Study evaluates aesthetic concerns among Hispanic, Latinx women

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Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m2 to <25 kg/m2 (42%) and 25 to <30 kg/m2 (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

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Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m2 to <25 kg/m2 (42%) and 25 to <30 kg/m2 (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m2 to <25 kg/m2 (42%) and 25 to <30 kg/m2 (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

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MediFinders Keepers ... Unfortunately

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In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

Dr. Allan M. Block

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

Dr. Allan M. Block

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

Dr. Allan M. Block

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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Common radiological alterations and their predictors in PsA

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Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

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Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

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Central sensitization associated with increased disease burden in PsA

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Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

 

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Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

 

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

 

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Anti-TNF therapy may not be enough against non-inflammatory pain in bio-naive PsA patients

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Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

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Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

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Worsened psychosocial factors in PsA patients with non-inflammatory persistent joint pain

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Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

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Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

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First-line TNFi seem to be less effective for PsA in women than in men

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Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

 

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Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

 

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

 

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TNFi may improve ultrasound-confirmed active enthesitis more effectively than secukinumab

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Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

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Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

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Non-trough serum drug levels can identify TNFi treatment responders in PsA

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Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

 

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Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

 

Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

 

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Hyperuricemia associated with more comorbidities in PsA

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Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m2 vs 28.33 kg/m2), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428

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Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m2 vs 28.33 kg/m2), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428

Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m2 vs 28.33 kg/m2), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428

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