Would you consider using a JAK inhibitor in combination with an IL 23 inhibitor in cases of severe psoriasis, psoriatic arthritis, or axial spondyloarthritis that is refractory to multiple biologic DMARDs?  

Differential skin and joint responses in psoriasis, PsA and Axial SpA are not uncommon. Many PsA/PsO experts and scientists have postulated the potential benefit of using combination biologic (perhaps in serial fashion or lower doses of each) to treat these cases where there are suboptimal responses...

Psoriasis often requires multiple concurrent treatments to control the disease. With the advent of modern therapeutics, I find that even severe skin disease is significantly easier to control than severe joint disease. Look no further than the measures of improvement: PASI 75,90,100 versus ACR 20, 5...