Background: Anti-TNF-alpha and anti-IL-17 drugs are widely used in Psoriatic Arthritis (PsA) and have shown good results in terms of both efficacy and safety [1]. However, a subset of patients may still experience residual pain due to central sensitization mechanisms typical of Fibromyalgia (FM). This leads to more complex disease management and less satisfactory therapeutic outcomes.

Objectives: The aim of our study is to evaluate the efficacy of anti-TNF-alpha and anti-IL-17 drugs in managing inflammatory and neuropathic pain, as well as fatigue, in patients diagnosed with PsA and concomitant FM.

Methods: We enrolled 47 patients diagnosed with PsA (according to the CASPAR 2006 criteria) and FM (according to the ACR 2016 criteria) and treated with anti-TNF-alpha and anti-IL-17 drugs (Table 1). Disease activity was assessed using DAPSA, neuropathic pain using PDQ, subjective pain using VAS, and fatigue using FACIT. All data were collected at baseline and after 4 months of therapy. Statistical analysis was performed using the Wilcoxon test for paired samples and the Mann-Whitney U test for unpaired samples.

Results: Comparing the two patient groups, we observed that patients treated with Anti-TNF-alpha showed an improved fatigue (p=0.0119) (Figure 1 A) and reduced PDQ by 28.5% (Figure1 B). Patients treated with Anti-IL-17 achieved greater DAPSA reduction (p=0.0094) (Figure1 C) but had limited impact on fatigue and neuropathic pain (Figure1 D, E).

Conclusion: Residual pain in patients with psoriatic arthritis and concomitant fibromyalgia represents a challenging issue. Several studies have shown the role of anti-TNF-alpha and IL-17 in modulating neuropathic pain, suggesting a potential target for chronic pain [3, 4]. In our patients, there was also a reduction in fatigue and PDQ, demonstrating that these drugs have significant effects in improving chronic pain. Studies on a larger cohort of patients and long-term follow-up are needed to confirm the efficacy of these drugs on residual pain as well.

REFERENCES: [1] L. Gossec et al., “EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update,” Ann Rheum Dis, vol. 79, no. 6, pp. S700–S712, Jun. 2020.

[2] C. J. Woolf, “Central sensitization: Implications for the diagnosis and treatment of pain,” Pain, vol. 152, no. 3, pp. S2–S15, Mar. 2011.

[3] A. D. Kaye et al., “Tumor Necrosis Factor and Interleukin Modulators for Pathologic Pain States: A Narrative Review,” Pain Ther, vol. 13, no. 3, pp. 481–493, Jun. 2024.

[4] X. Jiang, R. Zhou, Y. Zhang, T. Zhu, Q. Li, and W. Zhang, “Interleukin-17 as a potential therapeutic target for chronic pain,” Front Immunol, vol. 13, Sep. 2022.

Table 1. Demographic characteristics of patients.

Figure 1.

Results of FACIT FS, PD-Q and DAPSA in patient treated with anti TNF alpha and anti IL17.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.