Psoriatic Arthritis ICYMI

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). 
5.    Walscheid K et al. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15).

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). 
5.    Walscheid K et al. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15).

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). 
5.    Walscheid K et al. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15).

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴ demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). doi: 10.1093/aje/kwac009. Epub ahead of print. PMID: 35029650.
5.    Walscheid K, Rothaus K, Niewerth M, Klotsche J, Minden K, Heiligenhaus A. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15). doi: 10.3899/jrheum.210755. Epub ahead of print. PMID: 35034000.
 

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴ demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). doi: 10.1093/aje/kwac009. Epub ahead of print. PMID: 35029650.
5.    Walscheid K, Rothaus K, Niewerth M, Klotsche J, Minden K, Heiligenhaus A. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15). doi: 10.3899/jrheum.210755. Epub ahead of print. PMID: 35034000.
 

The influence of sex and gender on psoriatic arthritis (PsA) continues to be of interest. Using data from the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR), Passia et al¹assessed sex-related differences in demographics, disease characteristics, and evolution over 1 year in 273 men and 294 women newly diagnosed with PsA. They found that at baseline, women had a significantly longer duration of symptoms, higher tender joint count and enthesitis, higher disease activity, higher levels of pain, more severe limitations in function and worse quality of life. During the 1 year follow up, composite measures of disease activity declined in men and women, but women continued to have higher levels than men. At the end of 1 year, fewer women achieved the criteria for minimal disease activity (MDA). Thus, the disease burden of PsA was higher in women vs. men at all time points and even after 1 year of standard-of-care treatment. Sex-specific treatment strategies might help a higher proportion of women achieve MDA.

Although, enthesitis is believed to be a primary pathogenetic lesion in PsA, the relationship between active enthesitis and disease severity as measured by the presence of joint erosions is less well studied. In a cross-sectional study of 104 PsA patients, Smerilli et al² explored the association between ultrasound (US) entheseal abnormalities and the presence of US detected bone erosions in PsA joints. At least 1 joint bone erosion was found in 45.2% of patients and was associated with power Doppler signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and greyscale synovitis (OR 2.59; P = .02). Thus, Doppler signal and bone erosions at entheses indicate more severe PsA and patients with such abnormalities should therefore be treated aggressively.

Comorbidities and associated conditions were a focus of several publications last month. Venous thromboembolism (VTE) is associated with inflammatory diseases, including PsA. In a retrospective cohort study including 5,275 patients with newly diagnosed PsA, Gazitt et al³ assessed the association between PsA and VTE events using a large population-based database in Israel. During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE. Thus, VTE in patients with PsA may be associated with underlying comorbidities rather than PsA per se. In another study, Harris et al⁴ demonstrated that PsA was associated with increased risk of endometriosis. In an analysis of 4112 patients with laparoscopically confirmed endometriosis from the Nurses’ Health Study II, they found that psoriasis with concomitant PsA was associated with increased risk for subsequent endometriosis (HR 2.01; 95% CI 1.23-3.30), which persisted even after adjusting for comorbidities. Finally, in a cross-sectional study using data from 1862 juvenile PsA (jPsA) patients (122 [6.6%] of whom developed uveitis) in the German National Pediatric Rheumatological Database, Walscheid et al⁵ showed that patients with jPsA were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

References

1.    Passia E et al. Sex-specific differences and how to handle them in early psoriatic arthritis. Arthritis Res Ther. 2022;24(1):22 (Jan 11). 
2.    Smerilli G et al. Doppler signal and bone erosions at the enthesis are independently associated with ultrasound joint erosive damage in psoriatic arthritis. J Rheumatol. 2022 (Feb 1). 
3.    Gazitt T et al. The association between psoriatic arthritis and venous thromboembolism: a population-based cohort study. Arthritis Res Ther. 2022;24(1):16 (Jan 7). 
4.    Harris HR et al. Endometriosis, psoriasis and psoriatic arthritis: A prospective cohort study. Am J Epidemiol. 2022 (Jan 13). doi: 10.1093/aje/kwac009. Epub ahead of print. PMID: 35029650.
5.    Walscheid K, Rothaus K, Niewerth M, Klotsche J, Minden K, Heiligenhaus A. Occurrence and risk factors of uveitis in juvenile psoriatic arthritis: Data from a population-based nationwide study in Germany. J Rheumatol. 2022 (Jan 15). doi: 10.3899/jrheum.210755. Epub ahead of print. PMID: 35034000.
 

Key clinical point: Despite reducing cellular inflammation and improving clinical outcome for joint involvement, adalimumab, a tumor necrosis factor (TNF) inhibitor, did not affect the levels of interleukin (IL)-17 cytokines and its receptors in the skin and synovium of patients with psoriatic arthritis (PsA).

Major finding: At baseline, the skin of patients with PsA vs. healthy donors (HD) showed significantly lower levels of IL-17A (P = .017) and its receptor IL-17RA (P = .007), but higher levels of IL-17F (P = .0002) and its receptor IL-17RC (P = .024). After 4 weeks of treatment, patients recieving adalimumab and placebo showed similar levels of IL-17A, IL-17F, and IL-17RC.

Study details: Findings are from a double-blind, single-center study including 24 patients with PsA and mild psoriatic skin lesions who were randomly assigned to adalimumab or placebo.

Disclosures: This study was funded by the Innovative Medicines Initiatives European Union. The authors declared no conflicts of interest.

Source: Bolt JW et al. Biomedicines. 2022;10(2):324 (Jan 29). Doi: 10.3390/biomedicines10020324.

Key clinical point: Despite reducing cellular inflammation and improving clinical outcome for joint involvement, adalimumab, a tumor necrosis factor (TNF) inhibitor, did not affect the levels of interleukin (IL)-17 cytokines and its receptors in the skin and synovium of patients with psoriatic arthritis (PsA).

Major finding: At baseline, the skin of patients with PsA vs. healthy donors (HD) showed significantly lower levels of IL-17A (P = .017) and its receptor IL-17RA (P = .007), but higher levels of IL-17F (P = .0002) and its receptor IL-17RC (P = .024). After 4 weeks of treatment, patients recieving adalimumab and placebo showed similar levels of IL-17A, IL-17F, and IL-17RC.

Study details: Findings are from a double-blind, single-center study including 24 patients with PsA and mild psoriatic skin lesions who were randomly assigned to adalimumab or placebo.

Disclosures: This study was funded by the Innovative Medicines Initiatives European Union. The authors declared no conflicts of interest.

Source: Bolt JW et al. Biomedicines. 2022;10(2):324 (Jan 29). Doi: 10.3390/biomedicines10020324.

Key clinical point: Despite reducing cellular inflammation and improving clinical outcome for joint involvement, adalimumab, a tumor necrosis factor (TNF) inhibitor, did not affect the levels of interleukin (IL)-17 cytokines and its receptors in the skin and synovium of patients with psoriatic arthritis (PsA).

Major finding: At baseline, the skin of patients with PsA vs. healthy donors (HD) showed significantly lower levels of IL-17A (P = .017) and its receptor IL-17RA (P = .007), but higher levels of IL-17F (P = .0002) and its receptor IL-17RC (P = .024). After 4 weeks of treatment, patients recieving adalimumab and placebo showed similar levels of IL-17A, IL-17F, and IL-17RC.

Study details: Findings are from a double-blind, single-center study including 24 patients with PsA and mild psoriatic skin lesions who were randomly assigned to adalimumab or placebo.

Disclosures: This study was funded by the Innovative Medicines Initiatives European Union. The authors declared no conflicts of interest.

Source: Bolt JW et al. Biomedicines. 2022;10(2):324 (Jan 29). Doi: 10.3390/biomedicines10020324.

Key clinical point: The disease burden of psoriatic arthritis (PsA) was higher in women vs. men even after 1 year of standard-of-care treatment.

Major finding: Women vs. men reported a significantly longer duration of symptoms, higher tender joint count (both P < .05) and enthesitis at baseline (P < .05), and higher disease activity, higher levels of pain, and a lower functional capacity even after 1 year of follow-up (all P < .05). Minimal disease activity was predominantly present among men vs. women at baseline (18% vs. 10%; P < .05) and at 1 year of follow-up (59% vs. 37%, P < .00).

Study details: This prospective cohort study included 307 men and 313 women newly diagnosed with PsA from the Dutch south-west Early Psoriatic Arthritis Registry (DEPAR), who were followed up for 1 year.

Disclosures: No source of funding was reported for the study. The DEPAR cohort received funding from the Dutch Government, Pfizer, and other sources. The authors declared no conflicts of interest.

Source: Passia E et al. Arthritis Res Ther. 2022;24:22 (Jan 11). Doi: 10.1186/s13075-021-02680-y.

Key clinical point: The disease burden of psoriatic arthritis (PsA) was higher in women vs. men even after 1 year of standard-of-care treatment.

Major finding: Women vs. men reported a significantly longer duration of symptoms, higher tender joint count (both P < .05) and enthesitis at baseline (P < .05), and higher disease activity, higher levels of pain, and a lower functional capacity even after 1 year of follow-up (all P < .05). Minimal disease activity was predominantly present among men vs. women at baseline (18% vs. 10%; P < .05) and at 1 year of follow-up (59% vs. 37%, P < .00).

Study details: This prospective cohort study included 307 men and 313 women newly diagnosed with PsA from the Dutch south-west Early Psoriatic Arthritis Registry (DEPAR), who were followed up for 1 year.

Disclosures: No source of funding was reported for the study. The DEPAR cohort received funding from the Dutch Government, Pfizer, and other sources. The authors declared no conflicts of interest.

Source: Passia E et al. Arthritis Res Ther. 2022;24:22 (Jan 11). Doi: 10.1186/s13075-021-02680-y.

Key clinical point: The disease burden of psoriatic arthritis (PsA) was higher in women vs. men even after 1 year of standard-of-care treatment.

Major finding: Women vs. men reported a significantly longer duration of symptoms, higher tender joint count (both P < .05) and enthesitis at baseline (P < .05), and higher disease activity, higher levels of pain, and a lower functional capacity even after 1 year of follow-up (all P < .05). Minimal disease activity was predominantly present among men vs. women at baseline (18% vs. 10%; P < .05) and at 1 year of follow-up (59% vs. 37%, P < .00).

Study details: This prospective cohort study included 307 men and 313 women newly diagnosed with PsA from the Dutch south-west Early Psoriatic Arthritis Registry (DEPAR), who were followed up for 1 year.

Disclosures: No source of funding was reported for the study. The DEPAR cohort received funding from the Dutch Government, Pfizer, and other sources. The authors declared no conflicts of interest.

Source: Passia E et al. Arthritis Res Ther. 2022;24:22 (Jan 11). Doi: 10.1186/s13075-021-02680-y.

Key clinical point: Patients with psoriatic arthritis (PsA) have high anxiety levels before initiating biologics, which decreased within 6 months thereafter and was tied with better patient outcomes.

Major finding: Overall, 64% of patients had high anxiety levels before initiating biologics, with the proportion of patients with high anxiety levels and mean anxiety scores decreasing significantly within 6 months of initiating biologics (both P < .001). A change in anxiety score correlated positively with a change in pain score, patient global assessment score, Bath Ankylosing Spondylitis Disease Activity Index, Health Assessment Questionnaire-Disability Index score, Disease Activity Score-28, and PsA Impact of Disease score (all P < .05).

Study details: Findings are from an analysis of 147 patients with PsA who initiated  biologic agents and had an anxiety score assessed at both baseline and first visit within 6 months.

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

Source: Ayan G et al. Clin Rheumatol. 2022 (Jan 27). Doi: 10.1007/s10067-021-06012-y.

Key clinical point: Patients with psoriatic arthritis (PsA) have high anxiety levels before initiating biologics, which decreased within 6 months thereafter and was tied with better patient outcomes.

Major finding: Overall, 64% of patients had high anxiety levels before initiating biologics, with the proportion of patients with high anxiety levels and mean anxiety scores decreasing significantly within 6 months of initiating biologics (both P < .001). A change in anxiety score correlated positively with a change in pain score, patient global assessment score, Bath Ankylosing Spondylitis Disease Activity Index, Health Assessment Questionnaire-Disability Index score, Disease Activity Score-28, and PsA Impact of Disease score (all P < .05).

Study details: Findings are from an analysis of 147 patients with PsA who initiated  biologic agents and had an anxiety score assessed at both baseline and first visit within 6 months.

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

Source: Ayan G et al. Clin Rheumatol. 2022 (Jan 27). Doi: 10.1007/s10067-021-06012-y.

Key clinical point: Patients with psoriatic arthritis (PsA) have high anxiety levels before initiating biologics, which decreased within 6 months thereafter and was tied with better patient outcomes.

Major finding: Overall, 64% of patients had high anxiety levels before initiating biologics, with the proportion of patients with high anxiety levels and mean anxiety scores decreasing significantly within 6 months of initiating biologics (both P < .001). A change in anxiety score correlated positively with a change in pain score, patient global assessment score, Bath Ankylosing Spondylitis Disease Activity Index, Health Assessment Questionnaire-Disability Index score, Disease Activity Score-28, and PsA Impact of Disease score (all P < .05).

Study details: Findings are from an analysis of 147 patients with PsA who initiated  biologic agents and had an anxiety score assessed at both baseline and first visit within 6 months.

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

Source: Ayan G et al. Clin Rheumatol. 2022 (Jan 27). Doi: 10.1007/s10067-021-06012-y.

Key clinical point: Minimal important change (MIC) of the Psoriatic Arthritis Disease Activity Score (PASDAS) could help physicians understand patients' perspectives of disease activity and provide an additional tool for the treatment of psoriatic arthritis (PsA).

Major finding: The overall MIC of the PASDAS was 0.67 (95% CI 0.55-0.79) and results for improvement and deterioration were 0.65 (95% CI 0.46-0.83) and 0.71 (95% CI 0.49-0.93), respectively.

Study details: Findings are from a retrospective cohort study that evaluated routine practice data of 408 patients with PsA.

Disclosures: This work was supported by the Regional Junior Researcher Grant from the Sint Maartenskliniek, Nijmegen, and the Radboudumc, Nijmegen, the Netherlands. The authors declared no conflicts of interest.

Source: Mulder MLM et al. Rheumatology (Oxford). 2022 (Jan 13). Doi: 10.1093/rheumatology/keac025.

Key clinical point: Minimal important change (MIC) of the Psoriatic Arthritis Disease Activity Score (PASDAS) could help physicians understand patients' perspectives of disease activity and provide an additional tool for the treatment of psoriatic arthritis (PsA).

Major finding: The overall MIC of the PASDAS was 0.67 (95% CI 0.55-0.79) and results for improvement and deterioration were 0.65 (95% CI 0.46-0.83) and 0.71 (95% CI 0.49-0.93), respectively.

Study details: Findings are from a retrospective cohort study that evaluated routine practice data of 408 patients with PsA.

Disclosures: This work was supported by the Regional Junior Researcher Grant from the Sint Maartenskliniek, Nijmegen, and the Radboudumc, Nijmegen, the Netherlands. The authors declared no conflicts of interest.

Source: Mulder MLM et al. Rheumatology (Oxford). 2022 (Jan 13). Doi: 10.1093/rheumatology/keac025.

Key clinical point: Minimal important change (MIC) of the Psoriatic Arthritis Disease Activity Score (PASDAS) could help physicians understand patients' perspectives of disease activity and provide an additional tool for the treatment of psoriatic arthritis (PsA).

Major finding: The overall MIC of the PASDAS was 0.67 (95% CI 0.55-0.79) and results for improvement and deterioration were 0.65 (95% CI 0.46-0.83) and 0.71 (95% CI 0.49-0.93), respectively.

Study details: Findings are from a retrospective cohort study that evaluated routine practice data of 408 patients with PsA.

Disclosures: This work was supported by the Regional Junior Researcher Grant from the Sint Maartenskliniek, Nijmegen, and the Radboudumc, Nijmegen, the Netherlands. The authors declared no conflicts of interest.

Source: Mulder MLM et al. Rheumatology (Oxford). 2022 (Jan 13). Doi: 10.1093/rheumatology/keac025.

Key clinical point: Entheseal power Doppler (PD) signal, entheseal bone erosions, and gray scale (GS) joint synovitis were indicative of severe psoriatic arthritis (PsA) in terms of ultrasound (US)-detected joint bone erosion.

Major finding: At least 1 joint bone erosion was found in 45.2% of patients and was associated with PD signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and GS synovitis (OR 2.59; P = .02).

Study details: Findings are from a cross-sectional study including 104 patients with PsA.

Disclosures: This study did not receive any specific funding. E Filippucci and W Grassi declared receiving speaker fees from various sources.

Source: Smerilli G et al. J Rheumatol. 2022 (Feb 1). Doi: 10.3899/jrheum.210974.

Key clinical point: Entheseal power Doppler (PD) signal, entheseal bone erosions, and gray scale (GS) joint synovitis were indicative of severe psoriatic arthritis (PsA) in terms of ultrasound (US)-detected joint bone erosion.

Major finding: At least 1 joint bone erosion was found in 45.2% of patients and was associated with PD signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and GS synovitis (OR 2.59; P = .02).

Study details: Findings are from a cross-sectional study including 104 patients with PsA.

Disclosures: This study did not receive any specific funding. E Filippucci and W Grassi declared receiving speaker fees from various sources.

Source: Smerilli G et al. J Rheumatol. 2022 (Feb 1). Doi: 10.3899/jrheum.210974.

Key clinical point: Entheseal power Doppler (PD) signal, entheseal bone erosions, and gray scale (GS) joint synovitis were indicative of severe psoriatic arthritis (PsA) in terms of ultrasound (US)-detected joint bone erosion.

Major finding: At least 1 joint bone erosion was found in 45.2% of patients and was associated with PD signal at enthesis (odds ratio [OR] 1.74; P < .01), entheseal bone erosions (OR 3.17; P = .01), and GS synovitis (OR 2.59; P = .02).

Study details: Findings are from a cross-sectional study including 104 patients with PsA.

Disclosures: This study did not receive any specific funding. E Filippucci and W Grassi declared receiving speaker fees from various sources.

Source: Smerilli G et al. J Rheumatol. 2022 (Feb 1). Doi: 10.3899/jrheum.210974.

Key clinical point: Patients with psoriatic arthritis (PsA) receiving tofacitinib experienced a shorter time to initial clinically meaningful response than those who switched from placebo to tofacitinib.

Major finding: Median time to the initial Health Assessment Questionnaire-Disability Index score response was shorter in patients receiving 5 mg tofacitinib (29-30 days) and 10 mg tofacitinib (53.5 days) than in those switching from placebo to 5 mg tofacitinib (162 days) or 10 mg tofacitinib (112 days; P < .01). The initial Functional Assessment of Chronic Illness Therapy-Fatigue total score response was achieved faster with 5 mg tofacitinib vs. other treatment groups.

Study details: Findings are from a post hoc analysis of 2 phase 3 trials (OPAL BROADEN and OPAL BEYOND) including 816 patients with PsA randomly assigned to 5 mg tofacitinib, 10 mg tofacitinib, 40 mg adalimumab, or placebo switching to 5 or 10 mg tofacitinib at month 3.

Disclosures: This study was funded by Pfizer. The authors declared receiving research grants, consulting fees, and honoraria from Pfizer and other sources. Four authors declared being employees and stockholders of Pfizer.

Source: Gladman DD et al. Arthritis Res Ther. 2022;24:40 (Feb 9). Doi: 10.1186/s13075-022-02721-0.

Key clinical point: Patients with psoriatic arthritis (PsA) receiving tofacitinib experienced a shorter time to initial clinically meaningful response than those who switched from placebo to tofacitinib.

Major finding: Median time to the initial Health Assessment Questionnaire-Disability Index score response was shorter in patients receiving 5 mg tofacitinib (29-30 days) and 10 mg tofacitinib (53.5 days) than in those switching from placebo to 5 mg tofacitinib (162 days) or 10 mg tofacitinib (112 days; P < .01). The initial Functional Assessment of Chronic Illness Therapy-Fatigue total score response was achieved faster with 5 mg tofacitinib vs. other treatment groups.

Study details: Findings are from a post hoc analysis of 2 phase 3 trials (OPAL BROADEN and OPAL BEYOND) including 816 patients with PsA randomly assigned to 5 mg tofacitinib, 10 mg tofacitinib, 40 mg adalimumab, or placebo switching to 5 or 10 mg tofacitinib at month 3.

Disclosures: This study was funded by Pfizer. The authors declared receiving research grants, consulting fees, and honoraria from Pfizer and other sources. Four authors declared being employees and stockholders of Pfizer.

Source: Gladman DD et al. Arthritis Res Ther. 2022;24:40 (Feb 9). Doi: 10.1186/s13075-022-02721-0.

Key clinical point: Patients with psoriatic arthritis (PsA) receiving tofacitinib experienced a shorter time to initial clinically meaningful response than those who switched from placebo to tofacitinib.

Major finding: Median time to the initial Health Assessment Questionnaire-Disability Index score response was shorter in patients receiving 5 mg tofacitinib (29-30 days) and 10 mg tofacitinib (53.5 days) than in those switching from placebo to 5 mg tofacitinib (162 days) or 10 mg tofacitinib (112 days; P < .01). The initial Functional Assessment of Chronic Illness Therapy-Fatigue total score response was achieved faster with 5 mg tofacitinib vs. other treatment groups.

Study details: Findings are from a post hoc analysis of 2 phase 3 trials (OPAL BROADEN and OPAL BEYOND) including 816 patients with PsA randomly assigned to 5 mg tofacitinib, 10 mg tofacitinib, 40 mg adalimumab, or placebo switching to 5 or 10 mg tofacitinib at month 3.

Disclosures: This study was funded by Pfizer. The authors declared receiving research grants, consulting fees, and honoraria from Pfizer and other sources. Four authors declared being employees and stockholders of Pfizer.

Source: Gladman DD et al. Arthritis Res Ther. 2022;24:40 (Feb 9). Doi: 10.1186/s13075-022-02721-0.

Key clinical point: Increased risk for venous thromboembolism (VTE) in patients with psoriatic arthritis (PsA) seemed to be associated with underlying comorbidities and not independently associated with PsA.

Major finding: During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and  history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE after multivariate adjustment.

Study details: This retrospective cohort study included 5,275 patients with newly diagnosed PsA who were matched with 21,011 control individuals without PsA.

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

Source: Gazitt T et al. Arthritis Res Ther. 2022;24:16 (Jan 7). Doi: 10.1186/s13075-021-02703-8.

Key clinical point: Increased risk for venous thromboembolism (VTE) in patients with psoriatic arthritis (PsA) seemed to be associated with underlying comorbidities and not independently associated with PsA.

Major finding: During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and  history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE after multivariate adjustment.

Study details: This retrospective cohort study included 5,275 patients with newly diagnosed PsA who were matched with 21,011 control individuals without PsA.

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

Source: Gazitt T et al. Arthritis Res Ther. 2022;24:16 (Jan 7). Doi: 10.1186/s13075-021-02703-8.

Key clinical point: Increased risk for venous thromboembolism (VTE) in patients with psoriatic arthritis (PsA) seemed to be associated with underlying comorbidities and not independently associated with PsA.

Major finding: During follow-up, 1.2% vs. 0.8% patients in the PsA vs. control group were diagnosed with VTE, but this association was not statistically significant after adjusting for demographic factors and comorbidities (adjusted hazard ratio [aHR] 1.27; P = .16) with only older age (aHR 1.08; P < .0001) and  history of VTE (aHR 31.63; P < .0001) remaining associated with an increased risk for VTE after multivariate adjustment.

Study details: This retrospective cohort study included 5,275 patients with newly diagnosed PsA who were matched with 21,011 control individuals without PsA.

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

Source: Gazitt T et al. Arthritis Res Ther. 2022;24:16 (Jan 7). Doi: 10.1186/s13075-021-02703-8.

Key clinical point: Patients with juvenile psoriatic arthritis (JPsA) were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody (ANA) positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

Major finding: Patients with JPsA with vs. without uveitis were younger at JPsA onset (5.3 years vs. 9.3 years) and were more frequently positive for ANA (60.3% vs. 37%; both P < .001). The mean clinical Juvenile Arthritis Disease Activity Score 10 was the only factor significantly associated with the development of uveitis in patients with JPsA (hazard ratio 1.16; P = .025).

Study details: This was an analysis of cross-sectional data from 1,862 patients with JPsA from the National Pediatric Rheumatological Database. Of the patients in the study, 122 developed uveitis.

Disclosures: This study was funded by the Federal Ministry for Research and Education, Deutsche Kinderrheuma-Stiftung, and others. Some of the authors declared receiving honoraria and research grants from several sources.

Source: Walscheid K et al. J Rheumatol. 2022 (Jan 15). Doi: 10.3899/jrheum.210755.

Key clinical point: Patients with juvenile psoriatic arthritis (JPsA) were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody (ANA) positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

Major finding: Patients with JPsA with vs. without uveitis were younger at JPsA onset (5.3 years vs. 9.3 years) and were more frequently positive for ANA (60.3% vs. 37%; both P < .001). The mean clinical Juvenile Arthritis Disease Activity Score 10 was the only factor significantly associated with the development of uveitis in patients with JPsA (hazard ratio 1.16; P = .025).

Study details: This was an analysis of cross-sectional data from 1,862 patients with JPsA from the National Pediatric Rheumatological Database. Of the patients in the study, 122 developed uveitis.

Disclosures: This study was funded by the Federal Ministry for Research and Education, Deutsche Kinderrheuma-Stiftung, and others. Some of the authors declared receiving honoraria and research grants from several sources.

Source: Walscheid K et al. J Rheumatol. 2022 (Jan 15). Doi: 10.3899/jrheum.210755.

Key clinical point: Patients with juvenile psoriatic arthritis (JPsA) were more likely to develop uveitis if they were diagnosed with PsA at a younger age or were antinuclear antibody (ANA) positive, with higher disease activity being the only factor significantly associated with the presence of uveitis.

Major finding: Patients with JPsA with vs. without uveitis were younger at JPsA onset (5.3 years vs. 9.3 years) and were more frequently positive for ANA (60.3% vs. 37%; both P < .001). The mean clinical Juvenile Arthritis Disease Activity Score 10 was the only factor significantly associated with the development of uveitis in patients with JPsA (hazard ratio 1.16; P = .025).

Study details: This was an analysis of cross-sectional data from 1,862 patients with JPsA from the National Pediatric Rheumatological Database. Of the patients in the study, 122 developed uveitis.

Disclosures: This study was funded by the Federal Ministry for Research and Education, Deutsche Kinderrheuma-Stiftung, and others. Some of the authors declared receiving honoraria and research grants from several sources.

Source: Walscheid K et al. J Rheumatol. 2022 (Jan 15). Doi: 10.3899/jrheum.210755.