{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:19:15Z","timestamp":1788898755994,"version":"build-2803163510"},"reference-count":43,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"unspecified","delay-in-days":6,"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":[[2022,11,2]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Tumour necrosis factor inhibitor (TNFi) agents are most often the first-choice biological treatment for patients with psoriatic arthritis (PsA). When their discontinuation is needed, a switch to another TNFi or to another therapeutic class may be considered. However, data supporting one approach over another are lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare the long-term persistence of classes of biologics in PsA patients with prior TNFi exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to the hospital discharge database. We included all adults with PsA starting a second-line biological after discontinuing a TNFi during 2015\u20132020. Persistence was defined as the time from biological initiation to discontinuation and was estimated by the Kaplan-Meier method. Comparison of persistence by biological class was performed with Poisson regression models with time divided into 6-month intervals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 2975 patients: 1580 (53%) initiating a second TNFi, 426 (14%) an interleukin 12\/23 inhibitor (IL-12\/23i) and 969 (33%) an IL-17 inhibitor (IL-17i). Overall, 1-year and 3-year persistence rates were 42% and 17%, respectively. After adjustment, persistence was associated with treatment with an IL-17i (adjusted relative risk (RR<jats:sub>a<\/jats:sub>) 0.79, 95%\u2009CI 0.71 to 0.87) or IL-12\/23i (RR<jats:sub>a<\/jats:sub> 0.69, 95%\u2009CI 0.61 to 0.79) vs a TNFi, with no significant difference between IL-12\/23 and IL-17 inhibitors (RR<jats:sub>a<\/jats:sub> 0.88, 95%\u2009CI 0.76 to 1.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, this real-life study shows low persistence for all biologics at 3 years in PsA patients previously exposed to a TNFi. However, persistence was higher with an IL-17i or IL-12\/23i than a TNFi.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002681","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T09:22:56Z","timestamp":1670404976000},"page":"e002681","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Long-term persistence of second-line biologics in psoriatic arthritis patients with prior TNF inhibitor exposure: a nationwide cohort study from the French health insurance database (SNDS)"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-1148","authenticated-orcid":false,"given":"Laura","family":"Pina Vegas","sequence":"first","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, France"},{"name":"Rhumatologie, H\u00f4pital Henri Mondor, Creteil cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9a","family":"Hoisnard","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, France"},{"name":"F\u00e9d\u00e9ration Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, H\u00f4pital Henri Mondor, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9a","family":"Bastard","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, France"},{"name":"Rhumatologie, H\u00f4pital Henri Mondor, Creteil cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Sbidian","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, France"},{"name":"Inserm, Centre d\u2019investigation clinique 1430, H\u00f4pital Henri Mondor, Cr\u00e9teil, France"},{"name":"Dermatologie, H\u00f4pital Henri Mondor, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1911-0544","authenticated-orcid":false,"given":"Pascal","family":"Claudepierre","sequence":"additional","affiliation":[{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, France"},{"name":"Rhumatologie, H\u00f4pital Henri Mondor, Creteil cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"2025090313390044000_8.2.e002681.1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.semarthrit.2018.01.003","article-title":"Prevalence and incidence of psoriatic arthritis: a systematic review and meta-analysis","volume":"48","author":"Scotti","year":"2018","journal-title":"Semin Arthritis 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