Factors associated with discontinuation of biologics in patients with inflammatory arthritis in remission: data from the BIOBADASER registry

Inflammatory tissue priming: novel insights and therapeutic opportunities for inflammatory rheumatic diseases

Due to optimised treatment strategies and the availability of new therapies during the last decades, formerly devastating chronic inflammatory diseases such as rheumatoid arthritis or systemic sclerosis (SSc) have become less menacing. However, in many patients, even state-of-the-art treatment cannot induce remission. Moreover, the risk for flares strongly increases once anti-inflammatory therapy is tapered or withdrawn, suggesting that underlying pathological processes remain active even in the absence of overt inflammation. It has become evident that tissues have the ability to remember past encounters with pathogens, wounds and other irritants, and to react more strongly and/or persistently to the next occurrence. This priming of the tissue bears a paramount role in defence from microbes, but on the other hand drives inflammatory pathologies (the Dr Jekyll and Mr Hyde aspect of tissue adaptation). Emerging evidence suggests that long-lived tissue-resident cells, such as fibroblasts, macrophages, long-lived plasma cells and tissue-resident memory T cells, determine inflammatory tissue priming in an interplay with infiltrating immune cells of lymphoid and myeloid origin, and with systemically acting factors such as cytokines, extracellular vesicles and antibodies. Here, we review the current state of science on inflammatory tissue priming, focusing on tissue-resident and tissue-occupying cells in arthritis and SSc, and reflect on the most promising treatment options targeting the maladapted tissue response during these diseases.

An observational study on treatment regimens and effectiveness for psoriasis in real-world settings among 407 patients in Southeast China

Introduction

While new targeted therapies have advanced psoriasis treatment, real-world data on comparative effectiveness is lacking. This study analyzed treatment regimens and response in an observational cohort, examining potential disparities between clinical trials and routine practice.

Methods

Data from the Psoriasis Standardized Diagnosis and Treatment Center registry were analyzed. Patients with ≥1 follow-up were included. Treatment response was assessed using PASI 50/90 criteria. Factors associated with response were analyzed.

Results

407 patients were included (46 first-time diagnosed, 361 previously diagnosed). A higher proportion of first-time diagnosed patients achieved treatment response than previously diagnosed (76.1% vs. 62.6%). Multivariable analysis identified factors associated with reduced response in previously treated patients.

Conclusion

This real-world study found lower treatment response rates compared to clinical trials, especially in previously treated patients. Disparities highlight remaining unmet needs for psoriasis management. Combination and rotational strategies may improve outcomes in patients unresponsive to available therapies. Ongoing research on novel targets and pathways is warranted to address treatment gaps.