Cycle versus Swap Treatment Strategies in Psoriatic Arthritis

This original research article compares the effectiveness of a cycle versus a swap treatment strategy following the discontinuation of tumor necrosis factor inhibitors (TNFi) in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). The study was conducted after a change in the local treatment protocol, which shifted from prescribing a second TNFi to an interleukin-17 inhibitor (IL-17i) as the second biological disease-modifying antirheumatic drug (bDMARD). A retrospective analysis was performed to evaluate the three-year drug retention rates and disease activity in patients diagnosed with PsA and axSpA. The results indicated no significant difference in drug retention rates between the two strategies for PsA patients, while axSpA patients showed a higher risk of treatment discontinuation with the swap strategy. The findings suggest that cycling within the same mode of action may be beneficial for both PsA and axSpA patients after the first TNFi discontinuation.