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If you’re living with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA), you might be on a treatment called a TNFi, short for Tumor Necrosis Factor inhibitor. These medicines are often used to manage symptoms like pain and stiffness, however they don’t work for everyone. So how can you and your doctor make the most informed decisions about the best treatment options for you? Recent studies from a registry database offer some important insights.

What the Studies Found

Researchers wanted to see if people who started a TNFi had their symptoms under control after six months and one year. Here’s what they discovered:

  • For PsA: Seven out of 10 people did not see enough improvement in their symptoms after six months of starting a TNFi.
  • For axSpA: Eight out of 10 people did not achieve good disease control at the six-month mark.
  • At 12 months: In both the PsA and axSpA groups, most of those who had not improved by six months still had not improved by 12 months, with nine out of 10 people’s symptoms remaining unchanged.

What Do These Results Mean for You?

These findings suggest that if your symptoms haven’t improved after six months on a TNFi, it may be time to talk to your doctor about what to do next.

“If someone’s not doing well at six months, we should probably be doing something different,” says Dr. Alexis R. Ogdie-Beatty, Associate Professor of Medicine and Epidemiology in the Perelman School of Medicine. This could mean switching therapies, trying physical therapy, or exploring other treatment options to help you feel better.

Why Is It Important to Act?

Getting your symptoms under control means less pain, better movement, and better quality of life. “Our goal in treatment is to get patients into a state of low disease activity so that they can have normal lives,” explains Dr. Philip J. Mease, Clinical Professor at the University of Washington and Director of Rheumatology Research at Swedish Medical Center in Seattle. If your treatment isn’t achieving this, it’s worth exploring other options with your doctor.

What Should You Do Next?

If you’ve been on a TNFi for at least six months and your symptoms are not improving, here’s what you can do:

  • Talk to your doctor: Share exactly how you are feeling and whether you have noticed any improvements. Be open about all your symptoms, even small ones.
  • Track your symptoms: Keep a daily record of your pain levels, stiffness, and any side effects. This will help during your regular check-ins with your doctor to see if your treatment is working.
  • Ask questions: Don’t hesitate to ask about the benefits and side effects of your current medicine and other options you might have. Knowing what to expect helps you make informed decisions.
  • Set goals together: Work with your doctor to set specific goals, like reducing pain or improving movement. Clear goals can guide your treatment plan.

Why Shared Decision-Making Matters

Shared decision-making means that you and your doctor make treatment decisions together, based on your symptoms, goals, and lifestyle.

Dr. Mease emphasizes, “It’s essential for health care providers to actively involve patients in the decision-making process and consider their preferences and values. By working together, patient and clinician, we can improve treatment outcomes and enhance the overall patient experience.”

Managing PsA or axSpA can be challenging, but you don’t have to do it alone. If your current treatment isn’t helping after six months, it’s okay to ask, “What’s next?” Together, you and your doctor can find the answer.

Check Out Remission Possible

Our Remission Possible podcast is dedicated to guiding and supporting you on your mission to take back your life and control symptoms. In each episode, we share inspiring stories from patients who are succeeding in their mission. We also discuss how patients and doctors can work together to better understand the optimal course of treatment for different chronic conditions while keeping personal goals and lifestyle choices in mind. Listen now.

This article was made possible with support from AbbVie.

Sources:

Mease, P, et al. Real-world burden of uncontrolled disease despite treatment with tumor necrosis factor inhibitors among psoriatic arthritis patients in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry. Annals of the Rheumatic Diseases. 2024. doi: https://doi.org/10.1136/annrheumdis-2024-eular.1506.

Ogdie, A, et al. Real-world burden of uncontrolled disease despite treatment with tumor necrosis factor inhibitors among axial spondyloarthritis patients in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry. Annals of the Rheumatic Diseases. 2024. doi: https://doi.org/10.1136/annrheumdis-2024-eular.914.

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