Valero-Martínez, CristinaFont Urgelles, JuditSallés, MeritxellJoven-Ibáñez, Beatriz E.Juanes, Alexia deRamírez, JulioJuanola, XavierAlmodóvar, RaquelLaiz, AnaMoreno, MireiaPujol, ManelBeltrán, EmmaPinto-Tasende, José AntonioCrespí, LauraSala-Icardo, LuisCastañeda, SantosGarcía-Vicuna, Rosario2024-05-102024-05-102023Valero-Martínez C, Urgelles JF, Sallés M, Joven-Ibáñez BE, Juanes A, Ramírez J, et al. Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: a real-world multicenter experience from Spain. Front Immunol. 2023 Oct 23;14:1283251. DOI: 10.3389/fimmu.2023.12832511664-3224http://hdl.handle.net/10230/60096Dual targeted therapy (DTT) has emerged as a promising approach in patients with refractory spondyloarthritis (SpA) or psoriatic arthritis (PsA) and extra-musculoskeletal manifestations of both diseases, but its effectiveness/safety ratio still remains unclear. This is a retrospective, real-world multicenter study in refractory SpA and PsA patients with simultaneous use of two biological or synthetic targeted agents. Effectiveness was assessed using Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) and Disease Activity in Psoriatic Arthritis (DAPSA) Score. We identified 39 different DTT combinations in 36 patients (22 SpA; 14 PsA), 25 of them with concomitant inflammatory bowel disease. The most commonly used combinations were TNF inhibitor plus antagonist of the IL12/23 pathway, followed by TNF inhibitor plus IL-17 antagonist. During a median exposure of 14.86 months (IQR 8-20.2), DTT retention rate was 69.4% (n=25/36; 19 SpA, 6 PsA). Major clinical improvement (change in ASDAS-CRP > 2 or improvement > 85% in DAPSA) was achieved in 69.4% of patients (n=25/36 therapeutical combinations; 17/21 SpA, 8/15 PsA), with a 58.3% (n=21/36 combinations; 15/20 SpA, 6/13 PsA) low-activity/remission rate. Of the patients who were receiving glucocorticoids, 55% managed to withdraw them during follow-up. Interestingly, only four serious adverse events in three patients were observed, leading to DTT discontinuation.application/pdfeng© 2023 Valero-Martínez, Urgelles, Sallés, Joven-Ibáñez, de Juanes, Ramírez, Juanola, Almodóvar, Laiz, Moreno, Pujol, Beltrán, Pinto-Tasende, Crespí, Sala-Icardo, Castañeda and García-Vicuña. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fimmu.2023.1283251BiologicsCombination (combined) therapyInflammatory bowel diseaseMulticenter studyPsoriatic arthritis (PsA)Real word dataSafetySpondyloarthritisinfo:eu-repo/semantics/openAccess