Secondary Failure in Psoriatic Arthritis as a Model of Dynamic Disease: Implications for Clinical Evaluation and Digital Systems

This perspective examines secondary failure to biologic therapy in psoriatic arthritis as a manifestation of dynamic disease behavior rather than isolated treatment failure. Using recent longitudinal data from The Journal of Rheumatology as an empirical anchor, the paper argues that clinical response is a time-dependent state shaped by residual disease activity, evolving phenotypes, and changing clinical contexts. The work highlights implications for chronic disease management, clinical decision-making, and the design and governance of AI-enabled and guideline-driven healthcare systems, emphasizing that safety and effectiveness must be evaluated after adoption, not only at initial response.

Kharouf F, et al. Incidence and Predictors of Secondary Failure to Biologic Therapy in Patients With Psoriatic Arthritis.
Journal of Rheumatology. 2026;53(2):162–169.
DOI: https://doi.org/10.3899/jrheum.2025-0518