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Nurse makes millions selling her licensing exam study sheets
Ms. Beggs, 28, sells one-page study sheets or bundles of sheets, sometimes with colorful drawings, conversation bubbles and underlining, that boil down concepts for particular conditions into easy-to-understand language.
The biggest seller on Ms. Beggs’ online marketplace Etsy site, RNExplained, is a bundle of study guides covering eight core nursing classes. The notes range in price from $2 to $150. More than 70,000 customers have bought the $60 bundle, according to the website.
Ms. Beggs’ business developed in a “very unintentional” way when COVID hit with just months left in her nursing program at Mount Saint Mary’s University, Los Angeles, she told this news organization.
Classes had switched to Zoom, and she had no one to study with as she prepared to take her board exams.
“The best way I know how to study is to teach things out loud. But because I had nobody to teach out loud to, I would literally teach them to the wall,” Ms. Beggs said. “I would record myself so I could play it back and teach myself these topics that were hard for me to understand.”
Just for fun, she says, she posted them on TikTok and the responses started flowing in, with followers asking where she was selling the sheets. She now has more than 660,000 TikTok followers and 9 million likes.
Ms. Beggs said that every sheet highlights a condition, and she has made 308 of them.
Traditional classroom lessons typically teach one medical condition in 5-6 pages, Ms. Beggs said. “I go straight to the point.”
One reviewer on Ms. Beggs’ Etsy site appreciated the handwritten notes, calling them “simplified and concise.” Another commented: “Definitely helped me pass my last exam.”
Ms. Beggs says that her notes may seem simple, but each page represents comprehensive research.
“I have to go through not just one source of information to make sure my information is factual,” Ms. Beggs says. “What you teach in California might be a little different than what you teach in Florida. It’s very meticulous. The lab values will be a little different everywhere you go.”
She acknowledges her competition, noting that there are many other study guides for the NCLEX and nursing courses.
Nursing groups weigh in
Dawn Kappel, spokesperson for the National Council of State Boards of Nursing, which oversees NCLEX, said in an interview that “NCSBN has no issue with the current content of Stephanee Beggs’ business venture.”
For many students, the study guides will be helpful, especially for visual learners, said Carole Kenner, PhD, RN, dean and professor in the School of Nursing and Health Sciences at The College of New Jersey.
But for students “who are less confident in their knowledge, I would want to see a lot more in-depth explanation and rationale,” Dr. Kenner said.
“Since the NCLEX is moving to more cased-based scenarios, the next-gen unfolding cases, you really have to understand a lot of the rationale.”
The notes remind Dr. Kenner of traditional flash cards. “I don’t think it will work for all students, but even the fanciest of onsite review courses are useful to everyone,” she said.
‘Not cutting corners’
As an emergency nurse, Ms. Beggs said, “I have the experience as a nurse to show people that what you are learning will be seen in real life.”
“The way I teach my brand is not to take shortcuts. I love to teach to understand rather than teaching to memorize for an exam.”
She said she sees her guides as a supplement to learning, not a replacement.
“It’s not cutting corners,” she says. “I condense a medical condition that could take a very long time to understand and break it into layman’s terms.”
Ms. Beggs said when people hear about the $2 million, they often ask her whether she plans to give up her shifts in the emergency department for the more lucrative venture.
The answer is no, at least not yet.
“Aside from teaching, I genuinely love being at the bedside,” Ms. Beggs said. “I don’t foresee myself leaving that for good for as long as I can handle both.” She acknowledged, though, that her business now takes up most of her time.
“I love everything about both aspects, so it’s hard for me to choose.”
A version of this article first appeared on Medscape.com.
Ms. Beggs, 28, sells one-page study sheets or bundles of sheets, sometimes with colorful drawings, conversation bubbles and underlining, that boil down concepts for particular conditions into easy-to-understand language.
The biggest seller on Ms. Beggs’ online marketplace Etsy site, RNExplained, is a bundle of study guides covering eight core nursing classes. The notes range in price from $2 to $150. More than 70,000 customers have bought the $60 bundle, according to the website.
Ms. Beggs’ business developed in a “very unintentional” way when COVID hit with just months left in her nursing program at Mount Saint Mary’s University, Los Angeles, she told this news organization.
Classes had switched to Zoom, and she had no one to study with as she prepared to take her board exams.
“The best way I know how to study is to teach things out loud. But because I had nobody to teach out loud to, I would literally teach them to the wall,” Ms. Beggs said. “I would record myself so I could play it back and teach myself these topics that were hard for me to understand.”
Just for fun, she says, she posted them on TikTok and the responses started flowing in, with followers asking where she was selling the sheets. She now has more than 660,000 TikTok followers and 9 million likes.
Ms. Beggs said that every sheet highlights a condition, and she has made 308 of them.
Traditional classroom lessons typically teach one medical condition in 5-6 pages, Ms. Beggs said. “I go straight to the point.”
One reviewer on Ms. Beggs’ Etsy site appreciated the handwritten notes, calling them “simplified and concise.” Another commented: “Definitely helped me pass my last exam.”
Ms. Beggs says that her notes may seem simple, but each page represents comprehensive research.
“I have to go through not just one source of information to make sure my information is factual,” Ms. Beggs says. “What you teach in California might be a little different than what you teach in Florida. It’s very meticulous. The lab values will be a little different everywhere you go.”
She acknowledges her competition, noting that there are many other study guides for the NCLEX and nursing courses.
Nursing groups weigh in
Dawn Kappel, spokesperson for the National Council of State Boards of Nursing, which oversees NCLEX, said in an interview that “NCSBN has no issue with the current content of Stephanee Beggs’ business venture.”
For many students, the study guides will be helpful, especially for visual learners, said Carole Kenner, PhD, RN, dean and professor in the School of Nursing and Health Sciences at The College of New Jersey.
But for students “who are less confident in their knowledge, I would want to see a lot more in-depth explanation and rationale,” Dr. Kenner said.
“Since the NCLEX is moving to more cased-based scenarios, the next-gen unfolding cases, you really have to understand a lot of the rationale.”
The notes remind Dr. Kenner of traditional flash cards. “I don’t think it will work for all students, but even the fanciest of onsite review courses are useful to everyone,” she said.
‘Not cutting corners’
As an emergency nurse, Ms. Beggs said, “I have the experience as a nurse to show people that what you are learning will be seen in real life.”
“The way I teach my brand is not to take shortcuts. I love to teach to understand rather than teaching to memorize for an exam.”
She said she sees her guides as a supplement to learning, not a replacement.
“It’s not cutting corners,” she says. “I condense a medical condition that could take a very long time to understand and break it into layman’s terms.”
Ms. Beggs said when people hear about the $2 million, they often ask her whether she plans to give up her shifts in the emergency department for the more lucrative venture.
The answer is no, at least not yet.
“Aside from teaching, I genuinely love being at the bedside,” Ms. Beggs said. “I don’t foresee myself leaving that for good for as long as I can handle both.” She acknowledged, though, that her business now takes up most of her time.
“I love everything about both aspects, so it’s hard for me to choose.”
A version of this article first appeared on Medscape.com.
Ms. Beggs, 28, sells one-page study sheets or bundles of sheets, sometimes with colorful drawings, conversation bubbles and underlining, that boil down concepts for particular conditions into easy-to-understand language.
The biggest seller on Ms. Beggs’ online marketplace Etsy site, RNExplained, is a bundle of study guides covering eight core nursing classes. The notes range in price from $2 to $150. More than 70,000 customers have bought the $60 bundle, according to the website.
Ms. Beggs’ business developed in a “very unintentional” way when COVID hit with just months left in her nursing program at Mount Saint Mary’s University, Los Angeles, she told this news organization.
Classes had switched to Zoom, and she had no one to study with as she prepared to take her board exams.
“The best way I know how to study is to teach things out loud. But because I had nobody to teach out loud to, I would literally teach them to the wall,” Ms. Beggs said. “I would record myself so I could play it back and teach myself these topics that were hard for me to understand.”
Just for fun, she says, she posted them on TikTok and the responses started flowing in, with followers asking where she was selling the sheets. She now has more than 660,000 TikTok followers and 9 million likes.
Ms. Beggs said that every sheet highlights a condition, and she has made 308 of them.
Traditional classroom lessons typically teach one medical condition in 5-6 pages, Ms. Beggs said. “I go straight to the point.”
One reviewer on Ms. Beggs’ Etsy site appreciated the handwritten notes, calling them “simplified and concise.” Another commented: “Definitely helped me pass my last exam.”
Ms. Beggs says that her notes may seem simple, but each page represents comprehensive research.
“I have to go through not just one source of information to make sure my information is factual,” Ms. Beggs says. “What you teach in California might be a little different than what you teach in Florida. It’s very meticulous. The lab values will be a little different everywhere you go.”
She acknowledges her competition, noting that there are many other study guides for the NCLEX and nursing courses.
Nursing groups weigh in
Dawn Kappel, spokesperson for the National Council of State Boards of Nursing, which oversees NCLEX, said in an interview that “NCSBN has no issue with the current content of Stephanee Beggs’ business venture.”
For many students, the study guides will be helpful, especially for visual learners, said Carole Kenner, PhD, RN, dean and professor in the School of Nursing and Health Sciences at The College of New Jersey.
But for students “who are less confident in their knowledge, I would want to see a lot more in-depth explanation and rationale,” Dr. Kenner said.
“Since the NCLEX is moving to more cased-based scenarios, the next-gen unfolding cases, you really have to understand a lot of the rationale.”
The notes remind Dr. Kenner of traditional flash cards. “I don’t think it will work for all students, but even the fanciest of onsite review courses are useful to everyone,” she said.
‘Not cutting corners’
As an emergency nurse, Ms. Beggs said, “I have the experience as a nurse to show people that what you are learning will be seen in real life.”
“The way I teach my brand is not to take shortcuts. I love to teach to understand rather than teaching to memorize for an exam.”
She said she sees her guides as a supplement to learning, not a replacement.
“It’s not cutting corners,” she says. “I condense a medical condition that could take a very long time to understand and break it into layman’s terms.”
Ms. Beggs said when people hear about the $2 million, they often ask her whether she plans to give up her shifts in the emergency department for the more lucrative venture.
The answer is no, at least not yet.
“Aside from teaching, I genuinely love being at the bedside,” Ms. Beggs said. “I don’t foresee myself leaving that for good for as long as I can handle both.” She acknowledged, though, that her business now takes up most of her time.
“I love everything about both aspects, so it’s hard for me to choose.”
A version of this article first appeared on Medscape.com.
Disease burden is higher in women vs men with psoriatic arthritis
Key clinical point: The psoriatic arthritis (PsA) disease burden had worse impact on women vs men with PsA, with women having a higher disease activity, worse function, and greater disease burden.
Major finding: Female vs male patients with PsA had a significantly higher mean patient global assessment score (P < .001), patient’s pain score (P = .003), tender joint count (P < .001), swollen joint count (P = .033), and Disease Activity Score for PsA (P < .001). Minimal disease activity was achieved by 44.0% of men vs 24.6% of women (P = .003).
Study details: Findings are from a cross-sectional analysis of 2 longitudinal cohorts including 141 male and 131 female patients with PsA who received treatment with conventional synthetic or biologic disease-modifying antirheumatic drugs for at least 6 months.
Disclosures: This study did not receive funding. The authors declared no conflicts of interest.
Source: Lubrano E et al. Psoriatic arthritis in males and females: Differences and similarities. Rheumatol Ther. 2023 (Feb 16). Doi: 10.1007/s40744-023-00535-3
Key clinical point: The psoriatic arthritis (PsA) disease burden had worse impact on women vs men with PsA, with women having a higher disease activity, worse function, and greater disease burden.
Major finding: Female vs male patients with PsA had a significantly higher mean patient global assessment score (P < .001), patient’s pain score (P = .003), tender joint count (P < .001), swollen joint count (P = .033), and Disease Activity Score for PsA (P < .001). Minimal disease activity was achieved by 44.0% of men vs 24.6% of women (P = .003).
Study details: Findings are from a cross-sectional analysis of 2 longitudinal cohorts including 141 male and 131 female patients with PsA who received treatment with conventional synthetic or biologic disease-modifying antirheumatic drugs for at least 6 months.
Disclosures: This study did not receive funding. The authors declared no conflicts of interest.
Source: Lubrano E et al. Psoriatic arthritis in males and females: Differences and similarities. Rheumatol Ther. 2023 (Feb 16). Doi: 10.1007/s40744-023-00535-3
Key clinical point: The psoriatic arthritis (PsA) disease burden had worse impact on women vs men with PsA, with women having a higher disease activity, worse function, and greater disease burden.
Major finding: Female vs male patients with PsA had a significantly higher mean patient global assessment score (P < .001), patient’s pain score (P = .003), tender joint count (P < .001), swollen joint count (P = .033), and Disease Activity Score for PsA (P < .001). Minimal disease activity was achieved by 44.0% of men vs 24.6% of women (P = .003).
Study details: Findings are from a cross-sectional analysis of 2 longitudinal cohorts including 141 male and 131 female patients with PsA who received treatment with conventional synthetic or biologic disease-modifying antirheumatic drugs for at least 6 months.
Disclosures: This study did not receive funding. The authors declared no conflicts of interest.
Source: Lubrano E et al. Psoriatic arthritis in males and females: Differences and similarities. Rheumatol Ther. 2023 (Feb 16). Doi: 10.1007/s40744-023-00535-3
Apremilast safe and effective in biologic-naive patients with early PsA
Key clinical point: Early initiation of apremilast led to rapid and sustained improvements in psoriatic arthritis (PsA) manifestations with a consistent safety profile in a real-world cohort of biologic-naive patients who were intolerant of conventional synthetic disease-modifying antirheumatic drugs (csDMARD).
Major finding: Among patients with baseline swollen joint count (SJC) and tender joint count (TJC) of >0, significant median decreases in SJC (50% and 90%, respectively) and TJC (50% and 80%, respectively) were observed at 16 and 52 weeks (all P < .001), with 55.2% of evaluable patients achieving minimal disease activity at 52 weeks. Overall, 13.8% of patients experienced ≥1 adverse event, with all except one being non-serious.
Study details: This prospective study included 167 biologic-naive patients with early peripheral PsA and intolerance or inadequate response to csDMARD who initiated apremilast.
Disclosures: This study was funded by Genesis Pharma and Celgene. Some authors reported ties with various sources, including Genesis Pharma. A Kekki and N Antonakopoulos reported being employees of Genesis Pharma.
Source: Sfikakis PP et al. Apremilast for biologic-naïve, peripheral psoriatic arthritis, including patients with early disease: Results from the APROACH observational prospective study. Rheumatol Int. 2023 (Mar 1). Doi: 10.1007/s00296-022-05269-z
Key clinical point: Early initiation of apremilast led to rapid and sustained improvements in psoriatic arthritis (PsA) manifestations with a consistent safety profile in a real-world cohort of biologic-naive patients who were intolerant of conventional synthetic disease-modifying antirheumatic drugs (csDMARD).
Major finding: Among patients with baseline swollen joint count (SJC) and tender joint count (TJC) of >0, significant median decreases in SJC (50% and 90%, respectively) and TJC (50% and 80%, respectively) were observed at 16 and 52 weeks (all P < .001), with 55.2% of evaluable patients achieving minimal disease activity at 52 weeks. Overall, 13.8% of patients experienced ≥1 adverse event, with all except one being non-serious.
Study details: This prospective study included 167 biologic-naive patients with early peripheral PsA and intolerance or inadequate response to csDMARD who initiated apremilast.
Disclosures: This study was funded by Genesis Pharma and Celgene. Some authors reported ties with various sources, including Genesis Pharma. A Kekki and N Antonakopoulos reported being employees of Genesis Pharma.
Source: Sfikakis PP et al. Apremilast for biologic-naïve, peripheral psoriatic arthritis, including patients with early disease: Results from the APROACH observational prospective study. Rheumatol Int. 2023 (Mar 1). Doi: 10.1007/s00296-022-05269-z
Key clinical point: Early initiation of apremilast led to rapid and sustained improvements in psoriatic arthritis (PsA) manifestations with a consistent safety profile in a real-world cohort of biologic-naive patients who were intolerant of conventional synthetic disease-modifying antirheumatic drugs (csDMARD).
Major finding: Among patients with baseline swollen joint count (SJC) and tender joint count (TJC) of >0, significant median decreases in SJC (50% and 90%, respectively) and TJC (50% and 80%, respectively) were observed at 16 and 52 weeks (all P < .001), with 55.2% of evaluable patients achieving minimal disease activity at 52 weeks. Overall, 13.8% of patients experienced ≥1 adverse event, with all except one being non-serious.
Study details: This prospective study included 167 biologic-naive patients with early peripheral PsA and intolerance or inadequate response to csDMARD who initiated apremilast.
Disclosures: This study was funded by Genesis Pharma and Celgene. Some authors reported ties with various sources, including Genesis Pharma. A Kekki and N Antonakopoulos reported being employees of Genesis Pharma.
Source: Sfikakis PP et al. Apremilast for biologic-naïve, peripheral psoriatic arthritis, including patients with early disease: Results from the APROACH observational prospective study. Rheumatol Int. 2023 (Mar 1). Doi: 10.1007/s00296-022-05269-z
Concurrent onset of skin and joint symptoms tied to high disease activity in PsA
Key clinical point: Concurrent onset of skin lesions and joint symptoms increased the likelihood of moderate or high disease activity in patients with psoriatic arthritis (PsA), highlighting the importance of sequence in which skin and joint symptoms appear in disease management.
Major finding: Patients with concurrent onset of skin and joint symptoms (adjusted odds ratio 4.65; P = .007) were more likely to have a moderate or high disease activity (Psoriatic Arthritis Disease Activity Score >3.2).
Study details: Findings are from a retrospective cross-sectional study including 286 patients with PsA.
Disclosures: This study was funded by the National Natural Science Foundation of China. No conflicts of interest were declared.
Source: Tan M et al. Concurrent onset of skin and joint symptoms correlates with higher psoriatic arthritis disease activity: A single-center retrospective study. J Am Acad Dermatol. 2023 (Mar 6). Doi: 10.1016/j.jaad.2023.02.045
Key clinical point: Concurrent onset of skin lesions and joint symptoms increased the likelihood of moderate or high disease activity in patients with psoriatic arthritis (PsA), highlighting the importance of sequence in which skin and joint symptoms appear in disease management.
Major finding: Patients with concurrent onset of skin and joint symptoms (adjusted odds ratio 4.65; P = .007) were more likely to have a moderate or high disease activity (Psoriatic Arthritis Disease Activity Score >3.2).
Study details: Findings are from a retrospective cross-sectional study including 286 patients with PsA.
Disclosures: This study was funded by the National Natural Science Foundation of China. No conflicts of interest were declared.
Source: Tan M et al. Concurrent onset of skin and joint symptoms correlates with higher psoriatic arthritis disease activity: A single-center retrospective study. J Am Acad Dermatol. 2023 (Mar 6). Doi: 10.1016/j.jaad.2023.02.045
Key clinical point: Concurrent onset of skin lesions and joint symptoms increased the likelihood of moderate or high disease activity in patients with psoriatic arthritis (PsA), highlighting the importance of sequence in which skin and joint symptoms appear in disease management.
Major finding: Patients with concurrent onset of skin and joint symptoms (adjusted odds ratio 4.65; P = .007) were more likely to have a moderate or high disease activity (Psoriatic Arthritis Disease Activity Score >3.2).
Study details: Findings are from a retrospective cross-sectional study including 286 patients with PsA.
Disclosures: This study was funded by the National Natural Science Foundation of China. No conflicts of interest were declared.
Source: Tan M et al. Concurrent onset of skin and joint symptoms correlates with higher psoriatic arthritis disease activity: A single-center retrospective study. J Am Acad Dermatol. 2023 (Mar 6). Doi: 10.1016/j.jaad.2023.02.045
Ultrasound helps screen patients with moderate-to-severe psoriasis progressing to subclinical PsA
Key clinical point: In patients with moderate-to-severe psoriasis, the presence of synovio-enthesitis on ultrasound, particularly in lower limbs, indicated progression to subclinical psoriatic arthritis (PsA). Therefore, routine ultrasound screening should be performed irrespective of arthritis symptoms.
Major finding: Only synovio-enthesitis diagnosis differed significantly among patients with silent psoriasis vs control individuals (16.1% vs 1.3%; P < .001), with 12.7% of patients diagnosed with synovio-enthesitis progressing to subclinical PsA and the top four sites with synovio-enthesitis involvement being in lower limbs. Body surface area and Psoriasis Area and Severity Index scores were not different in psoriasis, subclinical PsA, and prodromal/active PsA phases.
Study details: This cross-sectional study included 490 patients with moderate-to-severe psoriasis, of which 384 and 106 patients without and with arthritis symptoms formed the silent psoriasis and clinical PsA groups, respectively, and 80 age- and sex-matched control individuals without psoriasis.
Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.
Source: Chen ZT et al. The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol. 2023 (Feb 28). Doi: 10.1007/s00330-023-09493-4
Key clinical point: In patients with moderate-to-severe psoriasis, the presence of synovio-enthesitis on ultrasound, particularly in lower limbs, indicated progression to subclinical psoriatic arthritis (PsA). Therefore, routine ultrasound screening should be performed irrespective of arthritis symptoms.
Major finding: Only synovio-enthesitis diagnosis differed significantly among patients with silent psoriasis vs control individuals (16.1% vs 1.3%; P < .001), with 12.7% of patients diagnosed with synovio-enthesitis progressing to subclinical PsA and the top four sites with synovio-enthesitis involvement being in lower limbs. Body surface area and Psoriasis Area and Severity Index scores were not different in psoriasis, subclinical PsA, and prodromal/active PsA phases.
Study details: This cross-sectional study included 490 patients with moderate-to-severe psoriasis, of which 384 and 106 patients without and with arthritis symptoms formed the silent psoriasis and clinical PsA groups, respectively, and 80 age- and sex-matched control individuals without psoriasis.
Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.
Source: Chen ZT et al. The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol. 2023 (Feb 28). Doi: 10.1007/s00330-023-09493-4
Key clinical point: In patients with moderate-to-severe psoriasis, the presence of synovio-enthesitis on ultrasound, particularly in lower limbs, indicated progression to subclinical psoriatic arthritis (PsA). Therefore, routine ultrasound screening should be performed irrespective of arthritis symptoms.
Major finding: Only synovio-enthesitis diagnosis differed significantly among patients with silent psoriasis vs control individuals (16.1% vs 1.3%; P < .001), with 12.7% of patients diagnosed with synovio-enthesitis progressing to subclinical PsA and the top four sites with synovio-enthesitis involvement being in lower limbs. Body surface area and Psoriasis Area and Severity Index scores were not different in psoriasis, subclinical PsA, and prodromal/active PsA phases.
Study details: This cross-sectional study included 490 patients with moderate-to-severe psoriasis, of which 384 and 106 patients without and with arthritis symptoms formed the silent psoriasis and clinical PsA groups, respectively, and 80 age- and sex-matched control individuals without psoriasis.
Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.
Source: Chen ZT et al. The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol. 2023 (Feb 28). Doi: 10.1007/s00330-023-09493-4
Real world study finds no evidence of increased cancer risk with JAKi vs TNFi in PsA
Key clinical point: The short-term risk for cancer other than non-melanoma skin cancer (NMSC) or NMSC was not significantly higher among patients with psoriatic arthritis (PsA) who initiated Janus kinase inhibitors (JAKi) than those who initiated tumor necrosis factor inhibitors (TNFi).
Major finding: JAKi vs TNFi was not significantly associated with a higher risk for cancer other than NMSC (adjusted hazard ratio [aHR] 1.88; 95% CI 0.68-5.16) or NMSC (aHR 2.05; 95% CI 0.79-5.31) in patients with PsA.
Study details: The data come from an observational cohort study that evaluated prospectively collected data of 4443 patients with PsA and 10,447 patients with RA, all without previous cancer, who received JAKi, TNFi, or other non-TNFi biologic disease-modifying antirheumatic drugs.
Disclosures: This study was funded by the Karolinska Institute Region Stockholm funds (ALF), Swedish Research Council, and others. T Frisell and H Bower declared being partly employed by the ARTIS project. J Askling reported research agreements with various sources.
Source: Huss V et al on behalf of the ARTIS group. Cancer risks with JAKi and biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis or psoriatic arthritis: A national real-world cohort study. Ann Rheum Dis. 2023 (Mar 3). Doi: 10.1136/ard-2022-223636
Key clinical point: The short-term risk for cancer other than non-melanoma skin cancer (NMSC) or NMSC was not significantly higher among patients with psoriatic arthritis (PsA) who initiated Janus kinase inhibitors (JAKi) than those who initiated tumor necrosis factor inhibitors (TNFi).
Major finding: JAKi vs TNFi was not significantly associated with a higher risk for cancer other than NMSC (adjusted hazard ratio [aHR] 1.88; 95% CI 0.68-5.16) or NMSC (aHR 2.05; 95% CI 0.79-5.31) in patients with PsA.
Study details: The data come from an observational cohort study that evaluated prospectively collected data of 4443 patients with PsA and 10,447 patients with RA, all without previous cancer, who received JAKi, TNFi, or other non-TNFi biologic disease-modifying antirheumatic drugs.
Disclosures: This study was funded by the Karolinska Institute Region Stockholm funds (ALF), Swedish Research Council, and others. T Frisell and H Bower declared being partly employed by the ARTIS project. J Askling reported research agreements with various sources.
Source: Huss V et al on behalf of the ARTIS group. Cancer risks with JAKi and biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis or psoriatic arthritis: A national real-world cohort study. Ann Rheum Dis. 2023 (Mar 3). Doi: 10.1136/ard-2022-223636
Key clinical point: The short-term risk for cancer other than non-melanoma skin cancer (NMSC) or NMSC was not significantly higher among patients with psoriatic arthritis (PsA) who initiated Janus kinase inhibitors (JAKi) than those who initiated tumor necrosis factor inhibitors (TNFi).
Major finding: JAKi vs TNFi was not significantly associated with a higher risk for cancer other than NMSC (adjusted hazard ratio [aHR] 1.88; 95% CI 0.68-5.16) or NMSC (aHR 2.05; 95% CI 0.79-5.31) in patients with PsA.
Study details: The data come from an observational cohort study that evaluated prospectively collected data of 4443 patients with PsA and 10,447 patients with RA, all without previous cancer, who received JAKi, TNFi, or other non-TNFi biologic disease-modifying antirheumatic drugs.
Disclosures: This study was funded by the Karolinska Institute Region Stockholm funds (ALF), Swedish Research Council, and others. T Frisell and H Bower declared being partly employed by the ARTIS project. J Askling reported research agreements with various sources.
Source: Huss V et al on behalf of the ARTIS group. Cancer risks with JAKi and biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis or psoriatic arthritis: A national real-world cohort study. Ann Rheum Dis. 2023 (Mar 3). Doi: 10.1136/ard-2022-223636
JAKi effective for PsA but higher doses may have increased toxicity
Key clinical point: All Janus kinase inhibitors (JAKi) were more effective than placebo in patients with psoriatic arthritis (PsA), but led to a higher overall incidence of adverse events, particularly at higher doses.
Major finding: JAKi vs placebo were associated with a significantly higher American College of Rheumatology 20 response rate (relative risk [RR] 2.09; P < .00001), with the response being the highest for filgotinib (RR 2.40; P < .00001), followed by upadacitinib, tofacitinib, and deucravacitinib. However, the overall incidence of adverse events was higher with JAKi vs placebo (RR 1.17; P < .00001) and significantly higher with 10 mg vs 5 mg tofacitinib (P = .03).
Study details: The data come from a systematic review and meta-analysis of 17 phase 2/3 randomized controlled trials including 6802 patients with PsA or moderate-to-severe plaque psoriasis who received ≥1 JAKi.
Disclosures: This study was supported by the National Basic Research Program of China. The authors declared no conflicts of interest.
Source: Yang F et al. Efficacy and safety of Janus kinase inhibitors in patients with psoriasis and psoriatic arthritis: A systematic review and meta‑analysis. Clin Rheumatol. 2023 (Feb 10). Doi: 10.1007/s10067-023-06529-4
Key clinical point: All Janus kinase inhibitors (JAKi) were more effective than placebo in patients with psoriatic arthritis (PsA), but led to a higher overall incidence of adverse events, particularly at higher doses.
Major finding: JAKi vs placebo were associated with a significantly higher American College of Rheumatology 20 response rate (relative risk [RR] 2.09; P < .00001), with the response being the highest for filgotinib (RR 2.40; P < .00001), followed by upadacitinib, tofacitinib, and deucravacitinib. However, the overall incidence of adverse events was higher with JAKi vs placebo (RR 1.17; P < .00001) and significantly higher with 10 mg vs 5 mg tofacitinib (P = .03).
Study details: The data come from a systematic review and meta-analysis of 17 phase 2/3 randomized controlled trials including 6802 patients with PsA or moderate-to-severe plaque psoriasis who received ≥1 JAKi.
Disclosures: This study was supported by the National Basic Research Program of China. The authors declared no conflicts of interest.
Source: Yang F et al. Efficacy and safety of Janus kinase inhibitors in patients with psoriasis and psoriatic arthritis: A systematic review and meta‑analysis. Clin Rheumatol. 2023 (Feb 10). Doi: 10.1007/s10067-023-06529-4
Key clinical point: All Janus kinase inhibitors (JAKi) were more effective than placebo in patients with psoriatic arthritis (PsA), but led to a higher overall incidence of adverse events, particularly at higher doses.
Major finding: JAKi vs placebo were associated with a significantly higher American College of Rheumatology 20 response rate (relative risk [RR] 2.09; P < .00001), with the response being the highest for filgotinib (RR 2.40; P < .00001), followed by upadacitinib, tofacitinib, and deucravacitinib. However, the overall incidence of adverse events was higher with JAKi vs placebo (RR 1.17; P < .00001) and significantly higher with 10 mg vs 5 mg tofacitinib (P = .03).
Study details: The data come from a systematic review and meta-analysis of 17 phase 2/3 randomized controlled trials including 6802 patients with PsA or moderate-to-severe plaque psoriasis who received ≥1 JAKi.
Disclosures: This study was supported by the National Basic Research Program of China. The authors declared no conflicts of interest.
Source: Yang F et al. Efficacy and safety of Janus kinase inhibitors in patients with psoriasis and psoriatic arthritis: A systematic review and meta‑analysis. Clin Rheumatol. 2023 (Feb 10). Doi: 10.1007/s10067-023-06529-4
Guselkumab resolves dactylitis and improves clinical outcomes in patients with active PsA
Key clinical point: Guselkumab effectively resolved dactylitis in the majority of patients with psoriatic arthritis (PsA), with improvements sustained through 1 year, which in turn improved other clinical outcomes.
Major finding: At week 24, a significantly higher proportion of patients receiving guselkumab every 4 or 8 weeks (Q4W or Q8W) vs placebo (63.5% or 59.4% vs 42.2%, respectively; P < .05) achieved dactylitis resolution; approximately 80% of patients receiving guselkumab achieved ≥70% improvement in dactylitis severity score by week 52. Patients with resolved dactylitis at week 24 were more likely to achieve American College of Rheumatology 50 response and other clinical outcomes (P < .05).
Study details: This pooled analysis included 1120 patients with active PsA from the phase 3 DISCOVER-1 and DISCOVER-2 studies who were randomly assigned to receive 100 mg guselkumab Q4W or Q8W or placebo.
Disclosures: This study was supported by Janssen Research & Development, LLC. Several authors declared being employees, holding patents, or having other ties with Janssen or other sources.
Source: McGonagle D et al. Guselkumab, a selective Interleukin-23 p19 subunit Inhibitor, resolves dactylitis in patients with active psoriatic arthritis: Pooled results through week 52 from two phase 3 studies. ACR Open Rheumatol. 2023 (Mar 7). Doi: 10.1002/acr2.11537
Key clinical point: Guselkumab effectively resolved dactylitis in the majority of patients with psoriatic arthritis (PsA), with improvements sustained through 1 year, which in turn improved other clinical outcomes.
Major finding: At week 24, a significantly higher proportion of patients receiving guselkumab every 4 or 8 weeks (Q4W or Q8W) vs placebo (63.5% or 59.4% vs 42.2%, respectively; P < .05) achieved dactylitis resolution; approximately 80% of patients receiving guselkumab achieved ≥70% improvement in dactylitis severity score by week 52. Patients with resolved dactylitis at week 24 were more likely to achieve American College of Rheumatology 50 response and other clinical outcomes (P < .05).
Study details: This pooled analysis included 1120 patients with active PsA from the phase 3 DISCOVER-1 and DISCOVER-2 studies who were randomly assigned to receive 100 mg guselkumab Q4W or Q8W or placebo.
Disclosures: This study was supported by Janssen Research & Development, LLC. Several authors declared being employees, holding patents, or having other ties with Janssen or other sources.
Source: McGonagle D et al. Guselkumab, a selective Interleukin-23 p19 subunit Inhibitor, resolves dactylitis in patients with active psoriatic arthritis: Pooled results through week 52 from two phase 3 studies. ACR Open Rheumatol. 2023 (Mar 7). Doi: 10.1002/acr2.11537
Key clinical point: Guselkumab effectively resolved dactylitis in the majority of patients with psoriatic arthritis (PsA), with improvements sustained through 1 year, which in turn improved other clinical outcomes.
Major finding: At week 24, a significantly higher proportion of patients receiving guselkumab every 4 or 8 weeks (Q4W or Q8W) vs placebo (63.5% or 59.4% vs 42.2%, respectively; P < .05) achieved dactylitis resolution; approximately 80% of patients receiving guselkumab achieved ≥70% improvement in dactylitis severity score by week 52. Patients with resolved dactylitis at week 24 were more likely to achieve American College of Rheumatology 50 response and other clinical outcomes (P < .05).
Study details: This pooled analysis included 1120 patients with active PsA from the phase 3 DISCOVER-1 and DISCOVER-2 studies who were randomly assigned to receive 100 mg guselkumab Q4W or Q8W or placebo.
Disclosures: This study was supported by Janssen Research & Development, LLC. Several authors declared being employees, holding patents, or having other ties with Janssen or other sources.
Source: McGonagle D et al. Guselkumab, a selective Interleukin-23 p19 subunit Inhibitor, resolves dactylitis in patients with active psoriatic arthritis: Pooled results through week 52 from two phase 3 studies. ACR Open Rheumatol. 2023 (Mar 7). Doi: 10.1002/acr2.11537
Active disease in third trimester increases risk for emergency caesarean section in PsA
Key clinical point: Women with psoriatic arthritis (PsA) were at an increased risk for emergency caesarean section, with active disease in the third trimester further amplifying the risk, highlighting the importance of pregestational counseling and disease control along with systematic monitoring during pregnancy.
Major finding: Compared with control individuals, women with PsA had a higher risk for caesarean section (risk difference [RD] 15.0%; P < .001) and for emergency caesarean section (RD 10.6%; P < .001), with active disease in the third trimester further amplifying both risks (caesarean section: RD 17.7%; P = .028; emergency caesarean section: RD 15.9%; P = .015).
Study details: The data come from a population-based cohort study that included women with PsA (n = 121), women with axial spondyloarthritis (n = 312), and control individuals (n = 575,798) with singleton births.
Disclosures: This study was funded by The Norwegian Women’s Public Health Association. The authors did not declare any conflicts of interest.
Source: Skorpen CG et al. Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: A population-based study. RMD Open. 2023;9(1):e002760 (Mar 2). Doi: 10.1136/rmdopen-2022-002760
Key clinical point: Women with psoriatic arthritis (PsA) were at an increased risk for emergency caesarean section, with active disease in the third trimester further amplifying the risk, highlighting the importance of pregestational counseling and disease control along with systematic monitoring during pregnancy.
Major finding: Compared with control individuals, women with PsA had a higher risk for caesarean section (risk difference [RD] 15.0%; P < .001) and for emergency caesarean section (RD 10.6%; P < .001), with active disease in the third trimester further amplifying both risks (caesarean section: RD 17.7%; P = .028; emergency caesarean section: RD 15.9%; P = .015).
Study details: The data come from a population-based cohort study that included women with PsA (n = 121), women with axial spondyloarthritis (n = 312), and control individuals (n = 575,798) with singleton births.
Disclosures: This study was funded by The Norwegian Women’s Public Health Association. The authors did not declare any conflicts of interest.
Source: Skorpen CG et al. Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: A population-based study. RMD Open. 2023;9(1):e002760 (Mar 2). Doi: 10.1136/rmdopen-2022-002760
Key clinical point: Women with psoriatic arthritis (PsA) were at an increased risk for emergency caesarean section, with active disease in the third trimester further amplifying the risk, highlighting the importance of pregestational counseling and disease control along with systematic monitoring during pregnancy.
Major finding: Compared with control individuals, women with PsA had a higher risk for caesarean section (risk difference [RD] 15.0%; P < .001) and for emergency caesarean section (RD 10.6%; P < .001), with active disease in the third trimester further amplifying both risks (caesarean section: RD 17.7%; P = .028; emergency caesarean section: RD 15.9%; P = .015).
Study details: The data come from a population-based cohort study that included women with PsA (n = 121), women with axial spondyloarthritis (n = 312), and control individuals (n = 575,798) with singleton births.
Disclosures: This study was funded by The Norwegian Women’s Public Health Association. The authors did not declare any conflicts of interest.
Source: Skorpen CG et al. Caesarean section in women with axial spondyloarthritis and psoriatic arthritis: A population-based study. RMD Open. 2023;9(1):e002760 (Mar 2). Doi: 10.1136/rmdopen-2022-002760
Achievement of low disease activity improves long-term structural damage in PsA
Key clinical point: Achievement of low or minimal disease activity levels with guselkumab therapy diminished radiographic progression over 2 years in patients with psoriatic arthritis (PsA) at risk for radiographic damage.
Major finding: Among patients receiving guselkumab, the mean change in total van der Heijde-Sharp score from 0 to 100 weeks was numerically lower among those who achieved clinical response at week 52 vs non-responders, as assessed by ≥20% improvement in American College of Rheumatology criteria (1.0-1.2 vs 2.8-4.1), PsA Disease Activity Score low disease activity (LDA; 1.0 vs 1.9-2.4), and Disease Activity in PsA LDA (0.7-0.9 vs 2.3-3.1).
Study details: The data come from a post hoc analysis of the DISCOVER-2 study including 664 biologic-naïve patients with PsA who received guselkumab or placebo.
Disclosures: This study was funded by the Janssen Research & Development, LLC. Some authors reported ties with various sources, including Janssen. Some authors declared being employees of Janssen and owning stocks in Johnson & Johnson.
Source: Gottlieb AB et al. Low rates of radiographic progression associated with clinical efficacy following up to 2 years of treatment with guselkumab: Results from a phase 3, randomised, double-blind, placebo-controlled study of biologic-naïve patients with active psoriatic arthritis. RMD Open. 2023;9:e002789 (Feb 24). Doi: 10.1136/rmdopen-2022-002789
Key clinical point: Achievement of low or minimal disease activity levels with guselkumab therapy diminished radiographic progression over 2 years in patients with psoriatic arthritis (PsA) at risk for radiographic damage.
Major finding: Among patients receiving guselkumab, the mean change in total van der Heijde-Sharp score from 0 to 100 weeks was numerically lower among those who achieved clinical response at week 52 vs non-responders, as assessed by ≥20% improvement in American College of Rheumatology criteria (1.0-1.2 vs 2.8-4.1), PsA Disease Activity Score low disease activity (LDA; 1.0 vs 1.9-2.4), and Disease Activity in PsA LDA (0.7-0.9 vs 2.3-3.1).
Study details: The data come from a post hoc analysis of the DISCOVER-2 study including 664 biologic-naïve patients with PsA who received guselkumab or placebo.
Disclosures: This study was funded by the Janssen Research & Development, LLC. Some authors reported ties with various sources, including Janssen. Some authors declared being employees of Janssen and owning stocks in Johnson & Johnson.
Source: Gottlieb AB et al. Low rates of radiographic progression associated with clinical efficacy following up to 2 years of treatment with guselkumab: Results from a phase 3, randomised, double-blind, placebo-controlled study of biologic-naïve patients with active psoriatic arthritis. RMD Open. 2023;9:e002789 (Feb 24). Doi: 10.1136/rmdopen-2022-002789
Key clinical point: Achievement of low or minimal disease activity levels with guselkumab therapy diminished radiographic progression over 2 years in patients with psoriatic arthritis (PsA) at risk for radiographic damage.
Major finding: Among patients receiving guselkumab, the mean change in total van der Heijde-Sharp score from 0 to 100 weeks was numerically lower among those who achieved clinical response at week 52 vs non-responders, as assessed by ≥20% improvement in American College of Rheumatology criteria (1.0-1.2 vs 2.8-4.1), PsA Disease Activity Score low disease activity (LDA; 1.0 vs 1.9-2.4), and Disease Activity in PsA LDA (0.7-0.9 vs 2.3-3.1).
Study details: The data come from a post hoc analysis of the DISCOVER-2 study including 664 biologic-naïve patients with PsA who received guselkumab or placebo.
Disclosures: This study was funded by the Janssen Research & Development, LLC. Some authors reported ties with various sources, including Janssen. Some authors declared being employees of Janssen and owning stocks in Johnson & Johnson.
Source: Gottlieb AB et al. Low rates of radiographic progression associated with clinical efficacy following up to 2 years of treatment with guselkumab: Results from a phase 3, randomised, double-blind, placebo-controlled study of biologic-naïve patients with active psoriatic arthritis. RMD Open. 2023;9:e002789 (Feb 24). Doi: 10.1136/rmdopen-2022-002789