Clinical Edge Journal Scan

Key clinical point: A longer interval between rituximab infusion and SARS-CoV-2 vaccine may elicit an optimal response in patients with rheumatoid arthritis (RA) taking rituximab, with a third vaccination dose given 6-9 months after rituximab, boosting the cellular response despite the absence of a noticeable serological response.

Major finding: The median time between the last rituximab infusion and the first vaccination dose was significantly longer in responders vs. nonresponders (267 days vs. 107 days; P < .0001). A third vaccine dose in patients with insufficient serological response to 2 doses induced T-cell responses in all patients assessed, despite serological response in only 16.3% of patients. No serious adverse events or deaths were reported.

Study details: A prospective cohort study, Nor-vaC included patients with RA taking rituximab (n = 90) and healthy controls (n = 1,114) who received 2 or 3 doses of SARS-CoV-2 vaccines.

Disclosures: The study was funded by the Coalition for Epidemic Preparedness Innovations, Research Council of Norway COVID, and others. Several authors reported receiving speaker/consulting fees or grants/financial support from various sources.

Source: I Jyssum et al. Lancet Rheumatol. 2021 (Dec 23). Doi: 10.1016/S2665-9913(21)00394-5.

Key clinical point: A longer interval between rituximab infusion and SARS-CoV-2 vaccine may elicit an optimal response in patients with rheumatoid arthritis (RA) taking rituximab, with a third vaccination dose given 6-9 months after rituximab, boosting the cellular response despite the absence of a noticeable serological response.

Major finding: The median time between the last rituximab infusion and the first vaccination dose was significantly longer in responders vs. nonresponders (267 days vs. 107 days; P < .0001). A third vaccine dose in patients with insufficient serological response to 2 doses induced T-cell responses in all patients assessed, despite serological response in only 16.3% of patients. No serious adverse events or deaths were reported.

Study details: A prospective cohort study, Nor-vaC included patients with RA taking rituximab (n = 90) and healthy controls (n = 1,114) who received 2 or 3 doses of SARS-CoV-2 vaccines.

Disclosures: The study was funded by the Coalition for Epidemic Preparedness Innovations, Research Council of Norway COVID, and others. Several authors reported receiving speaker/consulting fees or grants/financial support from various sources.

Source: I Jyssum et al. Lancet Rheumatol. 2021 (Dec 23). Doi: 10.1016/S2665-9913(21)00394-5.

Key clinical point: A longer interval between rituximab infusion and SARS-CoV-2 vaccine may elicit an optimal response in patients with rheumatoid arthritis (RA) taking rituximab, with a third vaccination dose given 6-9 months after rituximab, boosting the cellular response despite the absence of a noticeable serological response.

Major finding: The median time between the last rituximab infusion and the first vaccination dose was significantly longer in responders vs. nonresponders (267 days vs. 107 days; P < .0001). A third vaccine dose in patients with insufficient serological response to 2 doses induced T-cell responses in all patients assessed, despite serological response in only 16.3% of patients. No serious adverse events or deaths were reported.

Study details: A prospective cohort study, Nor-vaC included patients with RA taking rituximab (n = 90) and healthy controls (n = 1,114) who received 2 or 3 doses of SARS-CoV-2 vaccines.

Disclosures: The study was funded by the Coalition for Epidemic Preparedness Innovations, Research Council of Norway COVID, and others. Several authors reported receiving speaker/consulting fees or grants/financial support from various sources.

Source: I Jyssum et al. Lancet Rheumatol. 2021 (Dec 23). Doi: 10.1016/S2665-9913(21)00394-5.

Key clinical point: Patients with psoriasis who showed ultrasound abnormalities in hand, knee, toe joints, and few other anatomical sites are more likely to progress to psoriatic arthritis (PsA).

Major finding: Hand joint power Doppler (PD) signals (grade 0 and ≥1), knee joint PD signals (grade 0 and ≥1), toe joint PD signals (grade 0 and ≥1), quadriceps tendon and patellar tendon enthesitis (all P < .001), wrist joint synovial thickening (grade 1-3; P = .001), and Achilles tendon and plantar aponeurosis enthesitis (P = .007) were all significant risk predictors for PsA.

Study details: Findings are from a cross-sectional study including 852 patients with psoriasis but without PsA, 261 patients with PsA, and 86 healthy volunteers who underwent an ultrasound examination.

Disclosures: This study was funded by West China Hospital, West China Precision Medicine Industrial Technology Institutes, and Sichuan Provincial Science and Technology Project. The authors declared no conflict of interests.

Source: Wang Y et al. Dermatol Ther (Heidelb). 2021 (Dec 19). Doi: 10.1007/s13555-021-00663-0.

Key clinical point: Patients with psoriasis who showed ultrasound abnormalities in hand, knee, toe joints, and few other anatomical sites are more likely to progress to psoriatic arthritis (PsA).

Major finding: Hand joint power Doppler (PD) signals (grade 0 and ≥1), knee joint PD signals (grade 0 and ≥1), toe joint PD signals (grade 0 and ≥1), quadriceps tendon and patellar tendon enthesitis (all P < .001), wrist joint synovial thickening (grade 1-3; P = .001), and Achilles tendon and plantar aponeurosis enthesitis (P = .007) were all significant risk predictors for PsA.

Study details: Findings are from a cross-sectional study including 852 patients with psoriasis but without PsA, 261 patients with PsA, and 86 healthy volunteers who underwent an ultrasound examination.

Disclosures: This study was funded by West China Hospital, West China Precision Medicine Industrial Technology Institutes, and Sichuan Provincial Science and Technology Project. The authors declared no conflict of interests.

Source: Wang Y et al. Dermatol Ther (Heidelb). 2021 (Dec 19). Doi: 10.1007/s13555-021-00663-0.

Key clinical point: Patients with psoriasis who showed ultrasound abnormalities in hand, knee, toe joints, and few other anatomical sites are more likely to progress to psoriatic arthritis (PsA).

Major finding: Hand joint power Doppler (PD) signals (grade 0 and ≥1), knee joint PD signals (grade 0 and ≥1), toe joint PD signals (grade 0 and ≥1), quadriceps tendon and patellar tendon enthesitis (all P < .001), wrist joint synovial thickening (grade 1-3; P = .001), and Achilles tendon and plantar aponeurosis enthesitis (P = .007) were all significant risk predictors for PsA.

Study details: Findings are from a cross-sectional study including 852 patients with psoriasis but without PsA, 261 patients with PsA, and 86 healthy volunteers who underwent an ultrasound examination.

Disclosures: This study was funded by West China Hospital, West China Precision Medicine Industrial Technology Institutes, and Sichuan Provincial Science and Technology Project. The authors declared no conflict of interests.

Source: Wang Y et al. Dermatol Ther (Heidelb). 2021 (Dec 19). Doi: 10.1007/s13555-021-00663-0.

Key clinical point: Patients with psoriatic arthritis (PsA) who received treatment with tofacitinib experienced mostly mild/moderate nonserious adverse events (AE), which persisted for a shorter duration and had a minimum effect on the continuation of tofacitinib treatment.

Major finding: In the first 3 months of treatment, the most frequent nonserious AEs were headache (incidence rate [IR] 16.9-39.2) and diarrhea (IR 15-17) and duration of such AEs was ≤4 weeks with none leading to permanent discontinuation of treatment.

Study details: Findings are from a post hoc analysis of phase 3 studies including 710 patients with active PsA who received 5 mg tofacitinib, 10 mg tofacitinib, or placebo and had a previous inadequate response to ≥1 conventional synthetic disease-modifying antirheumatic drug or ≥1 tumor necrosis factor inhibitor.

Disclosures: This study was funded by Pfizer. Five authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Dikranian A et al. Rheumatol Ther. 2021 (Dec 17). Doi: 10.1007/s40744-021-00405-w.

Key clinical point: Patients with psoriatic arthritis (PsA) who received treatment with tofacitinib experienced mostly mild/moderate nonserious adverse events (AE), which persisted for a shorter duration and had a minimum effect on the continuation of tofacitinib treatment.

Major finding: In the first 3 months of treatment, the most frequent nonserious AEs were headache (incidence rate [IR] 16.9-39.2) and diarrhea (IR 15-17) and duration of such AEs was ≤4 weeks with none leading to permanent discontinuation of treatment.

Study details: Findings are from a post hoc analysis of phase 3 studies including 710 patients with active PsA who received 5 mg tofacitinib, 10 mg tofacitinib, or placebo and had a previous inadequate response to ≥1 conventional synthetic disease-modifying antirheumatic drug or ≥1 tumor necrosis factor inhibitor.

Disclosures: This study was funded by Pfizer. Five authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Dikranian A et al. Rheumatol Ther. 2021 (Dec 17). Doi: 10.1007/s40744-021-00405-w.

Key clinical point: Patients with psoriatic arthritis (PsA) who received treatment with tofacitinib experienced mostly mild/moderate nonserious adverse events (AE), which persisted for a shorter duration and had a minimum effect on the continuation of tofacitinib treatment.

Major finding: In the first 3 months of treatment, the most frequent nonserious AEs were headache (incidence rate [IR] 16.9-39.2) and diarrhea (IR 15-17) and duration of such AEs was ≤4 weeks with none leading to permanent discontinuation of treatment.

Study details: Findings are from a post hoc analysis of phase 3 studies including 710 patients with active PsA who received 5 mg tofacitinib, 10 mg tofacitinib, or placebo and had a previous inadequate response to ≥1 conventional synthetic disease-modifying antirheumatic drug or ≥1 tumor necrosis factor inhibitor.

Disclosures: This study was funded by Pfizer. Five authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Dikranian A et al. Rheumatol Ther. 2021 (Dec 17). Doi: 10.1007/s40744-021-00405-w.

Key clinical point: Ultrasound assessment of entheses may help differentiate psoriatic arthritis (PsA) from fibromyalgia syndrome (FMS) as patients with PsA showed more frequent ultrasound changes both in gray scale (GS) and power Doppler (PD) mode than those with FMS.

Major finding: A higher proportion of patients with PsA vs. FMS was detected with ≥1 entheses in GS (P < .0001) and PD (P = .0033) mode, with GS and PD identifying changes in a higher proportion of PsA vs. FMS entheses (P < .0001 for both). Area under the curve values for GS and PD mode were 0.77 and 0.66, respectively, with 3.5 being the best cutoff GS score to discriminate PsA from FMS (sensitivity, 0.75; specificity, 0.63).

Study details: Findings are from a post hoc analysis of the cross‐sectional ULISSE study including 140 and 51 patients with PsA and FMS, respectively.

Disclosures: This study was funded by AbbVie Srl. Three authors declared being employees and shareholders of AbbVie, and some of the authors declared receiving consultancy fees and research support from several sources.

Source: Marchesoni A et al. J Clin Med. 2021;11(1):180 (Dec 29). Doi: 10.3390/jcm11010180.

Key clinical point: Ultrasound assessment of entheses may help differentiate psoriatic arthritis (PsA) from fibromyalgia syndrome (FMS) as patients with PsA showed more frequent ultrasound changes both in gray scale (GS) and power Doppler (PD) mode than those with FMS.

Major finding: A higher proportion of patients with PsA vs. FMS was detected with ≥1 entheses in GS (P < .0001) and PD (P = .0033) mode, with GS and PD identifying changes in a higher proportion of PsA vs. FMS entheses (P < .0001 for both). Area under the curve values for GS and PD mode were 0.77 and 0.66, respectively, with 3.5 being the best cutoff GS score to discriminate PsA from FMS (sensitivity, 0.75; specificity, 0.63).

Study details: Findings are from a post hoc analysis of the cross‐sectional ULISSE study including 140 and 51 patients with PsA and FMS, respectively.

Disclosures: This study was funded by AbbVie Srl. Three authors declared being employees and shareholders of AbbVie, and some of the authors declared receiving consultancy fees and research support from several sources.

Source: Marchesoni A et al. J Clin Med. 2021;11(1):180 (Dec 29). Doi: 10.3390/jcm11010180.

Key clinical point: Ultrasound assessment of entheses may help differentiate psoriatic arthritis (PsA) from fibromyalgia syndrome (FMS) as patients with PsA showed more frequent ultrasound changes both in gray scale (GS) and power Doppler (PD) mode than those with FMS.

Major finding: A higher proportion of patients with PsA vs. FMS was detected with ≥1 entheses in GS (P < .0001) and PD (P = .0033) mode, with GS and PD identifying changes in a higher proportion of PsA vs. FMS entheses (P < .0001 for both). Area under the curve values for GS and PD mode were 0.77 and 0.66, respectively, with 3.5 being the best cutoff GS score to discriminate PsA from FMS (sensitivity, 0.75; specificity, 0.63).

Study details: Findings are from a post hoc analysis of the cross‐sectional ULISSE study including 140 and 51 patients with PsA and FMS, respectively.

Disclosures: This study was funded by AbbVie Srl. Three authors declared being employees and shareholders of AbbVie, and some of the authors declared receiving consultancy fees and research support from several sources.

Source: Marchesoni A et al. J Clin Med. 2021;11(1):180 (Dec 29). Doi: 10.3390/jcm11010180.

Key clinical point: This real-world study confirms sustained improvements in signs and symptoms of psoriatic arthritis (PsA) with apremilast along with a tolerable safety profile.

Major finding: Overall, 43.5% of patients who received apremilast within 30 days of participating in the study and completed ≥150 days of treatment achieved PsA Response Criteria. In detail, 26.8% and 41.8% of patients with 68-tender joint count >0 and 66-swollen joint count >0 at baseline, respectively, achieved complete joint count resolution at month 6. No new adverse events were reported.

Study details: Findings are from the prospective, observational APOLO study including 107 patients with active PsA, of which 106 patients received ≥1 dose of apremilast.

Disclosures: This study was funded by Celgene. Some of the authors declared receiving research grants and consultancy and speaker fees from Celgene and other sources.

Source: Vlam KD et al. Adv Ther. 2022 (Jan 3). Doi: 10.1007/s12325-021-02016-x.

Key clinical point: This real-world study confirms sustained improvements in signs and symptoms of psoriatic arthritis (PsA) with apremilast along with a tolerable safety profile.

Major finding: Overall, 43.5% of patients who received apremilast within 30 days of participating in the study and completed ≥150 days of treatment achieved PsA Response Criteria. In detail, 26.8% and 41.8% of patients with 68-tender joint count >0 and 66-swollen joint count >0 at baseline, respectively, achieved complete joint count resolution at month 6. No new adverse events were reported.

Study details: Findings are from the prospective, observational APOLO study including 107 patients with active PsA, of which 106 patients received ≥1 dose of apremilast.

Disclosures: This study was funded by Celgene. Some of the authors declared receiving research grants and consultancy and speaker fees from Celgene and other sources.

Source: Vlam KD et al. Adv Ther. 2022 (Jan 3). Doi: 10.1007/s12325-021-02016-x.

Key clinical point: This real-world study confirms sustained improvements in signs and symptoms of psoriatic arthritis (PsA) with apremilast along with a tolerable safety profile.

Major finding: Overall, 43.5% of patients who received apremilast within 30 days of participating in the study and completed ≥150 days of treatment achieved PsA Response Criteria. In detail, 26.8% and 41.8% of patients with 68-tender joint count >0 and 66-swollen joint count >0 at baseline, respectively, achieved complete joint count resolution at month 6. No new adverse events were reported.

Study details: Findings are from the prospective, observational APOLO study including 107 patients with active PsA, of which 106 patients received ≥1 dose of apremilast.

Disclosures: This study was funded by Celgene. Some of the authors declared receiving research grants and consultancy and speaker fees from Celgene and other sources.

Source: Vlam KD et al. Adv Ther. 2022 (Jan 3). Doi: 10.1007/s12325-021-02016-x.

Key clinical point: Patients with psoriasis were more likely to have a delayed onset of psoriatic arthritis (PsA) if they were diagnosed with psoriasis at a younger age or suffered from severe psoriasis.

Major finding: The median time from psoriasis diagnosis to the incidence of PsA was 35.5 months with age at psoriasis onset (odds ratio [OR] per 10-year decrease 1.63; 95% CI 1.26-2.11) and its severity (OR for severe vs. mild 3.65; 95% CI 1.18-11.32) being associated with having a psoriasis diagnosis >1 year prior to incident PsA.

Study details: Findings are from a retrospective nested case-control study including 158 patients with incident PsA, of which 41% had concurrent psoriasis and 59% patients had onset of psoriasis before PsA.

Disclosures: This study was funded by the Rochester Epidemiology Project supported by National Institute on Aging, National Center for Advancing Translational Sciences, and others. The authors declared serving as consultants or receiving grants, consulting fees, honoraria, and research support from several sources.

Source: Karmacharya P et al. Semin Arthritis Rheum. 2021;151949 (Dec 31). Doi:  10.1016/j.semarthrit.2021.12.013.

Key clinical point: Patients with psoriasis were more likely to have a delayed onset of psoriatic arthritis (PsA) if they were diagnosed with psoriasis at a younger age or suffered from severe psoriasis.

Major finding: The median time from psoriasis diagnosis to the incidence of PsA was 35.5 months with age at psoriasis onset (odds ratio [OR] per 10-year decrease 1.63; 95% CI 1.26-2.11) and its severity (OR for severe vs. mild 3.65; 95% CI 1.18-11.32) being associated with having a psoriasis diagnosis >1 year prior to incident PsA.

Study details: Findings are from a retrospective nested case-control study including 158 patients with incident PsA, of which 41% had concurrent psoriasis and 59% patients had onset of psoriasis before PsA.

Disclosures: This study was funded by the Rochester Epidemiology Project supported by National Institute on Aging, National Center for Advancing Translational Sciences, and others. The authors declared serving as consultants or receiving grants, consulting fees, honoraria, and research support from several sources.

Source: Karmacharya P et al. Semin Arthritis Rheum. 2021;151949 (Dec 31). Doi:  10.1016/j.semarthrit.2021.12.013.

Key clinical point: Patients with psoriasis were more likely to have a delayed onset of psoriatic arthritis (PsA) if they were diagnosed with psoriasis at a younger age or suffered from severe psoriasis.

Major finding: The median time from psoriasis diagnosis to the incidence of PsA was 35.5 months with age at psoriasis onset (odds ratio [OR] per 10-year decrease 1.63; 95% CI 1.26-2.11) and its severity (OR for severe vs. mild 3.65; 95% CI 1.18-11.32) being associated with having a psoriasis diagnosis >1 year prior to incident PsA.

Study details: Findings are from a retrospective nested case-control study including 158 patients with incident PsA, of which 41% had concurrent psoriasis and 59% patients had onset of psoriasis before PsA.

Disclosures: This study was funded by the Rochester Epidemiology Project supported by National Institute on Aging, National Center for Advancing Translational Sciences, and others. The authors declared serving as consultants or receiving grants, consulting fees, honoraria, and research support from several sources.

Source: Karmacharya P et al. Semin Arthritis Rheum. 2021;151949 (Dec 31). Doi:  10.1016/j.semarthrit.2021.12.013.

Key clinical point: Presence of dactylitis independently confirmed more severe disease burden with higher swollen joint counts (SJC), C-reactive protein (CRP) levels, ultrasound-detected synovitis, and bone erosion in disease-modifying antirheumatic drug (DMARD)-naive patients with early psoriatic arthritis (PsA).

Major finding: Dactylitic vs. nondactylitic PsA was associated with a higher SJC (P < .001) and CRP level (P = .006) and a higher prevalence of ultrasound synovitis (P < .001) and bone erosions (P < .001). After excluding dactylitic digits, SJC was greater (P = .002) and ultrasound-detected synovitis (P < .001) and erosions (P = .008) were more prevalent in dactylitic vs. nondactylitic PsA.

Study details: This study included 177 DMARD-naive patients with early PsA who were stratified by the presence or absence of dactylitis at baseline.

Disclosures: This study was funded by the National Institute for Health Research Leeds Biomedical Research Centre. The authors declared no conflict of interests.

Source: Dubash S et al. Ann Rheum Dis. 2021 (Dec 10). Doi: 10.1136/annrheumdis-2021-220964.

Key clinical point: Presence of dactylitis independently confirmed more severe disease burden with higher swollen joint counts (SJC), C-reactive protein (CRP) levels, ultrasound-detected synovitis, and bone erosion in disease-modifying antirheumatic drug (DMARD)-naive patients with early psoriatic arthritis (PsA).

Major finding: Dactylitic vs. nondactylitic PsA was associated with a higher SJC (P < .001) and CRP level (P = .006) and a higher prevalence of ultrasound synovitis (P < .001) and bone erosions (P < .001). After excluding dactylitic digits, SJC was greater (P = .002) and ultrasound-detected synovitis (P < .001) and erosions (P = .008) were more prevalent in dactylitic vs. nondactylitic PsA.

Study details: This study included 177 DMARD-naive patients with early PsA who were stratified by the presence or absence of dactylitis at baseline.

Disclosures: This study was funded by the National Institute for Health Research Leeds Biomedical Research Centre. The authors declared no conflict of interests.

Source: Dubash S et al. Ann Rheum Dis. 2021 (Dec 10). Doi: 10.1136/annrheumdis-2021-220964.

Key clinical point: Presence of dactylitis independently confirmed more severe disease burden with higher swollen joint counts (SJC), C-reactive protein (CRP) levels, ultrasound-detected synovitis, and bone erosion in disease-modifying antirheumatic drug (DMARD)-naive patients with early psoriatic arthritis (PsA).

Major finding: Dactylitic vs. nondactylitic PsA was associated with a higher SJC (P < .001) and CRP level (P = .006) and a higher prevalence of ultrasound synovitis (P < .001) and bone erosions (P < .001). After excluding dactylitic digits, SJC was greater (P = .002) and ultrasound-detected synovitis (P < .001) and erosions (P = .008) were more prevalent in dactylitic vs. nondactylitic PsA.

Study details: This study included 177 DMARD-naive patients with early PsA who were stratified by the presence or absence of dactylitis at baseline.

Disclosures: This study was funded by the National Institute for Health Research Leeds Biomedical Research Centre. The authors declared no conflict of interests.

Source: Dubash S et al. Ann Rheum Dis. 2021 (Dec 10). Doi: 10.1136/annrheumdis-2021-220964.

Key clinical point: Risankizumab effectively reduced clinical manifestations of psoriatic arthritis (PsA) in patients with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) with no new adverse events (AE).

Major finding: At week 24, at least a 20% improvement in the American College of Rheumatology score was achieved by a significantly higher proportion of patients receiving risankizumab vs. placebo (57.3% vs. 33.5%; P < .001). Treatment-emergent AEs were mild/moderate and reported at similar frequencies in risankizumab (40.4%) and placebo (38.7%) groups.

Study details: Findings are from a double-blind, phase 3 KEEPsAKE 1 study including 964 patients with active PsA and inadequate response to ≥1 csDMARDs who were randomly assigned to receive 150 mg risankizumab or placebo at weeks 0, 4, and 16.

Disclosures: This study did not report any source of funding. The authors declared serving as speaker, consultant, investigator, or receiving honoraria, fees, and grants from several sources. Five authors declared being employees or shareholders of AbbVie.

Source: Kristensen LE et al. Ann Rheum Dis. 2021;81:225-231 (Dec 15). Doi: 10.1136/annrheumdis-2021-221019.

Key clinical point: Risankizumab effectively reduced clinical manifestations of psoriatic arthritis (PsA) in patients with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) with no new adverse events (AE).

Major finding: At week 24, at least a 20% improvement in the American College of Rheumatology score was achieved by a significantly higher proportion of patients receiving risankizumab vs. placebo (57.3% vs. 33.5%; P < .001). Treatment-emergent AEs were mild/moderate and reported at similar frequencies in risankizumab (40.4%) and placebo (38.7%) groups.

Study details: Findings are from a double-blind, phase 3 KEEPsAKE 1 study including 964 patients with active PsA and inadequate response to ≥1 csDMARDs who were randomly assigned to receive 150 mg risankizumab or placebo at weeks 0, 4, and 16.

Disclosures: This study did not report any source of funding. The authors declared serving as speaker, consultant, investigator, or receiving honoraria, fees, and grants from several sources. Five authors declared being employees or shareholders of AbbVie.

Source: Kristensen LE et al. Ann Rheum Dis. 2021;81:225-231 (Dec 15). Doi: 10.1136/annrheumdis-2021-221019.

Key clinical point: Risankizumab effectively reduced clinical manifestations of psoriatic arthritis (PsA) in patients with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) with no new adverse events (AE).

Major finding: At week 24, at least a 20% improvement in the American College of Rheumatology score was achieved by a significantly higher proportion of patients receiving risankizumab vs. placebo (57.3% vs. 33.5%; P < .001). Treatment-emergent AEs were mild/moderate and reported at similar frequencies in risankizumab (40.4%) and placebo (38.7%) groups.

Study details: Findings are from a double-blind, phase 3 KEEPsAKE 1 study including 964 patients with active PsA and inadequate response to ≥1 csDMARDs who were randomly assigned to receive 150 mg risankizumab or placebo at weeks 0, 4, and 16.

Disclosures: This study did not report any source of funding. The authors declared serving as speaker, consultant, investigator, or receiving honoraria, fees, and grants from several sources. Five authors declared being employees or shareholders of AbbVie.

Source: Kristensen LE et al. Ann Rheum Dis. 2021;81:225-231 (Dec 15). Doi: 10.1136/annrheumdis-2021-221019.

Key clinical point: In patients with psoriatic arthritis (PsA), clinical inflammation monitored by swollen joint counts (SJC) and biochemical inflammation monitored by C-reactive protein (CRP) level, have a direct effect on structural progression.

Major finding: Progression was significantly higher in patients with active vs. inactive time-averaged SJC (odds ratio [OR] 1.24; P = .016) and time-averaged CRP (OR 6.08; P = .036). Progression was greatest in presence of both clinical and biochemical inflammation and lowest in absence of both (P = .05).

Study details: Findings are secondary analysis of patient data from the IMPACT 2 trial, including 145 patients with PsA.

Disclosures: The study did not report any source of funding. The authors declared serving as associate editor or receiving grants and honoraria from several sources.

Source: Borst C et al. RMD Open. 2021;7:e002038 (Dec 8). Doi: 10.1136/rmdopen-2021-002038.

Key clinical point: In patients with psoriatic arthritis (PsA), clinical inflammation monitored by swollen joint counts (SJC) and biochemical inflammation monitored by C-reactive protein (CRP) level, have a direct effect on structural progression.

Major finding: Progression was significantly higher in patients with active vs. inactive time-averaged SJC (odds ratio [OR] 1.24; P = .016) and time-averaged CRP (OR 6.08; P = .036). Progression was greatest in presence of both clinical and biochemical inflammation and lowest in absence of both (P = .05).

Study details: Findings are secondary analysis of patient data from the IMPACT 2 trial, including 145 patients with PsA.

Disclosures: The study did not report any source of funding. The authors declared serving as associate editor or receiving grants and honoraria from several sources.

Source: Borst C et al. RMD Open. 2021;7:e002038 (Dec 8). Doi: 10.1136/rmdopen-2021-002038.

Key clinical point: In patients with psoriatic arthritis (PsA), clinical inflammation monitored by swollen joint counts (SJC) and biochemical inflammation monitored by C-reactive protein (CRP) level, have a direct effect on structural progression.

Major finding: Progression was significantly higher in patients with active vs. inactive time-averaged SJC (odds ratio [OR] 1.24; P = .016) and time-averaged CRP (OR 6.08; P = .036). Progression was greatest in presence of both clinical and biochemical inflammation and lowest in absence of both (P = .05).

Study details: Findings are secondary analysis of patient data from the IMPACT 2 trial, including 145 patients with PsA.

Disclosures: The study did not report any source of funding. The authors declared serving as associate editor or receiving grants and honoraria from several sources.

Source: Borst C et al. RMD Open. 2021;7:e002038 (Dec 8). Doi: 10.1136/rmdopen-2021-002038.

Key clinical point: Upadacitinib showed similar efficacy and a consistent safety profile as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs (nbDMARDs) in patients with psoriatic arthritis (PsA).

Major finding: At week 12, ≥20% improvement in the American College of Rheumatology score was achieved by a similar proportion of patients receiving 15 mg upadacitinib or 30 mg upadacitinib as monotherapy (15 mg: 33.7%; 95% CI, 24.4%-43.1%; 30 mg: 45.7%; 95% CI, 36.9%-54.5%) or combination therapy (15 mg: 34.0%; 95% CI, 27.9%-40.1%; 30 mg: 39.6%; 95% CI, 33.7%-45.5%). Adverse events were generally similar with monotherapy and combination therapy.

Study details: This is a pooled analysis of 2 phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, including 1,916 patients with active PsA with an inadequate response to ≥1 nbDMARD/bDMARD who were randomly assigned to placebo, 15 mg upadacitinib, or 30 mg upadacitinib as monotherapy or in combination with ≤2 nbDMARDs for 24 weeks.

Disclosures: This work was supported by AbbVie. Six authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Nash P et al. Rheumatology (Oxford). 2021;keab905 (Dec 3). Doi:  10.1093/rheumatology/keab905.

Key clinical point: Upadacitinib showed similar efficacy and a consistent safety profile as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs (nbDMARDs) in patients with psoriatic arthritis (PsA).

Major finding: At week 12, ≥20% improvement in the American College of Rheumatology score was achieved by a similar proportion of patients receiving 15 mg upadacitinib or 30 mg upadacitinib as monotherapy (15 mg: 33.7%; 95% CI, 24.4%-43.1%; 30 mg: 45.7%; 95% CI, 36.9%-54.5%) or combination therapy (15 mg: 34.0%; 95% CI, 27.9%-40.1%; 30 mg: 39.6%; 95% CI, 33.7%-45.5%). Adverse events were generally similar with monotherapy and combination therapy.

Study details: This is a pooled analysis of 2 phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, including 1,916 patients with active PsA with an inadequate response to ≥1 nbDMARD/bDMARD who were randomly assigned to placebo, 15 mg upadacitinib, or 30 mg upadacitinib as monotherapy or in combination with ≤2 nbDMARDs for 24 weeks.

Disclosures: This work was supported by AbbVie. Six authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Nash P et al. Rheumatology (Oxford). 2021;keab905 (Dec 3). Doi:  10.1093/rheumatology/keab905.

Key clinical point: Upadacitinib showed similar efficacy and a consistent safety profile as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs (nbDMARDs) in patients with psoriatic arthritis (PsA).

Major finding: At week 12, ≥20% improvement in the American College of Rheumatology score was achieved by a similar proportion of patients receiving 15 mg upadacitinib or 30 mg upadacitinib as monotherapy (15 mg: 33.7%; 95% CI, 24.4%-43.1%; 30 mg: 45.7%; 95% CI, 36.9%-54.5%) or combination therapy (15 mg: 34.0%; 95% CI, 27.9%-40.1%; 30 mg: 39.6%; 95% CI, 33.7%-45.5%). Adverse events were generally similar with monotherapy and combination therapy.

Study details: This is a pooled analysis of 2 phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2, including 1,916 patients with active PsA with an inadequate response to ≥1 nbDMARD/bDMARD who were randomly assigned to placebo, 15 mg upadacitinib, or 30 mg upadacitinib as monotherapy or in combination with ≤2 nbDMARDs for 24 weeks.

Disclosures: This work was supported by AbbVie. Six authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Nash P et al. Rheumatology (Oxford). 2021;keab905 (Dec 3). Doi:  10.1093/rheumatology/keab905.