When psoriatic arthritis is severe and persistent, it can be treated with advanced drugs, called biologic or targeted synthetic DMARDs (b/tDMARDs). These treatments work well in some cases, but in others, they don’t work, or can cause side effects, meaning that patients need to switch treatments to try and get a better response. The BritPACT funded SEQUENCE study used data from routine clinical appointments to assess how well people had responded to b/tsDMARDs when they had needed more than 3 different drugs in a row. In the group of patients studied, it found that the first b/tsDMARD that someone was treated with tended to work best. The b/tsDMARDs worked as well when used as the 2nd or 3rd treatment, as when used as the 4th+ treatment, within this group of patients. This implies that people may be able to continue to have a positive response to later lines of b/tsDMARD treatment if more than 3 in a row are needed. Further studies are needed in patients who are difficult to treat to confirm these findings.