Introduction: Interleukin-17 inhibitors (IL-17i) represent a key therapeutic option for psoriatic arthritis (PsA), but real-world evidence regarding the effectiveness of cycling strategies within this class is lacking. This study evaluated the real-world retention of IL-17i in PsA, focusing on whether prior IL-17i exposure affects subsequent IL-17i persistence. Methods: This multicentre, retrospective, observational study included consecutive patients with PsA treated with an IL-17i across 24 Italian rheumatology centres. The primary outcome was drug retention, analysed using Kaplan–Meier methods, with differences between IL-17i-naïve and IL-17i-experienced patients assessed with the log-rank test. Secondary outcomes included baseline clinical characteristics and predictors of discontinuation. Results: A total of 868 patients were included (59.3% female, 40.7% male; median age 56 [48–63] years; 89.3% IL-17i-naïve). The overall median IL-17i retention rate was 90.7% [95% CI 88.7–92.8] at 6 months, 77.5% [95% CI 74.6– 80.6] at 12 months, 60.9% [95% CI 57.3–64.8] at 24 months, and 52.1% [95% CI 48.1–56.4] at 36 months. Among IL-17i-naïve patients, retention rates were 90.5%, 77.6%, 61.7%, and 53.9% at 6, 12, 24, and 36 months, respectively. Among IL-17i-experienced patients, the corresponding retention rates were 92.2%, 77.0%, 54.0%, and 33.9%. In multivariable Cox regression, male sex and prior IL-17 inhibitor exposure were associated with a lower risk of discontinuation, whereas axial involvement, a higher number of previous biologic/targeted synthetic diseasemodifying anti-rheumatic drugs (b/tsDMARDs), and later calendar year of IL-17i initiation predicted poorer retention. Conclusions: IL-17i showed high long-term retention in real-world PsA, with no significant difference between naïve and previously exposed patients. These findings support the sustained effectiveness of IL-17i therapy and suggest that cycling within the class may remain a reasonable option for selected cases.
Does Prior Exposure Affect Retention? A Real-World, Multicentre Assessment of IL-17 Inhibitor Cycling in Psoriatic Arthritis / Paci, Valentino; Ariani, Alarico; Celletti, Eleonora; Addimanda, Olga; Lo Gullo, Alberto; Mazzanti, Camilla; Di Penta, Myriam; Sabatini, Emanuela; Cipollone, Francesco; Santoboni, Gianluca; Angrisani, Claudio; De Simone, Massimiliano; Nucera, Valeria; Ianniello, Aurora; Vallifuoco, Giulia; Mansueto, Natalia; Andracco, Romina; Ferrero, Giulio; Caccavale, Rosalba; Paroli, Marino; Del Medico, Patrizia; Smerilli, Gianluca; Farina, Antonella; Scolieri, Palma; Bruzzese, Vincenzo; Giampietro, Cecilia; Ometto, Francesca; Vukatana, Gentiana; Trevisani, Marica; Mulè, Rita; Rossi, Elisa; Vandelli, Enrica; Bixio, Riccardo; Volpe, Alessandro; Marchetta, Antonio; Larosa, Maddalena; Camellino, Dario; Bianchi, Gerolamo; Ravagnani, Viviana; Lumetti, Federica; Molica Colella, Aldo Biagio; Franchina, Veronica; Colella, Francesco Molica; Bravi, Elena; Platè, Ilaria; Arrigoni, Eugenio; Vitetta, Rosetta; Serale, Francesca; Fiorenza, Alessia; Murgia, Davide; Rovera, Guido; Amati, Gabriele; Visalli, Elisa; Amato, Giorgio; De Lucia, Francesco; Bosco, Ylenia Dal; Foti, Roberta; Fusaro, Enrico; Ditto, Maria Chiara; Bernardi, Simone; Girelli, Francesco; Priora, Marta; Bezzi, Alessandra; Focherini, Maria Cristina; Mascella, Fabio; Becciolini, Andrea; Di Donato, Eleonora; Adorni, Giuditta; Lucchini, Gianluca; Santilli, Daniele; Gabrielli, Beatrice; Giuggioli, Dilia; Raffeiner, Bernd; Reta, Massimo; Magnani, Mirco; Idolazzi, Luca; Sandri, Gilda; Foti, Rosario; Parisi, Simone; Luchetti Gentiloni, Michele Maria; Moroncini, Gianluca. - In: RHEUMATOLOGY AND THERAPY. - ISSN 2198-6576. - (2026). [Epub ahead of print] [10.1007/s40744-026-00839-0]
Does Prior Exposure Affect Retention? A Real-World, Multicentre Assessment of IL-17 Inhibitor Cycling in Psoriatic Arthritis
Paci, Valentino;Ariani, Alarico;Del Medico, Patrizia;Smerilli, Gianluca;Rossi, Elisa;Di Donato, Eleonora;Santilli, Daniele;Magnani, Mirco;Luchetti Gentiloni, Michele Maria
;Moroncini, Gianluca
2026-01-01
Abstract
Introduction: Interleukin-17 inhibitors (IL-17i) represent a key therapeutic option for psoriatic arthritis (PsA), but real-world evidence regarding the effectiveness of cycling strategies within this class is lacking. This study evaluated the real-world retention of IL-17i in PsA, focusing on whether prior IL-17i exposure affects subsequent IL-17i persistence. Methods: This multicentre, retrospective, observational study included consecutive patients with PsA treated with an IL-17i across 24 Italian rheumatology centres. The primary outcome was drug retention, analysed using Kaplan–Meier methods, with differences between IL-17i-naïve and IL-17i-experienced patients assessed with the log-rank test. Secondary outcomes included baseline clinical characteristics and predictors of discontinuation. Results: A total of 868 patients were included (59.3% female, 40.7% male; median age 56 [48–63] years; 89.3% IL-17i-naïve). The overall median IL-17i retention rate was 90.7% [95% CI 88.7–92.8] at 6 months, 77.5% [95% CI 74.6– 80.6] at 12 months, 60.9% [95% CI 57.3–64.8] at 24 months, and 52.1% [95% CI 48.1–56.4] at 36 months. Among IL-17i-naïve patients, retention rates were 90.5%, 77.6%, 61.7%, and 53.9% at 6, 12, 24, and 36 months, respectively. Among IL-17i-experienced patients, the corresponding retention rates were 92.2%, 77.0%, 54.0%, and 33.9%. In multivariable Cox regression, male sex and prior IL-17 inhibitor exposure were associated with a lower risk of discontinuation, whereas axial involvement, a higher number of previous biologic/targeted synthetic diseasemodifying anti-rheumatic drugs (b/tsDMARDs), and later calendar year of IL-17i initiation predicted poorer retention. Conclusions: IL-17i showed high long-term retention in real-world PsA, with no significant difference between naïve and previously exposed patients. These findings support the sustained effectiveness of IL-17i therapy and suggest that cycling within the class may remain a reasonable option for selected cases.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
