MDedge Rheumatology

Key clinical point: Concomitant use of antimalarials with biologic disease-modifying antirheumatic drugs (bDMARD) or Janus kinase inhibitors (JAKi) improved the overall safety profile and persistence of treatment in patients with rheumatoid arthritis (RA).

Major finding: The concomitant use vs nonuse of antimalarials was associated with a reduced risk for serious adverse events (multivariate incidence rate ratios [mIRR] 0.49; P < .001), total adverse events (mIRR 0.68; P < .001), and serious infections (mIRR 0.53; P = .007) and with longer survival of treatment course (hazard ratio 0.72; P = .003).

Study details: Findings are from a registry-based cohort study including 1316 patients with RA who initiated their first bDMARD or JAKi with (n = 280) or without (n = 1,036) concomitant antimalarials.

Disclosures: This study was supported by the Brazilian Society of Rheumatology and other sources. The authors declared no conflicts of interest.

Source: Bredemeier M et al, for the Brazilian Society of Rheumatology and the Brazilian Registry of Biological Therapies in Rheumatic Diseases (BiobadaBrasil). The effect of antimalarials on the safety and persistence of treatment with biologic agents or JAK inhibitors in rheumatoid arthritis. Rheumatology (Oxford). 2023 (May 22). doi: 10.1093/rheumatology/kead232

Key clinical point: Concomitant use of antimalarials with biologic disease-modifying antirheumatic drugs (bDMARD) or Janus kinase inhibitors (JAKi) improved the overall safety profile and persistence of treatment in patients with rheumatoid arthritis (RA).

Major finding: The concomitant use vs nonuse of antimalarials was associated with a reduced risk for serious adverse events (multivariate incidence rate ratios [mIRR] 0.49; P < .001), total adverse events (mIRR 0.68; P < .001), and serious infections (mIRR 0.53; P = .007) and with longer survival of treatment course (hazard ratio 0.72; P = .003).

Study details: Findings are from a registry-based cohort study including 1316 patients with RA who initiated their first bDMARD or JAKi with (n = 280) or without (n = 1,036) concomitant antimalarials.

Disclosures: This study was supported by the Brazilian Society of Rheumatology and other sources. The authors declared no conflicts of interest.

Source: Bredemeier M et al, for the Brazilian Society of Rheumatology and the Brazilian Registry of Biological Therapies in Rheumatic Diseases (BiobadaBrasil). The effect of antimalarials on the safety and persistence of treatment with biologic agents or JAK inhibitors in rheumatoid arthritis. Rheumatology (Oxford). 2023 (May 22). doi: 10.1093/rheumatology/kead232

Key clinical point: Concomitant use of antimalarials with biologic disease-modifying antirheumatic drugs (bDMARD) or Janus kinase inhibitors (JAKi) improved the overall safety profile and persistence of treatment in patients with rheumatoid arthritis (RA).

Major finding: The concomitant use vs nonuse of antimalarials was associated with a reduced risk for serious adverse events (multivariate incidence rate ratios [mIRR] 0.49; P < .001), total adverse events (mIRR 0.68; P < .001), and serious infections (mIRR 0.53; P = .007) and with longer survival of treatment course (hazard ratio 0.72; P = .003).

Study details: Findings are from a registry-based cohort study including 1316 patients with RA who initiated their first bDMARD or JAKi with (n = 280) or without (n = 1,036) concomitant antimalarials.

Disclosures: This study was supported by the Brazilian Society of Rheumatology and other sources. The authors declared no conflicts of interest.

Source: Bredemeier M et al, for the Brazilian Society of Rheumatology and the Brazilian Registry of Biological Therapies in Rheumatic Diseases (BiobadaBrasil). The effect of antimalarials on the safety and persistence of treatment with biologic agents or JAK inhibitors in rheumatoid arthritis. Rheumatology (Oxford). 2023 (May 22). doi: 10.1093/rheumatology/kead232

Key clinical point: Peresolimab, a humanized antibody stimulating the programmed cell death protein 1 inhibitory pathway, showed significant efficacy compared with placebo in improving disease activity in patients with moderate-to-severe rheumatoid arthritis (RA).

Major finding: At week 12, 700 mg peresolimab vs placebo was associated with a significantly greater change in Disease Activity Scores for 28 joints based on C-reactive protein levels (between-group difference in change from baseline −1.09; P < .001). The safety profiles were similar in all treatment groups, and no deaths were reported.

Study details: This phase 2a trial included 98 patients with moderate-to-severe RA and inadequate or loss of response to or unacceptable side effects with conventional synthetic disease-modifying antirheumatic drugs who were randomly assigned to receive peresolimab (300 or 700 mg) or placebo once every 4 weeks.

Disclosures: This study was supported by Eli Lilly. Five authors declared being employees of or owning stocks in Eli Lilly. Several authors declared ties with various sources, including Eli Lilly.

Source: Tuttle J et al. A phase 2 trial of peresolimab for adults with rheumatoid arthritis. N Engl J Med. 2023;388:1853-1862 (May 18). doi: 10.1056/NEJMoa2209856

Key clinical point: Peresolimab, a humanized antibody stimulating the programmed cell death protein 1 inhibitory pathway, showed significant efficacy compared with placebo in improving disease activity in patients with moderate-to-severe rheumatoid arthritis (RA).

Major finding: At week 12, 700 mg peresolimab vs placebo was associated with a significantly greater change in Disease Activity Scores for 28 joints based on C-reactive protein levels (between-group difference in change from baseline −1.09; P < .001). The safety profiles were similar in all treatment groups, and no deaths were reported.

Study details: This phase 2a trial included 98 patients with moderate-to-severe RA and inadequate or loss of response to or unacceptable side effects with conventional synthetic disease-modifying antirheumatic drugs who were randomly assigned to receive peresolimab (300 or 700 mg) or placebo once every 4 weeks.

Disclosures: This study was supported by Eli Lilly. Five authors declared being employees of or owning stocks in Eli Lilly. Several authors declared ties with various sources, including Eli Lilly.

Source: Tuttle J et al. A phase 2 trial of peresolimab for adults with rheumatoid arthritis. N Engl J Med. 2023;388:1853-1862 (May 18). doi: 10.1056/NEJMoa2209856

Key clinical point: Peresolimab, a humanized antibody stimulating the programmed cell death protein 1 inhibitory pathway, showed significant efficacy compared with placebo in improving disease activity in patients with moderate-to-severe rheumatoid arthritis (RA).

Major finding: At week 12, 700 mg peresolimab vs placebo was associated with a significantly greater change in Disease Activity Scores for 28 joints based on C-reactive protein levels (between-group difference in change from baseline −1.09; P < .001). The safety profiles were similar in all treatment groups, and no deaths were reported.

Study details: This phase 2a trial included 98 patients with moderate-to-severe RA and inadequate or loss of response to or unacceptable side effects with conventional synthetic disease-modifying antirheumatic drugs who were randomly assigned to receive peresolimab (300 or 700 mg) or placebo once every 4 weeks.

Disclosures: This study was supported by Eli Lilly. Five authors declared being employees of or owning stocks in Eli Lilly. Several authors declared ties with various sources, including Eli Lilly.

Source: Tuttle J et al. A phase 2 trial of peresolimab for adults with rheumatoid arthritis. N Engl J Med. 2023;388:1853-1862 (May 18). doi: 10.1056/NEJMoa2209856

Adalimumab, sold under the brand name Humira, enjoyed a long run as one of the world’s best-selling medicines. But its 20-year, competition-free period has ended, and despite its best efforts to delay their arrival, drug manufacturer AbbVie now faces increasing competition from biosimilars entering the marketplace.
 

But one biosimilar about to be launched may be something of a game changer. Coherus BioSciences has announced plans to market its biosimilar Yusimry (adalimumab-aqvh) at a cost of $995 for two autoinjectors. This represents an approximate 85% discount over Humira’s sale list price of $6922.

This price, however, is slated to plunge even further as Coherus has also revealed that it will work with the Mark Cuban Cost Plus Drug Company (MCCPDC) to offer an even lower price. When Yusimry launches in July, it will sell for about $579 for two autoinjectors, making it the lowest-priced adalimumab biosimilar on the market.

“Coherus and Cost Plus Drug Company share a common mission, to increase access to high-quality medicine for patients at an affordable price,” said Dennis Lanfear, MBA, president, CEO and chairman of Coherus. “Mark Cuban and his team offer innovative solutions to health care problems, and Coherus is also a highly innovative company focused on unmet patient needs.”

He noted that, with adalimumab biosimilar pricing, this translates to a low list price approach. “We are pleased that Yusimry will be a part of that, as the first biologic they carry,” Mr. Lanfear said.

MCCPDC prices are based on the cost of ingredients and manufacturing plus 15% margin, a $3 pharmacy dispensing fee, and a $5 shipping fee. The company has expanded its inventory from 100 generics to more than 350 medications since it launched in January 2022. While MCCPDC is primarily directed to people who are paying cash for drugs, it does take insurance from select plans. And even for people who are covered by other insurers, the cost of drugs from Mr. Cuban’s company may be less than their out-of-pocket costs if they did go through their payer.

The low pricing of Yusimry is welcome, said Marcus Snow, MD, an assistant professor in the division of rheumatology at the University of Nebraska Medical Center, Omaha, but he pointed out that it is still a very expensive drug. “For patients who can’t afford Humira due to poor insurance coverage and high out-of-pocket costs, it is a welcome option. But it’s also unclear how many patients who lack adequate health insurance coverage can afford to pay $579 a month out of their own pockets.”
 

The biosimilars are coming

By early December 2022, the Food and Drug Administration had approved seven Humira biosimilars, and Amgen launched the first biosimilar to come on the market, Amjevita, soon afterward. By July 2023, half a dozen more are expected to enter the marketplace, said Steven Horvitz, managing director of EMC Analytics Group, a pharmaceutical research firm.

Mr. Horvitz agrees that the system is out of control, but it is unclear how much of an effect the low price tag on the Coherus product will have. “Some insurers may say, ‘we want the lowest price, and we don’t care about rebates,’ and will go with it,” he said. “PBMs [pharmacy benefit managers] are all about economics, so we have to see how many of their major clients will ask for the lowest price.”

Amgen has more or less followed the status quo on pricing for its biosimilar, but with a twist. It›s being offered at two different prices: $85,494 a year, which is only a 5% discount from Humira’s list price, or at $40,497 a year, a 55% discount. However, to date, the lower price has generally not been granted favorable formulary placement by PBMs. The plans that adopt the higher-priced biosimilar will get bigger rebates, but patients with coinsurance and deductibles will pay more out of pocket.

It is yet unknown how the pricing on Yusimry will affect the biosimilars ready to launch. “Will it give them pause for thought or not make any difference?” Mr. Horvitz said. “The companies do not reveal their pricing before the fact, so we have to wait and see.”

Large PBMs have not jumped at the opportunity to offer the Coherus biosimilar, but SmithRx, which bills itself as “next-generation pharmacy benefits management,” announced that it will offer Yusimry to its members at a discount of more than 90%.

“Unlike traditional PBMs, SmithRx prioritizes transparency and up-front cost savings. Humira is often an employer’s top drug expense so offering a low-cost alternative will have significant impact,” Jake Frenz, CEO and founder of SmithRx, said in a statement. “We’re excited to work with Cost Plus Drugs to bring this biosimilar to our members – and significantly reduce costs for them and their employers.”

A version of this article first appeared on Medscape.com.

Adalimumab, sold under the brand name Humira, enjoyed a long run as one of the world’s best-selling medicines. But its 20-year, competition-free period has ended, and despite its best efforts to delay their arrival, drug manufacturer AbbVie now faces increasing competition from biosimilars entering the marketplace.
 

But one biosimilar about to be launched may be something of a game changer. Coherus BioSciences has announced plans to market its biosimilar Yusimry (adalimumab-aqvh) at a cost of $995 for two autoinjectors. This represents an approximate 85% discount over Humira’s sale list price of $6922.

This price, however, is slated to plunge even further as Coherus has also revealed that it will work with the Mark Cuban Cost Plus Drug Company (MCCPDC) to offer an even lower price. When Yusimry launches in July, it will sell for about $579 for two autoinjectors, making it the lowest-priced adalimumab biosimilar on the market.

“Coherus and Cost Plus Drug Company share a common mission, to increase access to high-quality medicine for patients at an affordable price,” said Dennis Lanfear, MBA, president, CEO and chairman of Coherus. “Mark Cuban and his team offer innovative solutions to health care problems, and Coherus is also a highly innovative company focused on unmet patient needs.”

He noted that, with adalimumab biosimilar pricing, this translates to a low list price approach. “We are pleased that Yusimry will be a part of that, as the first biologic they carry,” Mr. Lanfear said.

MCCPDC prices are based on the cost of ingredients and manufacturing plus 15% margin, a $3 pharmacy dispensing fee, and a $5 shipping fee. The company has expanded its inventory from 100 generics to more than 350 medications since it launched in January 2022. While MCCPDC is primarily directed to people who are paying cash for drugs, it does take insurance from select plans. And even for people who are covered by other insurers, the cost of drugs from Mr. Cuban’s company may be less than their out-of-pocket costs if they did go through their payer.

The low pricing of Yusimry is welcome, said Marcus Snow, MD, an assistant professor in the division of rheumatology at the University of Nebraska Medical Center, Omaha, but he pointed out that it is still a very expensive drug. “For patients who can’t afford Humira due to poor insurance coverage and high out-of-pocket costs, it is a welcome option. But it’s also unclear how many patients who lack adequate health insurance coverage can afford to pay $579 a month out of their own pockets.”
 

The biosimilars are coming

By early December 2022, the Food and Drug Administration had approved seven Humira biosimilars, and Amgen launched the first biosimilar to come on the market, Amjevita, soon afterward. By July 2023, half a dozen more are expected to enter the marketplace, said Steven Horvitz, managing director of EMC Analytics Group, a pharmaceutical research firm.

Mr. Horvitz agrees that the system is out of control, but it is unclear how much of an effect the low price tag on the Coherus product will have. “Some insurers may say, ‘we want the lowest price, and we don’t care about rebates,’ and will go with it,” he said. “PBMs [pharmacy benefit managers] are all about economics, so we have to see how many of their major clients will ask for the lowest price.”

Amgen has more or less followed the status quo on pricing for its biosimilar, but with a twist. It›s being offered at two different prices: $85,494 a year, which is only a 5% discount from Humira’s list price, or at $40,497 a year, a 55% discount. However, to date, the lower price has generally not been granted favorable formulary placement by PBMs. The plans that adopt the higher-priced biosimilar will get bigger rebates, but patients with coinsurance and deductibles will pay more out of pocket.

It is yet unknown how the pricing on Yusimry will affect the biosimilars ready to launch. “Will it give them pause for thought or not make any difference?” Mr. Horvitz said. “The companies do not reveal their pricing before the fact, so we have to wait and see.”

Large PBMs have not jumped at the opportunity to offer the Coherus biosimilar, but SmithRx, which bills itself as “next-generation pharmacy benefits management,” announced that it will offer Yusimry to its members at a discount of more than 90%.

“Unlike traditional PBMs, SmithRx prioritizes transparency and up-front cost savings. Humira is often an employer’s top drug expense so offering a low-cost alternative will have significant impact,” Jake Frenz, CEO and founder of SmithRx, said in a statement. “We’re excited to work with Cost Plus Drugs to bring this biosimilar to our members – and significantly reduce costs for them and their employers.”

A version of this article first appeared on Medscape.com.

Adalimumab, sold under the brand name Humira, enjoyed a long run as one of the world’s best-selling medicines. But its 20-year, competition-free period has ended, and despite its best efforts to delay their arrival, drug manufacturer AbbVie now faces increasing competition from biosimilars entering the marketplace.
 

But one biosimilar about to be launched may be something of a game changer. Coherus BioSciences has announced plans to market its biosimilar Yusimry (adalimumab-aqvh) at a cost of $995 for two autoinjectors. This represents an approximate 85% discount over Humira’s sale list price of $6922.

This price, however, is slated to plunge even further as Coherus has also revealed that it will work with the Mark Cuban Cost Plus Drug Company (MCCPDC) to offer an even lower price. When Yusimry launches in July, it will sell for about $579 for two autoinjectors, making it the lowest-priced adalimumab biosimilar on the market.

“Coherus and Cost Plus Drug Company share a common mission, to increase access to high-quality medicine for patients at an affordable price,” said Dennis Lanfear, MBA, president, CEO and chairman of Coherus. “Mark Cuban and his team offer innovative solutions to health care problems, and Coherus is also a highly innovative company focused on unmet patient needs.”

He noted that, with adalimumab biosimilar pricing, this translates to a low list price approach. “We are pleased that Yusimry will be a part of that, as the first biologic they carry,” Mr. Lanfear said.

MCCPDC prices are based on the cost of ingredients and manufacturing plus 15% margin, a $3 pharmacy dispensing fee, and a $5 shipping fee. The company has expanded its inventory from 100 generics to more than 350 medications since it launched in January 2022. While MCCPDC is primarily directed to people who are paying cash for drugs, it does take insurance from select plans. And even for people who are covered by other insurers, the cost of drugs from Mr. Cuban’s company may be less than their out-of-pocket costs if they did go through their payer.

The low pricing of Yusimry is welcome, said Marcus Snow, MD, an assistant professor in the division of rheumatology at the University of Nebraska Medical Center, Omaha, but he pointed out that it is still a very expensive drug. “For patients who can’t afford Humira due to poor insurance coverage and high out-of-pocket costs, it is a welcome option. But it’s also unclear how many patients who lack adequate health insurance coverage can afford to pay $579 a month out of their own pockets.”
 

The biosimilars are coming

By early December 2022, the Food and Drug Administration had approved seven Humira biosimilars, and Amgen launched the first biosimilar to come on the market, Amjevita, soon afterward. By July 2023, half a dozen more are expected to enter the marketplace, said Steven Horvitz, managing director of EMC Analytics Group, a pharmaceutical research firm.

Mr. Horvitz agrees that the system is out of control, but it is unclear how much of an effect the low price tag on the Coherus product will have. “Some insurers may say, ‘we want the lowest price, and we don’t care about rebates,’ and will go with it,” he said. “PBMs [pharmacy benefit managers] are all about economics, so we have to see how many of their major clients will ask for the lowest price.”

Amgen has more or less followed the status quo on pricing for its biosimilar, but with a twist. It›s being offered at two different prices: $85,494 a year, which is only a 5% discount from Humira’s list price, or at $40,497 a year, a 55% discount. However, to date, the lower price has generally not been granted favorable formulary placement by PBMs. The plans that adopt the higher-priced biosimilar will get bigger rebates, but patients with coinsurance and deductibles will pay more out of pocket.

It is yet unknown how the pricing on Yusimry will affect the biosimilars ready to launch. “Will it give them pause for thought or not make any difference?” Mr. Horvitz said. “The companies do not reveal their pricing before the fact, so we have to wait and see.”

Large PBMs have not jumped at the opportunity to offer the Coherus biosimilar, but SmithRx, which bills itself as “next-generation pharmacy benefits management,” announced that it will offer Yusimry to its members at a discount of more than 90%.

“Unlike traditional PBMs, SmithRx prioritizes transparency and up-front cost savings. Humira is often an employer’s top drug expense so offering a low-cost alternative will have significant impact,” Jake Frenz, CEO and founder of SmithRx, said in a statement. “We’re excited to work with Cost Plus Drugs to bring this biosimilar to our members – and significantly reduce costs for them and their employers.”

A version of this article first appeared on Medscape.com.

Key clinical point: The visceral fat mass and percentage body fat were significantly higher in patients with psoriatic arthritis (PsA) compared with control individuals, and moderate-to-high physical activity was associated with reduced visceral fat mass and percentage body fat.

Major finding: PsA was associated with a mean increase in visceral fat mass of 2.0 kg (95% CI 1.2-2.8 kg) and in percentage body fat of 2.7% (95% CI 1.6%-3.8%). Moderate and high vs low physical activity were associated with lower visceral fat mass and percentage body fat in patients with PsA and control individuals (P < .001).

Study details: The data come from a retrospective study including 356 patients with PsA and 47,470 control individuals.

Disclosures: This study was funded by the Faculty of Medicine and Health Sciences at Norwegian University of Science and Technology. M Hoff declared receiving speaker honoraria from AbbVie and Janssen Pharmaceuticals. No other conflicts of interest were declared.

Source: Osman AA et al. High physical activity in persons with psoriatic arthritis is associated with reduced visceral fat mass and percentage body fat: The Trøndelag Health study. Rheumatol Int. 2023 (Jun 5). doi: 10.1007/s00296-023-05348-9

Key clinical point: The visceral fat mass and percentage body fat were significantly higher in patients with psoriatic arthritis (PsA) compared with control individuals, and moderate-to-high physical activity was associated with reduced visceral fat mass and percentage body fat.

Major finding: PsA was associated with a mean increase in visceral fat mass of 2.0 kg (95% CI 1.2-2.8 kg) and in percentage body fat of 2.7% (95% CI 1.6%-3.8%). Moderate and high vs low physical activity were associated with lower visceral fat mass and percentage body fat in patients with PsA and control individuals (P < .001).

Study details: The data come from a retrospective study including 356 patients with PsA and 47,470 control individuals.

Disclosures: This study was funded by the Faculty of Medicine and Health Sciences at Norwegian University of Science and Technology. M Hoff declared receiving speaker honoraria from AbbVie and Janssen Pharmaceuticals. No other conflicts of interest were declared.

Source: Osman AA et al. High physical activity in persons with psoriatic arthritis is associated with reduced visceral fat mass and percentage body fat: The Trøndelag Health study. Rheumatol Int. 2023 (Jun 5). doi: 10.1007/s00296-023-05348-9

Key clinical point: The visceral fat mass and percentage body fat were significantly higher in patients with psoriatic arthritis (PsA) compared with control individuals, and moderate-to-high physical activity was associated with reduced visceral fat mass and percentage body fat.

Major finding: PsA was associated with a mean increase in visceral fat mass of 2.0 kg (95% CI 1.2-2.8 kg) and in percentage body fat of 2.7% (95% CI 1.6%-3.8%). Moderate and high vs low physical activity were associated with lower visceral fat mass and percentage body fat in patients with PsA and control individuals (P < .001).

Study details: The data come from a retrospective study including 356 patients with PsA and 47,470 control individuals.

Disclosures: This study was funded by the Faculty of Medicine and Health Sciences at Norwegian University of Science and Technology. M Hoff declared receiving speaker honoraria from AbbVie and Janssen Pharmaceuticals. No other conflicts of interest were declared.

Source: Osman AA et al. High physical activity in persons with psoriatic arthritis is associated with reduced visceral fat mass and percentage body fat: The Trøndelag Health study. Rheumatol Int. 2023 (Jun 5). doi: 10.1007/s00296-023-05348-9

Key clinical point: Patients with psoriatic arthritis (PsA), particularly women, have higher disease burden from the patient’s perspective than those with rheumatoid arthritis (RA).

Major finding: The mean Visual Analogue Scale scores for pain (34 vs 32; P < .001) and fatigue (35 vs 33; P = .001) were slightly higher in patients with PsA vs RA. Women with PsA vs RA across all age groups had significantly higher scores for pain (<50 years old: 28 vs 18; >70 years old: 48 vs 38) and fatigue (50-59 years old: 41 vs 31; >70 years old: 46 vs 36; all P < .05).

Study details: Findings are from a cross-sectional analysis including patients with PsA (n = 3598) and RA (n = 13,913).

Disclosures: This study was funded by State Research Funding, Kuopio University Hospital Catchment Area, Kuopio, Finland. The authors declared no conflicts of interest.

Source: Weman L et al. Disease burden measured by patient-reported outcomes: Does psoriatic arthritis feel worse than rheumatoid arthritis? A cross-sectional nationwide study. Clin Exp Rheumatol. 2023 (May 15). doi: 10.55563/clinexprheumatol/h9hn90

Key clinical point: Patients with psoriatic arthritis (PsA), particularly women, have higher disease burden from the patient’s perspective than those with rheumatoid arthritis (RA).

Major finding: The mean Visual Analogue Scale scores for pain (34 vs 32; P < .001) and fatigue (35 vs 33; P = .001) were slightly higher in patients with PsA vs RA. Women with PsA vs RA across all age groups had significantly higher scores for pain (<50 years old: 28 vs 18; >70 years old: 48 vs 38) and fatigue (50-59 years old: 41 vs 31; >70 years old: 46 vs 36; all P < .05).

Study details: Findings are from a cross-sectional analysis including patients with PsA (n = 3598) and RA (n = 13,913).

Disclosures: This study was funded by State Research Funding, Kuopio University Hospital Catchment Area, Kuopio, Finland. The authors declared no conflicts of interest.

Source: Weman L et al. Disease burden measured by patient-reported outcomes: Does psoriatic arthritis feel worse than rheumatoid arthritis? A cross-sectional nationwide study. Clin Exp Rheumatol. 2023 (May 15). doi: 10.55563/clinexprheumatol/h9hn90

Key clinical point: Patients with psoriatic arthritis (PsA), particularly women, have higher disease burden from the patient’s perspective than those with rheumatoid arthritis (RA).

Major finding: The mean Visual Analogue Scale scores for pain (34 vs 32; P < .001) and fatigue (35 vs 33; P = .001) were slightly higher in patients with PsA vs RA. Women with PsA vs RA across all age groups had significantly higher scores for pain (<50 years old: 28 vs 18; >70 years old: 48 vs 38) and fatigue (50-59 years old: 41 vs 31; >70 years old: 46 vs 36; all P < .05).

Study details: Findings are from a cross-sectional analysis including patients with PsA (n = 3598) and RA (n = 13,913).

Disclosures: This study was funded by State Research Funding, Kuopio University Hospital Catchment Area, Kuopio, Finland. The authors declared no conflicts of interest.

Source: Weman L et al. Disease burden measured by patient-reported outcomes: Does psoriatic arthritis feel worse than rheumatoid arthritis? A cross-sectional nationwide study. Clin Exp Rheumatol. 2023 (May 15). doi: 10.55563/clinexprheumatol/h9hn90

Key clinical point: Many patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) have impaired sleep despite treatment, with female patients having worse sleep quality than male patients.

Major finding: Overall, 46.6% of patients in the entire cohort had abnormal sleep behavior, with sleep quality being worse in women vs men (P < .001). Depressive symptoms (P < .001), female sex (P = .014), and Disease Activity Score in 28 joints (P = .003) predicted insomnia in PsA.

Study details: The data come from a retrospective medical chart analysis of 330 patients with spondyloarthritis, including 168 patients with PsA and 162 patients with axSpA.

Disclosures: This study was partly funded by an unrestricted grant from Novartis Pharma GmbH, Germany. Several authors, including the lead author, reported receiving speaker honoraria or research or travel grants or serving on advisory boards for several sources, including Novartis.

Source: Frede N et al. Sleep behaviour differs in women and men with psoriatic arthritis and axial spondyloarthritis with impact on quality of life and depressive symptoms. RMD Open. 2023;9:e002912 (May 19). doi: 10.1136/rmdopen-2022-002912

Key clinical point: Many patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) have impaired sleep despite treatment, with female patients having worse sleep quality than male patients.

Major finding: Overall, 46.6% of patients in the entire cohort had abnormal sleep behavior, with sleep quality being worse in women vs men (P < .001). Depressive symptoms (P < .001), female sex (P = .014), and Disease Activity Score in 28 joints (P = .003) predicted insomnia in PsA.

Study details: The data come from a retrospective medical chart analysis of 330 patients with spondyloarthritis, including 168 patients with PsA and 162 patients with axSpA.

Disclosures: This study was partly funded by an unrestricted grant from Novartis Pharma GmbH, Germany. Several authors, including the lead author, reported receiving speaker honoraria or research or travel grants or serving on advisory boards for several sources, including Novartis.

Source: Frede N et al. Sleep behaviour differs in women and men with psoriatic arthritis and axial spondyloarthritis with impact on quality of life and depressive symptoms. RMD Open. 2023;9:e002912 (May 19). doi: 10.1136/rmdopen-2022-002912

Key clinical point: Many patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) have impaired sleep despite treatment, with female patients having worse sleep quality than male patients.

Major finding: Overall, 46.6% of patients in the entire cohort had abnormal sleep behavior, with sleep quality being worse in women vs men (P < .001). Depressive symptoms (P < .001), female sex (P = .014), and Disease Activity Score in 28 joints (P = .003) predicted insomnia in PsA.

Study details: The data come from a retrospective medical chart analysis of 330 patients with spondyloarthritis, including 168 patients with PsA and 162 patients with axSpA.

Disclosures: This study was partly funded by an unrestricted grant from Novartis Pharma GmbH, Germany. Several authors, including the lead author, reported receiving speaker honoraria or research or travel grants or serving on advisory boards for several sources, including Novartis.

Source: Frede N et al. Sleep behaviour differs in women and men with psoriatic arthritis and axial spondyloarthritis with impact on quality of life and depressive symptoms. RMD Open. 2023;9:e002912 (May 19). doi: 10.1136/rmdopen-2022-002912

Key clinical point: Patients with psoriatic arthritis (PsA) and those with Behçet’s syndrome (BS) had significantly elevated levels of serum interleukin-36 alpha (IL-36α), although the extent was lesser in BS, highlighting the potential role of the serum IL-36α level in differential diagnosis between PsA and BS.

Major finding: The median serum IL-36α level in patients with BS (201.7 pg/mL) was significantly higher than that in control individuals (16.9 pg/mL; P < .001) but lower than that in patients with PsA (544 pg/mL; P < .001). An empirical cut-off level of 420.6 pg/mL for IL-36α showed a specificity of 0.93 and sensitivity of 0.70 to distinguish patients with PsA from those with BS.

Study details: The data come from a cross-sectional study including patients with PsA (n = 80) and BS (n = 90) and control individuals without immune-mediated inflammatory disease (n = 80) who were assessed for serum IL-36α levels.

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

Source: Bettiol A et al. Serum interleukin-36 α as a candidate biomarker to distinguish Behçet’s syndrome and psoriatic arthritis. Int J Mol Sci. 2023;24:8817 (May 16). doi: 10.3390/ijms24108817

Key clinical point: Patients with psoriatic arthritis (PsA) and those with Behçet’s syndrome (BS) had significantly elevated levels of serum interleukin-36 alpha (IL-36α), although the extent was lesser in BS, highlighting the potential role of the serum IL-36α level in differential diagnosis between PsA and BS.

Major finding: The median serum IL-36α level in patients with BS (201.7 pg/mL) was significantly higher than that in control individuals (16.9 pg/mL; P < .001) but lower than that in patients with PsA (544 pg/mL; P < .001). An empirical cut-off level of 420.6 pg/mL for IL-36α showed a specificity of 0.93 and sensitivity of 0.70 to distinguish patients with PsA from those with BS.

Study details: The data come from a cross-sectional study including patients with PsA (n = 80) and BS (n = 90) and control individuals without immune-mediated inflammatory disease (n = 80) who were assessed for serum IL-36α levels.

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

Source: Bettiol A et al. Serum interleukin-36 α as a candidate biomarker to distinguish Behçet’s syndrome and psoriatic arthritis. Int J Mol Sci. 2023;24:8817 (May 16). doi: 10.3390/ijms24108817

Key clinical point: Patients with psoriatic arthritis (PsA) and those with Behçet’s syndrome (BS) had significantly elevated levels of serum interleukin-36 alpha (IL-36α), although the extent was lesser in BS, highlighting the potential role of the serum IL-36α level in differential diagnosis between PsA and BS.

Major finding: The median serum IL-36α level in patients with BS (201.7 pg/mL) was significantly higher than that in control individuals (16.9 pg/mL; P < .001) but lower than that in patients with PsA (544 pg/mL; P < .001). An empirical cut-off level of 420.6 pg/mL for IL-36α showed a specificity of 0.93 and sensitivity of 0.70 to distinguish patients with PsA from those with BS.

Study details: The data come from a cross-sectional study including patients with PsA (n = 80) and BS (n = 90) and control individuals without immune-mediated inflammatory disease (n = 80) who were assessed for serum IL-36α levels.

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

Source: Bettiol A et al. Serum interleukin-36 α as a candidate biomarker to distinguish Behçet’s syndrome and psoriatic arthritis. Int J Mol Sci. 2023;24:8817 (May 16). doi: 10.3390/ijms24108817

Key clinical point: No clinically meaningful treatment-related differences were observed in the efficacy, safety, and treatment persistence of ustekinumab over 3 years in younger (<60 years) and older (≥60 years) patients with psoriatic arthritis (PsA).

Major finding: At 6 months, 51.7% and 43.8% of patients aged <60 and ≥60 years achieved clinical Disease Activity Index for Psoriatic Arthritis low disease activity, respectively, with the efficacy being maintained through 36 months. The proportions of patients reporting at least one (32.7% vs 40.9%) and serious (5.3% vs 9.6%) adverse events and treatment persistence were not significantly different among patients age < 60 vs ≥ 60 years.

Study details: This post hoc analysis of the PsABio trial included patients with PsA who received ustekinumab and were subgrouped into those age < 60 years (n = 336) and ≥ 60 years (n = 103).

Disclosures: This study was sponsored by Janssen. Six authors declared being current or former employees of Janssen or shareholders of Johnson & Johnson. Three authors reported ties with various sources, including Janssen.

Source: Gossec L et al. Response to treatment in psoriatic arthritis, the effect of age: analysis of patients receiving ustekinumab in the PsABio real-world study. Arthritis Res Ther. 2023;25:100 (Jun 9). doi: 10.1186/s13075-023-03078-8

Key clinical point: No clinically meaningful treatment-related differences were observed in the efficacy, safety, and treatment persistence of ustekinumab over 3 years in younger (<60 years) and older (≥60 years) patients with psoriatic arthritis (PsA).

Major finding: At 6 months, 51.7% and 43.8% of patients aged <60 and ≥60 years achieved clinical Disease Activity Index for Psoriatic Arthritis low disease activity, respectively, with the efficacy being maintained through 36 months. The proportions of patients reporting at least one (32.7% vs 40.9%) and serious (5.3% vs 9.6%) adverse events and treatment persistence were not significantly different among patients age < 60 vs ≥ 60 years.

Study details: This post hoc analysis of the PsABio trial included patients with PsA who received ustekinumab and were subgrouped into those age < 60 years (n = 336) and ≥ 60 years (n = 103).

Disclosures: This study was sponsored by Janssen. Six authors declared being current or former employees of Janssen or shareholders of Johnson & Johnson. Three authors reported ties with various sources, including Janssen.

Source: Gossec L et al. Response to treatment in psoriatic arthritis, the effect of age: analysis of patients receiving ustekinumab in the PsABio real-world study. Arthritis Res Ther. 2023;25:100 (Jun 9). doi: 10.1186/s13075-023-03078-8

Key clinical point: No clinically meaningful treatment-related differences were observed in the efficacy, safety, and treatment persistence of ustekinumab over 3 years in younger (<60 years) and older (≥60 years) patients with psoriatic arthritis (PsA).

Major finding: At 6 months, 51.7% and 43.8% of patients aged <60 and ≥60 years achieved clinical Disease Activity Index for Psoriatic Arthritis low disease activity, respectively, with the efficacy being maintained through 36 months. The proportions of patients reporting at least one (32.7% vs 40.9%) and serious (5.3% vs 9.6%) adverse events and treatment persistence were not significantly different among patients age < 60 vs ≥ 60 years.

Study details: This post hoc analysis of the PsABio trial included patients with PsA who received ustekinumab and were subgrouped into those age < 60 years (n = 336) and ≥ 60 years (n = 103).

Disclosures: This study was sponsored by Janssen. Six authors declared being current or former employees of Janssen or shareholders of Johnson & Johnson. Three authors reported ties with various sources, including Janssen.

Source: Gossec L et al. Response to treatment in psoriatic arthritis, the effect of age: analysis of patients receiving ustekinumab in the PsABio real-world study. Arthritis Res Ther. 2023;25:100 (Jun 9). doi: 10.1186/s13075-023-03078-8

Key clinical point: Apremilast led to a significant improvement in enthesitis and dactylitis activity among patients with psoriatic arthritis (PsA) presenting with enthesitis and dactylitis phenotypes, with more than one-third of patients achieving remission after 1 year of treatment.

Major finding: After 6 and 12 months of apremilast treatment, remission was achieved by 25% and 34% of patients with enthesitis and 47% and 44% of patients with dactylitis, respectively, with significant improvements in the Leeds Enthesitis and Dactylitis Indexes (P < .001).

Study details: Findings are from a retrospective study including patients with PsA who presented with either enthesitis (n = 118) or dactylitis (n = 96) phenotype and received apremilast.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Lo Gullo A et al. Therapeutic effects of apremilast on enthesitis and dactylitis in real clinical setting: An Italian multicenter study. J Clin Med. 2023;12:3892 (Jun 7). doi: 10.3390/jcm12123892

Key clinical point: Apremilast led to a significant improvement in enthesitis and dactylitis activity among patients with psoriatic arthritis (PsA) presenting with enthesitis and dactylitis phenotypes, with more than one-third of patients achieving remission after 1 year of treatment.

Major finding: After 6 and 12 months of apremilast treatment, remission was achieved by 25% and 34% of patients with enthesitis and 47% and 44% of patients with dactylitis, respectively, with significant improvements in the Leeds Enthesitis and Dactylitis Indexes (P < .001).

Study details: Findings are from a retrospective study including patients with PsA who presented with either enthesitis (n = 118) or dactylitis (n = 96) phenotype and received apremilast.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Lo Gullo A et al. Therapeutic effects of apremilast on enthesitis and dactylitis in real clinical setting: An Italian multicenter study. J Clin Med. 2023;12:3892 (Jun 7). doi: 10.3390/jcm12123892

Key clinical point: Apremilast led to a significant improvement in enthesitis and dactylitis activity among patients with psoriatic arthritis (PsA) presenting with enthesitis and dactylitis phenotypes, with more than one-third of patients achieving remission after 1 year of treatment.

Major finding: After 6 and 12 months of apremilast treatment, remission was achieved by 25% and 34% of patients with enthesitis and 47% and 44% of patients with dactylitis, respectively, with significant improvements in the Leeds Enthesitis and Dactylitis Indexes (P < .001).

Study details: Findings are from a retrospective study including patients with PsA who presented with either enthesitis (n = 118) or dactylitis (n = 96) phenotype and received apremilast.

Disclosures: This study received no external funding. The authors declared no conflicts of interest.

Source: Lo Gullo A et al. Therapeutic effects of apremilast on enthesitis and dactylitis in real clinical setting: An Italian multicenter study. J Clin Med. 2023;12:3892 (Jun 7). doi: 10.3390/jcm12123892

Key clinical point: Axial spondyloarthritis (axSpA) with or without concomitant psoriasis and axial psoriatic arthritis (PsA) appear distinct entities based on marked demographic, clinical, and genetic differences.

Major finding: Patients with axial PsA vs axSpA with or without psoriasis were older at symptom onset (48.6 vs 44.7 or 41.4 years, respectively; P < .001), had a higher prevalence of dactylitis (43.2% vs 18.3% or 8.4%, respectively; P < .001) and peripheral arthritis (86.7% vs 58.1% or 44.3%, respectively; P < .001), and were less frequently HLA-B27 positive (22.3% vs 55.4% or 65.5%, respectively; P < .001).

Study details: This study included 5208 patients with axSpA (with or without psoriasis) and 2771 with PsA (axial or peripheral arthritis) from the Swiss Clinical Quality Management (SCQM) registry.

Disclosures: This study was funded by Eli Lilly. Two authors declared being employees of SCQM with salary partly financed by Eli Lilly. Several authors declared receiving honoraria, speaking or consulting fees, research grants, or other financial support from various sources, including Lilly and other SCQM supporters. Two authors declared no conflicts of interest.

Source: Ciurea A et al. Characterisation of patients with axial psoriatic arthritis and patients with axial spondyloarthritis and concomitant psoriasis in the SCQM registry. RMD Open. 2023;9:e002956 (Jun 5). doi: 10.1136/rmdopen-2022-002956

Key clinical point: Axial spondyloarthritis (axSpA) with or without concomitant psoriasis and axial psoriatic arthritis (PsA) appear distinct entities based on marked demographic, clinical, and genetic differences.

Major finding: Patients with axial PsA vs axSpA with or without psoriasis were older at symptom onset (48.6 vs 44.7 or 41.4 years, respectively; P < .001), had a higher prevalence of dactylitis (43.2% vs 18.3% or 8.4%, respectively; P < .001) and peripheral arthritis (86.7% vs 58.1% or 44.3%, respectively; P < .001), and were less frequently HLA-B27 positive (22.3% vs 55.4% or 65.5%, respectively; P < .001).

Study details: This study included 5208 patients with axSpA (with or without psoriasis) and 2771 with PsA (axial or peripheral arthritis) from the Swiss Clinical Quality Management (SCQM) registry.

Disclosures: This study was funded by Eli Lilly. Two authors declared being employees of SCQM with salary partly financed by Eli Lilly. Several authors declared receiving honoraria, speaking or consulting fees, research grants, or other financial support from various sources, including Lilly and other SCQM supporters. Two authors declared no conflicts of interest.

Source: Ciurea A et al. Characterisation of patients with axial psoriatic arthritis and patients with axial spondyloarthritis and concomitant psoriasis in the SCQM registry. RMD Open. 2023;9:e002956 (Jun 5). doi: 10.1136/rmdopen-2022-002956

Key clinical point: Axial spondyloarthritis (axSpA) with or without concomitant psoriasis and axial psoriatic arthritis (PsA) appear distinct entities based on marked demographic, clinical, and genetic differences.

Major finding: Patients with axial PsA vs axSpA with or without psoriasis were older at symptom onset (48.6 vs 44.7 or 41.4 years, respectively; P < .001), had a higher prevalence of dactylitis (43.2% vs 18.3% or 8.4%, respectively; P < .001) and peripheral arthritis (86.7% vs 58.1% or 44.3%, respectively; P < .001), and were less frequently HLA-B27 positive (22.3% vs 55.4% or 65.5%, respectively; P < .001).

Study details: This study included 5208 patients with axSpA (with or without psoriasis) and 2771 with PsA (axial or peripheral arthritis) from the Swiss Clinical Quality Management (SCQM) registry.

Disclosures: This study was funded by Eli Lilly. Two authors declared being employees of SCQM with salary partly financed by Eli Lilly. Several authors declared receiving honoraria, speaking or consulting fees, research grants, or other financial support from various sources, including Lilly and other SCQM supporters. Two authors declared no conflicts of interest.

Source: Ciurea A et al. Characterisation of patients with axial psoriatic arthritis and patients with axial spondyloarthritis and concomitant psoriasis in the SCQM registry. RMD Open. 2023;9:e002956 (Jun 5). doi: 10.1136/rmdopen-2022-002956