Benefits of early biologic treatment in psoriatic arthritis examined in studies

Two studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate, but these did not select for poor prognosis. The aim, therefore, of the SPEED trial (Severe Psoriatic arthritis—Early intervEntion to control Disease)—was to compare disease activity in 192 PsA patients with poor prognostic factors when treated with one of three regimens: standard step-up with conventional systemic disease-modifying antirheumatic drugs (csDMARD), combination csDMARD, or early induction with a tumor necrosis factor inhibitor (TNFi). The primary endpoint was the mean PsA disease activity score (PASDAS) at 24 weeks. Data were presented at the 2025 annual EULAR congress in Barcelona.