Paradoxical PsO (PP) studied in 2867 RA & 5316 SpA pts. 136 (1.7%) had paradox. Rxn, median 12 mos post TNFi [pustular (60%) or palmoplantar (31%)]. 73% PP favorably switched to other TNFi 46% or non-TNFi 27%. RA PP took SSZ, HCQ, LEF; SpA PP more smokers https://t.co/iYM3EOdSSM https://t.co/sruLP9adx3