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Subgroup analyses explored ACR response among patients with and without prior biological therapy exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The NMA included 46 studies. Results indicate that some tumour necrosis factor inhibitors (anti-TNFs) may perform numerically, but not significantly, better than interleukin (IL) inhibitors on ACR response but perform worse on PASI response. Few significant differences between bDMARDs on ACR response were observed after subgrouping for prior bDMARD exposure. Guselkumab and IL-17A or IL-17RA inhibitors\u2014brodalumab, ixekizumab, secukinumab\u2014were best on PASI response. These IL-inhibitors and adalimumab were similarly efficacious on resolution of enthesitis and dactylitis. Infliximab with and without methotrexate, certolizumab 400 mg every 4 weeks and tildrakizumab showed the highest rates of DAE; abatacept, golimumab and the IL-inhibitors, the lowest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite similar efficacy for ACR response, IL-17A and IL-17RA inhibitors and guselkumab offered preferential efficacy to anti-TNFs in skin manifestations, and for enthesitis and dactylitis, thereby supporting drug selection based on predominant clinical phenotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-002074","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T12:35:37Z","timestamp":1648038937000},"page":"e002074","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Targeted systemic therapies for psoriatic arthritis: a systematic review and comparative synthesis of short-term articular, dermatological, enthesitis and dactylitis outcomes"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct03895203","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03896581","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6462-4280","authenticated-orcid":false,"given":"Iain B","family":"McInnes","sequence":"first","affiliation":[{"name":"College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0854-6222","authenticated-orcid":false,"given":"Laura M","family":"Sawyer","sequence":"additional","affiliation":[{"name":"Symmetron Limited, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Markus","sequence":"additional","affiliation":[{"name":"Symmetron Limited, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"LeReun","sequence":"additional","affiliation":[{"name":"Independent Senior Biostatistician, Sainte-Anne, Guadeloupe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Sabry-Grant","sequence":"additional","affiliation":[{"name":"Symmetron Limited, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4155-9105","authenticated-orcid":false,"given":"Philip S","family":"Helliwell","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"2025090313143994000_8.1.e002074.1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/acr.23789","article-title":"Special article: 2018 American College of Rheumatology\/National psoriasis Foundation guideline for the treatment of psoriatic arthritis","volume":"71","author":"Singh","year":"2019","journal-title":"Arthritis Care Res"},{"key":"2025090313143994000_8.1.e002074.2","doi-asserted-by":"crossref","first-page":"i37","DOI":"10.1093\/rheumatology\/kez383","article-title":"Treatment guidelines in psoriatic arthritis","volume":"59","author":"Ogdie","year":"2020","journal-title":"Rheumatology"},{"key":"2025090313143994000_8.1.e002074.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2015.07.001"},{"key":"2025090313143994000_8.1.e002074.4","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s40744-020-00221-8","article-title":"Disease characteristics and the burden of joint and skin involvement amongst people with psoriatic arthritis: a population survey","volume":"7","author":"Tillett","year":"2020","journal-title":"Rheumatol Ther"},{"key":"2025090313143994000_8.1.e002074.5","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.17-1-65"},{"key":"2025090313143994000_8.1.e002074.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204858"},{"key":"2025090313143994000_8.1.e002074.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217159"},{"key":"2025090313143994000_8.1.e002074.8","doi-asserted-by":"publisher","DOI":"10.1177\/2040622315582354"},{"key":"2025090313143994000_8.1.e002074.9","unstructured":"EMA. 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