{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:57:52Z","timestamp":1773327472651,"version":"3.50.1"},"reference-count":47,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"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":[[2024,7,16]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the potential impact of targeted therapies for psoriatic arthritis (PsA) on symptomatic treatments (non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, opioid analgesics), methotrexate and mood disorder treatments and on hospitalisation and sick leave.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using the French health insurance database, this nationwide cohort study included adults with PsA who were new users (not in the year before the index date) of targeted therapies for \u22659 months during 2015\u20132021. Main endpoints were difference in proportion of users of associated treatments, hospitalisations and sick leaves between 3 and 9 months after and 6 months before targeted therapy initiation. Logistic regression models adjusted for sex, age, psoriasis, inflammatory bowel disease and Charlson Comorbidity Index compared the impact of biologics initiation (tumour necrosis factor inhibitor (TNFi)\/interleukin 17 inhibitor (IL17i)\/IL12\/23i) on associated treatment discontinuation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 9793 patients initiating targeted therapy for PsA (mean age: 51\u00b113 years, 47% men), 62% initiated TNFi, 14% IL17i, 10% IL12\/23i, 1% Janus kinase inhibitor, 12% phosphodiesterase-4 inhibitor. After treatment initiation, the proportion of treatment users was significantly reduced for NSAIDs (\u221215%), opioid analgesics (\u22129%), prednisone (\u22129%), methotrexate (\u221215%) and mood disorder treatments (\u22122%), along with decreased hospitalisations (\u221212%) and sick leaves (\u22124%). TNFi had a greater sparing effect on NSAIDs and prednisone use than IL17i (OR<jats:sub>a<\/jats:sub>=1.04, 95% CI=1.01 to 1.07; 1.04, 1.02 to 1.06) and IL12\/23i (1.07, 1.04 to 1.10; 1.06, 1.04 to 1.09). Odds of methotrexate discontinuation was reduced with TNFi versus IL17i (0.96, 0.94 to 0.98) and IL12\/23i (0.94, 0.92 to 0.97).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Targeted therapy initiation for PsA reduced the use of associated treatment and healthcare, with TNFi having a slightly greater effect than IL17i and IL12\/23i, except for methotrexate discontinuation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-004631","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T03:55:37Z","timestamp":1723089337000},"page":"e004631","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: a cohort study of 9793 patients from the French health insurance database (SNDS)"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-1148","authenticated-orcid":false,"given":"Laura","family":"Pina Vegas","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Henri Mondor, Cr\u00e9teil, \u00cele-de-France, France"},{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, \u00cele-de-France, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siham","family":"Iggui","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Henri Mondor, Cr\u00e9teil, \u00cele-de-France, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie","family":"Sbidian","sequence":"additional","affiliation":[{"name":"Inserm, Centre d\u2019investigation clinique 1430, H\u00f4pital Henri Mondor, Cr\u00e9teil, \u00cele-de-France, France"},{"name":"Service de Dermatologie, H\u00f4pital Henri Mondor, Cr\u00e9teil, \u00cele-de-France, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1911-0544","authenticated-orcid":false,"given":"Pascal","family":"Claudepierre","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Henri Mondor, Cr\u00e9teil, \u00cele-de-France, France"},{"name":"EpiDermE, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne, Cr\u00e9teil, \u00cele-de-France, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"2025090312151654000_10.3.e004631.1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160180"},{"key":"2025090312151654000_10.3.e004631.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2024-225531"},{"key":"2025090312151654000_10.3.e004631.3","doi-asserted-by":"crossref","first-page":"105344","DOI":"10.1016\/j.jbspin.2022.105344","article-title":"2022 French society for rheumatology (SFR) recommendations on the everyday management of patients with spondyloarthritis, including psoriatic arthritis","volume":"89","author":"Wendling","year":"2022","journal-title":"Joint Bone Spine"},{"key":"2025090312151654000_10.3.e004631.4","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1038\/s41584-022-00798-0","article-title":"Group for research and assessment of psoriasis and psoriatic arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021","volume":"18","author":"Coates","year":"2022","journal-title":"Nat Rev Rheumatol"},{"key":"2025090312151654000_10.3.e004631.5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/art.40726","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 Rheumatol"},{"key":"2025090312151654000_10.3.e004631.6","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.ad.2016.04.018","article-title":"The cost of psoriasis and psoriatic arthritis in 5 European countries: a systematic review","volume":"107","author":"Burgos-Pol","year":"2016","journal-title":"Actas Dermosifiliogr"},{"key":"2025090312151654000_10.3.e004631.7","first-page":"s267","article-title":"Quantifying the impact of NSAID-associated adverse events","volume":"19","author":"Fine","year":"2013","journal-title":"Am J Manag Care"},{"key":"2025090312151654000_10.3.e004631.8","unstructured":"National Agency for the Safety of Medicines and Health Products (ANSM) . 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