Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries

Adrian Ciurea; Seraphina Kissling; Andrea Götschi; Lykke Midtbøll Ørnbjerg; Simon Horskjær Rasmussen; Bálint Tamási; Burkhard Möller; Michael J. Nissen; Bente Glintborg; Anne Gitte Loft; Almut Scherer; René Bräm; Karel Pavelka; Jakub Závada; Joao Madruga Dias; Paula Valente; Bjorn Gudbjornsson; Olafur Palsson; Vappu Rantalaiho; Ritva Peltomaa; Catalin Codreanu; Corina Mogosan; Florenzo Iannone; Marco Sebastiani; Gareth T. Jones; Gary J. Macfarlane; Isabel Castrejon; Ziga Rotar; Brigitte Michelsen; Johan K. Wallman; Irene van der Horst-Bruinsma; Oliver Distler; Mikkel Østergaard; Merete Lund Hetland; Raphael Micheroli; Caroline Ospelt

doi:10.1186/s13075-025-03488-w

Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries

Adrian Ciurea^*, Seraphina Kissling, Andrea Götschi, Lykke Midtbøll Ørnbjerg, Simon Horskjær Rasmussen, Bálint Tamási, Burkhard Möller, Michael J. Nissen, Bente Glintborg, Anne Gitte Loft, Almut Scherer, René Bräm, Karel Pavelka, Jakub Závada, Joao Madruga Dias, Paula Valente, Bjorn Gudbjornsson, Olafur Palsson, Vappu Rantalaiho, Ritva PeltomaaCatalin Codreanu, Corina Mogosan, Florenzo Iannone, Marco Sebastiani, Gareth T. Jones, Gary J. Macfarlane, Isabel Castrejon, Ziga Rotar, Brigitte Michelsen, Johan K. Wallman, Irene van der Horst-Bruinsma, Oliver Distler, Mikkel Østergaard, Merete Lund Hetland, Raphael Micheroli, Caroline Ospelt

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

1 Citationer (Scopus)

Abstract

Background
Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care.

Methods
Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex.

Results
A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78).

Conclusion
The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints.

Originalsprog	Engelsk
Artikelnummer	18
Tidsskrift	Arthritis Research and Therapy
Vol/bind	27
Udgave nummer	1
Antal sider	16
ISSN	1478-6354
DOI	https://doi.org/10.1186/s13075-025-03488-w
Status	Udgivet - 2025

Bibliografisk note

Publisher Copyright:
© The Author(s) 2025.

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10.1186/s13075-025-03488-wLicens: CC BY-NC-ND

FulltextForlagets udgivne version, 1,46 MBLicens: CC BY-NC-ND

Citationsformater

Ciurea, A., Kissling, S., Götschi, A., Ørnbjerg, L. M., Rasmussen, S. H., Tamási, B., Möller, B., Nissen, M. J., Glintborg, B., Loft, A. G., Scherer, A., Bräm, R., Pavelka, K., Závada, J., Dias, J. M., Valente, P., Gudbjornsson, B., Palsson, O., Rantalaiho, V., ... Ospelt, C. (2025). Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries. Arthritis Research and Therapy, 27(1), Artikel 18. https://doi.org/10.1186/s13075-025-03488-w

Ciurea, A, Kissling, S, Götschi, A, Ørnbjerg, LM, Rasmussen, SH, Tamási, B, Möller, B, Nissen, MJ, Glintborg, B, Loft, AG, Scherer, A, Bräm, R, Pavelka, K, Závada, J, Dias, JM, Valente, P, Gudbjornsson, B, Palsson, O, Rantalaiho, V, Peltomaa, R, Codreanu, C, Mogosan, C, Iannone, F, Sebastiani, M, Jones, GT, Macfarlane, GJ, Castrejon, I, Rotar, Z, Michelsen, B, Wallman, JK, van der Horst-Bruinsma, I, Distler, O, Østergaard, M , Hetland, ML, Micheroli, R & Ospelt, C 2025, 'Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries', Arthritis Research and Therapy, bind 27, nr. 1, 18. https://doi.org/10.1186/s13075-025-03488-w

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title = "Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries",

abstract = "Background: Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care. Methods: Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex. Results: A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78). Conclusion: The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints.",

author = "Adrian Ciurea and Seraphina Kissling and Andrea G{\"o}tschi and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Rasmussen, {Simon Horskj{\ae}r} and B{\'a}lint Tam{\'a}si and Burkhard M{\"o}ller and Nissen, {Michael J.} and Bente Glintborg and Loft, {Anne Gitte} and Almut Scherer and Ren{\'e} Br{\"a}m and Karel Pavelka and Jakub Z{\'a}vada and Dias, {Joao Madruga} and Paula Valente and Bjorn Gudbjornsson and Olafur Palsson and Vappu Rantalaiho and Ritva Peltomaa and Catalin Codreanu and Corina Mogosan and Florenzo Iannone and Marco Sebastiani and Jones, {Gareth T.} and Macfarlane, {Gary J.} and Isabel Castrejon and Ziga Rotar and Brigitte Michelsen and Wallman, {Johan K.} and {van der Horst-Bruinsma}, Irene and Oliver Distler and Mikkel {\O}stergaard and Hetland, {Merete Lund} and Raphael Micheroli and Caroline Ospelt",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2025.",

year = "2025",

doi = "10.1186/s13075-025-03488-w",

language = "English",

volume = "27",

journal = "Arthritis Research and Therapy",

issn = "1478-6354",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis

T2 - results from nine European registries

AU - Ciurea, Adrian

AU - Kissling, Seraphina

AU - Götschi, Andrea

AU - Ørnbjerg, Lykke Midtbøll

AU - Rasmussen, Simon Horskjær

AU - Tamási, Bálint

AU - Möller, Burkhard

AU - Nissen, Michael J.

AU - Glintborg, Bente

AU - Loft, Anne Gitte

AU - Scherer, Almut

AU - Bräm, René

AU - Pavelka, Karel

AU - Závada, Jakub

AU - Dias, Joao Madruga

AU - Valente, Paula

AU - Gudbjornsson, Bjorn

AU - Palsson, Olafur

AU - Rantalaiho, Vappu

AU - Peltomaa, Ritva

AU - Codreanu, Catalin

AU - Mogosan, Corina

AU - Iannone, Florenzo

AU - Sebastiani, Marco

AU - Jones, Gareth T.

AU - Macfarlane, Gary J.

AU - Castrejon, Isabel

AU - Rotar, Ziga

AU - Michelsen, Brigitte

AU - Wallman, Johan K.

AU - van der Horst-Bruinsma, Irene

AU - Distler, Oliver

AU - Østergaard, Mikkel

AU - Hetland, Merete Lund

AU - Micheroli, Raphael

AU - Ospelt, Caroline

PY - 2025

Y1 - 2025

N2 - Background: Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care. Methods: Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex. Results: A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78). Conclusion: The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints.

AB - Background: Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care. Methods: Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex. Results: A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78). Conclusion: The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints.

U2 - 10.1186/s13075-025-03488-w

DO - 10.1186/s13075-025-03488-w

M3 - Journal article

C2 - 39891200

AN - SCOPUS:85217530578

SN - 1478-6354

VL - 27

JO - Arthritis Research and Therapy

JF - Arthritis Research and Therapy

IS - 1

M1 - 18

ER -