Clinical characteristics of treatment-resistant spondyloarthritis patients treated with multiple biologic pathways Çoklu biyolojik yolakların kullanıldığı tedavi dirençli spondiloartrit hastalarının klinik özellikleri
Journal of Turkish Society For Rheumatology, cilt.18, sa.1, ss.65-74, 2026 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/raed.galenos.2025.85570
- Dergi Adı: Journal of Turkish Society For Rheumatology
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.65-74
- Anahtar Kelimeler: biologic DMARDs, fibromyalgia, IL-17 inhibitors, Spondyloarthritis, TNF inhibitors, treatment resistance
- Gazi Üniversitesi Adresli: Evet
Özet
Objective: With increasing use of biologics targeting multiple pathways in treatment-resistant spondyloarthritis (SpA), understanding patient characteristics has become crucial. This study aims to assess the clinical and demographic characteristics of patients with SpA treated with anti-tumour necrosis factor (TNF) and interleukin (IL)-17/23 inhibitors. Methods: We retrospectively reviewed 90 SpA patients treated at Gazi University Faculty of Medicine, Rheumatology Clinic between 2018 and 2022 who had received both anti-TNF and IL-17/23 inhibitors. Clinical data, treatment lines, and responses were evaluated using ankylosing spondylitis disease activity scores. Results: 51% of patients were female, with a mean disease duration of 10.9 years. Of the patients, 76% had axial SpA and 24% had peripheral SpA. Remission rate with IL-17 inhibitors was 79% when used as second-line therapy, but decreased to 35% when used as fourth-line therapy (p=0.044). Patients with comorbid fibromyalgia showed a significantly lower response to treatment. Conclusion: Our findings indicate that IL-17 inhibitors are more effective when used earlier in the treatment course. Fibromyalgia negatively impacts treatment outcomes, highlighting the importance of differentiating centralized pain from inflammatory disease. Early initiation of IL-17 and careful evaluation for fibromyalgia are recommended.