Biologic Wars: Rheumatology Debate SeriesEp 3 of 4
Stopping Spinal Fusion Or Protecting The Gut?

Hosted by Sarah Mitchell & James Carter

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Key Takeaways
  • PsA biologic hierarchy differs from RA: IL-17 inhibitors (secukinumab, ixekizumab) and IL-23 inhibitors (guselkumab, risankizumab) are first-line for skin-dominant and enthesitis-predominant disease
  • Avoid IL-17 inhibitors in PsA with IBD; prefer anti-TNF monoclonals or IL-23 inhibitors in that overlap
  • In axSpA: IL-17 inhibitors show efficacy and potential structural modification - PREVENT showed secukinumab reduces syndesmophyte progression
  • For uveitis: monoclonal anti-TNF (adalimumab, infliximab) preferred; etanercept and IL-17 inhibitors do not protect against uveitis
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Team TLSFE. Stopping spinal fusion or protecting the gut?. The Life Science Feed. Published June 1, 2026. Updated June 1, 2026. Accessed June 1, 2026. https://thelifesciencefeed.com/rheumatology/arthritis-rheumatoid/research/stopping-spinal-fusion-or-protecting-the-gut.

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All content is researched from peer-reviewed, open-access sources — published trial data, clinical guidelines, and regulatory filings. AI tools are used solely to structure and summarise that evidence; no AI-generated conclusions appear without editor verification against the primary source.

Every article is reviewed by a named editor before publication. Source citations are listed in the References section. This content does not represent the views of any pharmaceutical company, medical device manufacturer, or healthcare provider.

References

[1] Mease PJ et al. DISCOVER-1. Lancet. 2020;395:1115-1125

[2] Baeten D et al. MEASURE-1. N Engl J Med. 2015;373:2534-2548

[3] Ramiro S et al. PREVENT. Ann Rheum Dis. 2021;80:1200-1207

[4] Smolen JS et al. EULAR PsA Recommendations. Ann Rheum Dis. 2020