Intensive Biological First Strategy Versus Standard Step-Up Care in Psoriatic Arthritis
A randomized clinical trial published in The Lancet Rheumatology in January 2026 studied whether early intensive treatment with the biological disease-modifying anti-rheumatic drug (DMARD) secukinumab (Cosentyx®) improved outcomes compared to standard treatment with oral methotrexate. The primary outcome was the ACR50 response, a measurement indicating at least a 50% improvement in psoriatic arthritis symptoms. All 120 participants were adults in the Netherlands with newly diagnosed psoriatic arthritis with a minimum of two swollen joints and no history of taking DMARDs. Early intensive treatment with secukinumab did not result in statistically superior outcomes. At month six, 42% of the secukinumab group and 35% of the methotrexate group achieved an ACR50 response. The authors conclude that treatment targets can be met regardless of treatment group.
