritis (PsA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We adapted a deidentified claims-based algorithm validated for inflammatory arthritis treatments to compare treatments among a retrospective cohort of commercially insured and Medicare Advantage beneficiaries with PsA from October 2013 to April 2019 in the OptumLabs Data Warehouse. Main outcomes include (1) treatment effectiveness, based on: adherence, adding or switching biologic or PDE4, addition of new non-biologic disease-modifying antirheumatic drug, increase in biologic or PDE4 dose or frequency and glucocorticoid use and (2) percentage of each group fulfilling the effectiveness algorithm. We used Poisson regression with robust variance stratified by prior PsA biologic exposure and adjusted for potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2730 individuals with PsA, 327 received IL-12\/23, 138 IL-17A\u2019s, 624 PDE4 and 1641 TNF-\u03b1\u2019s. Effectiveness criteria were fulfilled among 63 (19.3%) IL-12\/23 recipients, 40 (29.0%) IL-17A recipients, 160 (25.6%) PDE4 recipients and 530 (32.3%) TNF-\u03b1 recipients. Among biologic-na\u00efve individuals, IL-12\/23 was less effective than TNF-\u03b1\u2019s with fully adjusted relative risk (aRR) compared with TNF-\u03b1\u2019s of 0.63 (95% CI 0.45 to 0.89). Among biologic-experienced individuals, PDE4 recipients were less effective than TNF-\u03b1\u2019s (aRR 0.67, 95% CI 0.46 to 0.96).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>TNF-\u03b1\u2019s appeared more effective than IL-12\/23\u2019s for biologic-na\u00efve individuals, and PDE4\u2019s for biologic-experienced individuals. These results may help inform treatment choice for individuals with PsA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001399","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T10:35:39Z","timestamp":1618569339000},"page":"e001399","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Comparative effectiveness of biologics and targeted therapies for psoriatic arthritis"],"prefix":"10.1136","volume":"7","author":[{"given":"Hanzhe","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"OptumLabs Visiting Fellow, OptumLabs, Eden Prairie, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-2986","authenticated-orcid":false,"given":"G Caleb","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-8976","authenticated-orcid":false,"given":"Jeffrey R","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA"},{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"2025090312113215000_7.1.e001399.1","unstructured":"European Medicines Agency . Stelara. European medicines Agency. Available: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/stelara [Accessed 19 Apr 2020]."},{"key":"2025090312113215000_7.1.e001399.2","unstructured":"European Medicines Agency . Cosentyx. European medicines Agency. Available: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/cosentyx [Accessed 20 Apr 2020]."},{"key":"2025090312113215000_7.1.e001399.3","unstructured":"European Medicines Agency . Taltz. European medicines Agency. Available: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/taltz [Accessed 20 Apr 2020]."},{"key":"2025090312113215000_7.1.e001399.4","unstructured":"Development history and FDA approval process for Stelara. Drugs.com. Available: https:\/\/www.drugs.com\/history\/stelara.html [Accessed 11 Nov 2018]."},{"key":"2025090312113215000_7.1.e001399.5","unstructured":"Development history and FDA approval process for Cosentyx. Drugs.com. Available: https:\/\/www.drugs.com\/history\/cosentyx.html [Accessed 11 Nov 2018]."},{"key":"2025090312113215000_7.1.e001399.6","unstructured":"Development history and FDA approval process for Taltz. Drugs.com. Available: https:\/\/www.drugs.com\/history\/taltz.html [Accessed 6 Nov 2019]."},{"key":"2025090312113215000_7.1.e001399.7","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.2217\/cer-2018-0075","article-title":"Secukinumab for psoriatic arthritis: comparative effectiveness versus licensed biologics\/apremilast: a network meta-analysis","volume":"7","author":"McInnes","year":"2018","journal-title":"J Comp Eff Res"},{"key":"2025090312113215000_7.1.e001399.8","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00296-017-3919-7","article-title":"Comparative effectiveness of abatacept, apremilast, secukinumab and ustekinumab treatment of psoriatic arthritis: a systematic review and network meta-analysis","volume":"38","author":"Kawalec","year":"2018","journal-title":"Rheumatol Int"},{"key":"2025090312113215000_7.1.e001399.9","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/ar3472","article-title":"Use of administrative claims data for comparative effectiveness research of rheumatoid arthritis treatments","volume":"13","author":"Kim","year":"2011","journal-title":"Arthritis Res Ther"},{"key":"2025090312113215000_7.1.e001399.10","doi-asserted-by":"publisher","DOI":"10.1186\/ar3471"},{"key":"2025090312113215000_7.1.e001399.11","unstructured":"OptumLabs . 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