Would you use an anti-IL 17 over an anti-TNFa as your first line biologic in psoriatic arthritis?  

For the treatment of active psoriatic arthritis, I would use an IL17 inhibitor over a TNF inhibitor. Recent evidence supports this approach, and I review these data in the paragraphs below. Two studies of IL-17 inhibitors have now shown equivalent efficacy to TNF inhibitors for the psoriatic musculo...

I absolutely would. We tend to choose TNF inhibitors as our first line biologic, largely as a result of therapeutic inertia and a perception that these agents will have an easier path to approval. In patients with very active skin disease, however, using an IL17 inhibitor as the first biologic makes...

We do this in patients with a heavy psoriasis and lighter arthritis burden.