Combination Treatment of IL-17 Inhibitor and JAK Inhibitor in Psoriatic Arthritis: A Case Report and Scoping Review.

BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease with complex pathophysiology. Despite advancements in biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), treatment responses remain suboptimal for many patients. METHODS: We present a case of a 35-year-old male with refractory PsA who achieved significant clinical improvement through combination therapy with ixekizumab (an IL-17 inhibitor) and upadacitinib (a JAK inhibitor), following inadequate responses to multiple monotherapies. A scoping review of the literature was conducted, analyzing studies on dual b/tsDMARD therapy in PsA. RESULTS: The patient achieved rapid clinical improvement with complete resolution of articular symptoms, normalization of inflammatory markers, and significant metabolic improvements. The scoping review identified 16 studies, highlighting the potential of multi-target strategies while emphasizing safety concerns such as increased infection risks. CONCLUSION: This case and review underscore the promise of combination therapy in PsA while emphasizing the need for further research to optimize its use.