ACR Convergence 2025| Video: Rheum for Everyone, Episode 26—Ableism

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Emerging Treatments in Psoriatic Arthritis

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“Remember,” said Dr. Ogdie, “it’s not just about the pharmacotherapy. It’s also about making sure we’re choosing the right strategy and working to make the patient feel better, that we’re thinking about holistic management.”

Experts are currently in the process of updating psoriatic arthritis guidelines from both GRAPPA and the ACR/National Psoriasis Foundation.

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Ruth Jessen Hickman, MD, photoRuth Jessen Hickman, MD, a graduate of the Indiana University School of Medicine, is a medical and science writer in Bloomington, Ind.

 

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Table: Psoriatic Arthritis Treatment Option Classes

Class Members Firstline for axial PsA?
Oral small molecules methotrexate, sulfasalazine, cyclosporine, leflunomide, apremilast no
TNF-inhibitors etanercept, infliximab, adalimumab, golimumab, certolizumab pegol yes
IL-12/IL-23 inhibitor ustekinumab no
IL-17 inhibitors secukinumab, ixekizumab, bimekizumab*, izokipeb**, sonelokumab** yes
IL-23 inhibitors guselkumab, risankizumab, tildrakizumab**, icotrokinra** no
CTLA4-Ig abatacept no
Traditional JAK inhibitors tofacitinib, upadacitinib yes
TYK2 inhibitors deucravacitinib**, zasocitinib** no
Notes: * approved in 2024 for PsA; **under development for PsA

 

References

  1. Ogdie A, Coates LC, Gladman DD. Treatment  guidelines in psoriatic arthritis. Rheumatology (Oxford). 2020 Mar 1;59(Suppl 1):i37–i46.
  2. Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): Updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol. 2022 Aug;18(8):465–479.
  3. Singh JA, Guyatt G, Ogdie A, et al. Special article: 2018 American College of Rheumatology/National Psoriasis Foundation guideline for the treatment of psoriatic arthritis. Arthritis Rheumatol. 2019 Jan;71(1):5–32.
  4. Reich K, Warren RB, Lebwohl M, et al. Bimekizumab versus secukinumab in plaque psoriasis. N Engl J Med. 2021 Jul 8;385(2):142–152.
  5. McInnes IB, Asahina A, Coates LC, et al. Bimekizumab in patients with psoriatic arthritis, naive to biologic treatment: A randomised, double-blind, placebo-controlled, phase 3 trial (BE OPTIMAL). Lancet. 2023 Jan 7;401(10370):25–37.
  6. Merola JF, Landewé R, McInnes IB, et al. Bimekizumab in patients with active psoriatic arthritis and previous inadequate response or intolerance to tumour necrosis factor-α inhibitors: a randomised, double-blind, placebo-controlled, phase 3 trial (BE COMPLETE). Lancet. 2023 Jan 7;401(10370):38–48.
  7. McInnes IB, Coates LC, Mease PJ, et al. Sonelokimab, an IL-17A/IL-17F-inhibiting nanobody for active psoriatic arthritis: A randomized, placebo-controlled phase 2 trial. Nat Med. 2025 Oct 6. Online ahead of print.
  8. Taylor PC, Mease PJ, de Vlam K, et al. Efficacy and safety of izokibep in patients with active psoriatic arthritis: a randomised, double-blind, placebo-controlled, phase 2 study. Ann Rheum Dis. 2025 Apr 2:S0003-4967(25)00815-5.
  9. Mease P, Behrens F, Kivitz A, et al. Efficacy and safety of izokibep, a novel IL-17A inhibitor, in patients with active psoriatic arthritis: Week 52 results from a randomized, double-blind, placebo-controlled, multicenter, phase 2b/3 study [abstract LB08]. Arthritis Rheumatol. 2025;77(suppl 9).
  10. Mease PJ, Chohan S, Fructuoso FJG, et al. Efficacy and safety of tildrakizumab in patients with active psoriatic arthritis: Results of a randomised, double-blind, placebo-controlled, multiple-dose, 52-week phase IIb study. Ann Rheum Dis. 2021 Sep;80(9):1147–1157.
  11. Sun Pharma. Sun Pharma’s phase 3 clinical studies evaluating tildrakizumab 100 mg (ILUMYA®) in active psoriatic arthritis meet their primary endpoint. July 21, 2025. https://sunpharma.com/wp-content/uploads/2025/07/Press-Release-Phase-3-Clinical-Studies-PsA-ILUMYA-Topline.pdf.
  12. Bissonnette R, Pinter A, Ferris LK, et al. An oral interleukin-23-receptor antagonist peptide for plaque psoriasis. N Engl J Med. 2024 Feb 8;390(6):510–521.
  13. Mercola JF, Mease PH, Coates L. Icotrokinra (ICO), a novel targeted oral peptide, in patients (Pts) with psoriatic disease: Exploratory assessments from a phase 2 psoriasis (PsO) study informing a phase 3 clinical program in psoriatic arthritis (PsA) [abstract 0562]. Arthritis Rheumatol. 2025;77(suppl 9).
  14. Mease PJ, Chandran V, Armstrong AW, et al. Efficacy and safety of deucravacitinib up to week 52 from POETYK PsA-2: A multicenter, randomized, double-blind, placebo-controlled, phase 3 study in patients with psoriatic arthritis. Ann Rheum Dis. 2025 June;84(S1):84–85.
  15. Kivitz A, Baraliakos X, Muensterman ET, et al. Highly selective tyrosine kinase 2 inhibition with zasocitinib (TAK-279) improves outcomes in patients with active psoriatic arthritis: A randomised phase 2b study. Ann Rheum Dis. 2025 Oct;84(10):1660–1674.

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