Erenumab May Worsen Hypertension in Patients with Migraine

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Key clinical point: Nearly a quarter of patients with migraine who initiated erenumab experienced worsening blood pressure (BP), especially those with atrial fibrillation, highlighting the need for routine BP monitoring among these patients.

Major finding: Among patients with migraine receiving erenumab, 23.3% had worsening BP and 3.9% had an improvement in BP, with the risk of worsening BP being significantly higher among those with atrial fibrillation (adjusted odds ratio 4.72; P = .040). However, worsening BP was not associated with preexisting hypertension, sex, body mass index, and age.

Study details: This single-center observational retrospective cohort study included patients with migraine with (n = 70) and without (n = 265) preexisting hypertension who were treated with erenumab.

Disclosures: This study did not disclose the funding source. Dr David Dodick declared receiving research support, honoraria, and payment or honoraria for lectures from; serving on advisory boards or as a consultant for; and holding stock or stock options in various sources.

Source: Chhabra N, Mead-Harvey C, Dodoo CA, et al. Blood pressure elevation in erenumab-treated patients with migraine: A retrospective real-world experience. Headache. 2024 (Feb 27). doi: 10.1111/head.14679 Source

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Key clinical point: Nearly a quarter of patients with migraine who initiated erenumab experienced worsening blood pressure (BP), especially those with atrial fibrillation, highlighting the need for routine BP monitoring among these patients.

Major finding: Among patients with migraine receiving erenumab, 23.3% had worsening BP and 3.9% had an improvement in BP, with the risk of worsening BP being significantly higher among those with atrial fibrillation (adjusted odds ratio 4.72; P = .040). However, worsening BP was not associated with preexisting hypertension, sex, body mass index, and age.

Study details: This single-center observational retrospective cohort study included patients with migraine with (n = 70) and without (n = 265) preexisting hypertension who were treated with erenumab.

Disclosures: This study did not disclose the funding source. Dr David Dodick declared receiving research support, honoraria, and payment or honoraria for lectures from; serving on advisory boards or as a consultant for; and holding stock or stock options in various sources.

Source: Chhabra N, Mead-Harvey C, Dodoo CA, et al. Blood pressure elevation in erenumab-treated patients with migraine: A retrospective real-world experience. Headache. 2024 (Feb 27). doi: 10.1111/head.14679 Source

Key clinical point: Nearly a quarter of patients with migraine who initiated erenumab experienced worsening blood pressure (BP), especially those with atrial fibrillation, highlighting the need for routine BP monitoring among these patients.

Major finding: Among patients with migraine receiving erenumab, 23.3% had worsening BP and 3.9% had an improvement in BP, with the risk of worsening BP being significantly higher among those with atrial fibrillation (adjusted odds ratio 4.72; P = .040). However, worsening BP was not associated with preexisting hypertension, sex, body mass index, and age.

Study details: This single-center observational retrospective cohort study included patients with migraine with (n = 70) and without (n = 265) preexisting hypertension who were treated with erenumab.

Disclosures: This study did not disclose the funding source. Dr David Dodick declared receiving research support, honoraria, and payment or honoraria for lectures from; serving on advisory boards or as a consultant for; and holding stock or stock options in various sources.

Source: Chhabra N, Mead-Harvey C, Dodoo CA, et al. Blood pressure elevation in erenumab-treated patients with migraine: A retrospective real-world experience. Headache. 2024 (Feb 27). doi: 10.1111/head.14679 Source

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Comparing Efficacy and Safety of Atogepant and Rimegepant for Migraine Prevention

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Key clinical point: Atogepant led to greater improvements in efficacy and quality of life than rimegepant in patients with episodic migraine (EM), although both treatments had comparable safety profiles.

Major finding: Atogepant vs rimegepant led to significantly greater reductions in mean monthly migraine days (mean difference [MD] 1.65; P < .001) and acute medication use days (MD 2.08; P < .0001) across 1-12 weeks and significantly greater improvements in Migraine-Specific Quality of Life questionnaire version 2.1 Role Function-Restrictive domain scores at 12 weeks (MD 7.36; P < .01). Both treatments had comparable safety or tolerability profiles.

Study details: This anchored matching-adjusted indirect comparison analysis compared the efficacy and safety or tolerability of once-daily atogepant (60 mg) and once-every-other-day rimegepant (75 mg) for EM prevention using data from two phase 3 trials for atogepant (ADVANCE and PROGRESS) and one phase 2/3 trial for rimegepant.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of or holding stocks in AbbVie at the time of the study. Two authors are employees of Luminity, which was paid by AbbVie for the statistical analyses in this study. The other authors declared ties with various sources, including AbbVie. One author is an associate editor of Cephalalgia.

Source: Tassorelli C, Onishchenko K, Halker Singh RB, et al. Comparative efficacy, quality of life, safety, and tolerability of atogepant and rimegepant in migraine prevention: A matching-adjusted indirect comparison analysis. Cephalalgia. 2024 (Feb 27). doi: 10.1177/03331024241235156 Source

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Key clinical point: Atogepant led to greater improvements in efficacy and quality of life than rimegepant in patients with episodic migraine (EM), although both treatments had comparable safety profiles.

Major finding: Atogepant vs rimegepant led to significantly greater reductions in mean monthly migraine days (mean difference [MD] 1.65; P < .001) and acute medication use days (MD 2.08; P < .0001) across 1-12 weeks and significantly greater improvements in Migraine-Specific Quality of Life questionnaire version 2.1 Role Function-Restrictive domain scores at 12 weeks (MD 7.36; P < .01). Both treatments had comparable safety or tolerability profiles.

Study details: This anchored matching-adjusted indirect comparison analysis compared the efficacy and safety or tolerability of once-daily atogepant (60 mg) and once-every-other-day rimegepant (75 mg) for EM prevention using data from two phase 3 trials for atogepant (ADVANCE and PROGRESS) and one phase 2/3 trial for rimegepant.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of or holding stocks in AbbVie at the time of the study. Two authors are employees of Luminity, which was paid by AbbVie for the statistical analyses in this study. The other authors declared ties with various sources, including AbbVie. One author is an associate editor of Cephalalgia.

Source: Tassorelli C, Onishchenko K, Halker Singh RB, et al. Comparative efficacy, quality of life, safety, and tolerability of atogepant and rimegepant in migraine prevention: A matching-adjusted indirect comparison analysis. Cephalalgia. 2024 (Feb 27). doi: 10.1177/03331024241235156 Source

Key clinical point: Atogepant led to greater improvements in efficacy and quality of life than rimegepant in patients with episodic migraine (EM), although both treatments had comparable safety profiles.

Major finding: Atogepant vs rimegepant led to significantly greater reductions in mean monthly migraine days (mean difference [MD] 1.65; P < .001) and acute medication use days (MD 2.08; P < .0001) across 1-12 weeks and significantly greater improvements in Migraine-Specific Quality of Life questionnaire version 2.1 Role Function-Restrictive domain scores at 12 weeks (MD 7.36; P < .01). Both treatments had comparable safety or tolerability profiles.

Study details: This anchored matching-adjusted indirect comparison analysis compared the efficacy and safety or tolerability of once-daily atogepant (60 mg) and once-every-other-day rimegepant (75 mg) for EM prevention using data from two phase 3 trials for atogepant (ADVANCE and PROGRESS) and one phase 2/3 trial for rimegepant.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of or holding stocks in AbbVie at the time of the study. Two authors are employees of Luminity, which was paid by AbbVie for the statistical analyses in this study. The other authors declared ties with various sources, including AbbVie. One author is an associate editor of Cephalalgia.

Source: Tassorelli C, Onishchenko K, Halker Singh RB, et al. Comparative efficacy, quality of life, safety, and tolerability of atogepant and rimegepant in migraine prevention: A matching-adjusted indirect comparison analysis. Cephalalgia. 2024 (Feb 27). doi: 10.1177/03331024241235156 Source

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OnabotulinumtoxinA Reduces Interictal Burden and Allodynia Severity in Chronic Migraine

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Key clinical point: OnabotulinumtoxinA (BoNTA) had beneficial effects in reducing frequency or severity of interictal burden and cutaneous allodynia in patients with chronic migraine (CM).

Major finding: After three courses of BoNTA treatment, median Migraine Interictal Burden Scale-4 scores significantly reduced from 9 at baseline to 2 (z 7.222), median Allodynia Symptom Checklist-12 scores significantly reduced from 6 at baseline to 1 (z 5.393), and median pain intensity numerical rating scale scores for hair brushing significantly reduced from 5 at baseline to 1 (z −5.398; all P < .001).

Study details: This prospective open-label study included 70 BoNTA-naive patients with CM who received three consecutive cycles of BoNTA.

Disclosures: This study did not receive any funding. Several authors declared receiving investigator fees or travel grants from or serving as advisory board members or consultants for various sources.

Source: Argyriou AA, Dermitzakis EV, Rikos D, et al. Effects of onabotulinumtoxinA on allodynia and interictal burden of patients with chronic migraine. Toxins (Basel). 2024;16(2):106 (Feb 15). doi: 10.3390/toxins16020106 Source

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Key clinical point: OnabotulinumtoxinA (BoNTA) had beneficial effects in reducing frequency or severity of interictal burden and cutaneous allodynia in patients with chronic migraine (CM).

Major finding: After three courses of BoNTA treatment, median Migraine Interictal Burden Scale-4 scores significantly reduced from 9 at baseline to 2 (z 7.222), median Allodynia Symptom Checklist-12 scores significantly reduced from 6 at baseline to 1 (z 5.393), and median pain intensity numerical rating scale scores for hair brushing significantly reduced from 5 at baseline to 1 (z −5.398; all P < .001).

Study details: This prospective open-label study included 70 BoNTA-naive patients with CM who received three consecutive cycles of BoNTA.

Disclosures: This study did not receive any funding. Several authors declared receiving investigator fees or travel grants from or serving as advisory board members or consultants for various sources.

Source: Argyriou AA, Dermitzakis EV, Rikos D, et al. Effects of onabotulinumtoxinA on allodynia and interictal burden of patients with chronic migraine. Toxins (Basel). 2024;16(2):106 (Feb 15). doi: 10.3390/toxins16020106 Source

Key clinical point: OnabotulinumtoxinA (BoNTA) had beneficial effects in reducing frequency or severity of interictal burden and cutaneous allodynia in patients with chronic migraine (CM).

Major finding: After three courses of BoNTA treatment, median Migraine Interictal Burden Scale-4 scores significantly reduced from 9 at baseline to 2 (z 7.222), median Allodynia Symptom Checklist-12 scores significantly reduced from 6 at baseline to 1 (z 5.393), and median pain intensity numerical rating scale scores for hair brushing significantly reduced from 5 at baseline to 1 (z −5.398; all P < .001).

Study details: This prospective open-label study included 70 BoNTA-naive patients with CM who received three consecutive cycles of BoNTA.

Disclosures: This study did not receive any funding. Several authors declared receiving investigator fees or travel grants from or serving as advisory board members or consultants for various sources.

Source: Argyriou AA, Dermitzakis EV, Rikos D, et al. Effects of onabotulinumtoxinA on allodynia and interictal burden of patients with chronic migraine. Toxins (Basel). 2024;16(2):106 (Feb 15). doi: 10.3390/toxins16020106 Source

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Atogepant Effective and Safe in Pretreated Episodic Migraine, Shows Phase 3 Study

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Key clinical point: Atogepant (dosage 60 mg/day) may be an effective and safe treatment option in patients with difficult to treat episodic migraine who have previously failed 2-4 conventional oral preventive treatments.

Major finding: Patients receiving atogepant vs placebo had a significantly greater reduction in monthly migraine days across 12 weeks (adjusted least squares mean difference −2.4 days; P < .0001). Constipation was the most common treatment-emergent adverse event (TEAE) in the atogepant group (10%), with TEAE leading to treatment discontinuation in only 2% vs 1% of patients receiving atogepant vs placebo.

Study details: Findings are from the phase 3b ELEVATE trial including 315 patients with episodic migraine who had previously failed 2-4 classes of conventional oral migraine prevention treatments and were randomly assigned to receive 60 mg/day atogepant or placebo.

Disclosures: This study was funded by AbbVie. Five authors declared being employees of or holding stocks in AbbVie. The other authors declared ties with various sources, including AbbVie.

Source: Tassorelli C, Nagy K, Pozo-Rosich P, et al. Safety and efficacy of atogepant for the preventive treatment of episodic migraine in adults for whom conventional oral preventive treatments have failed (ELEVATE): A randomised, placebo-controlled, phase 3b trial. Lancet Neurol. 2024 (Feb 13). doi: 10.1016/S1474-4422(24)00025-5 Source

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Key clinical point: Atogepant (dosage 60 mg/day) may be an effective and safe treatment option in patients with difficult to treat episodic migraine who have previously failed 2-4 conventional oral preventive treatments.

Major finding: Patients receiving atogepant vs placebo had a significantly greater reduction in monthly migraine days across 12 weeks (adjusted least squares mean difference −2.4 days; P < .0001). Constipation was the most common treatment-emergent adverse event (TEAE) in the atogepant group (10%), with TEAE leading to treatment discontinuation in only 2% vs 1% of patients receiving atogepant vs placebo.

Study details: Findings are from the phase 3b ELEVATE trial including 315 patients with episodic migraine who had previously failed 2-4 classes of conventional oral migraine prevention treatments and were randomly assigned to receive 60 mg/day atogepant or placebo.

Disclosures: This study was funded by AbbVie. Five authors declared being employees of or holding stocks in AbbVie. The other authors declared ties with various sources, including AbbVie.

Source: Tassorelli C, Nagy K, Pozo-Rosich P, et al. Safety and efficacy of atogepant for the preventive treatment of episodic migraine in adults for whom conventional oral preventive treatments have failed (ELEVATE): A randomised, placebo-controlled, phase 3b trial. Lancet Neurol. 2024 (Feb 13). doi: 10.1016/S1474-4422(24)00025-5 Source

Key clinical point: Atogepant (dosage 60 mg/day) may be an effective and safe treatment option in patients with difficult to treat episodic migraine who have previously failed 2-4 conventional oral preventive treatments.

Major finding: Patients receiving atogepant vs placebo had a significantly greater reduction in monthly migraine days across 12 weeks (adjusted least squares mean difference −2.4 days; P < .0001). Constipation was the most common treatment-emergent adverse event (TEAE) in the atogepant group (10%), with TEAE leading to treatment discontinuation in only 2% vs 1% of patients receiving atogepant vs placebo.

Study details: Findings are from the phase 3b ELEVATE trial including 315 patients with episodic migraine who had previously failed 2-4 classes of conventional oral migraine prevention treatments and were randomly assigned to receive 60 mg/day atogepant or placebo.

Disclosures: This study was funded by AbbVie. Five authors declared being employees of or holding stocks in AbbVie. The other authors declared ties with various sources, including AbbVie.

Source: Tassorelli C, Nagy K, Pozo-Rosich P, et al. Safety and efficacy of atogepant for the preventive treatment of episodic migraine in adults for whom conventional oral preventive treatments have failed (ELEVATE): A randomised, placebo-controlled, phase 3b trial. Lancet Neurol. 2024 (Feb 13). doi: 10.1016/S1474-4422(24)00025-5 Source

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Do Migraine and Vasomotor Symptoms Raise CVD Risk in Women?

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Key clinical point: Persistent vasomotor symptoms (VMS) and a history of migraine were associated with an increased risk for cardiovascular disease (CVD) and stroke; however, these associations were attenuated after adjustment for CVD risk factors, such as blood pressure and glucose and cholesterol levels.

Major finding: Women with vs without persistent VMS and a history of migraine had over two times higher risk for CVD (adjusted HR [aHR] 2.25; 95% CI 1.15-4.38) and three times higher risk for stroke (aHR 3.15; 95% CI 1.35-7.34; both P < .05). These associations, however, diminished after adjustment for cigarette use and levels of glucose, cholesterol, and blood pressure.

Study details: This secondary analysis of a subset of the CARDIA study included 1954 women with 15-year follow-up data.

Disclosures: This study was supported by the US National Heart, Lung, and Blood Institute. The authors declared no conflicts of interest.

Source: Kim C, Schreiner PJ, Yin Z, et al. Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study. Menopause. 2024;31(3):202-208 (Feb 13). doi: 10.1097/GME.0000000000002311 Source

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Key clinical point: Persistent vasomotor symptoms (VMS) and a history of migraine were associated with an increased risk for cardiovascular disease (CVD) and stroke; however, these associations were attenuated after adjustment for CVD risk factors, such as blood pressure and glucose and cholesterol levels.

Major finding: Women with vs without persistent VMS and a history of migraine had over two times higher risk for CVD (adjusted HR [aHR] 2.25; 95% CI 1.15-4.38) and three times higher risk for stroke (aHR 3.15; 95% CI 1.35-7.34; both P < .05). These associations, however, diminished after adjustment for cigarette use and levels of glucose, cholesterol, and blood pressure.

Study details: This secondary analysis of a subset of the CARDIA study included 1954 women with 15-year follow-up data.

Disclosures: This study was supported by the US National Heart, Lung, and Blood Institute. The authors declared no conflicts of interest.

Source: Kim C, Schreiner PJ, Yin Z, et al. Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study. Menopause. 2024;31(3):202-208 (Feb 13). doi: 10.1097/GME.0000000000002311 Source

Key clinical point: Persistent vasomotor symptoms (VMS) and a history of migraine were associated with an increased risk for cardiovascular disease (CVD) and stroke; however, these associations were attenuated after adjustment for CVD risk factors, such as blood pressure and glucose and cholesterol levels.

Major finding: Women with vs without persistent VMS and a history of migraine had over two times higher risk for CVD (adjusted HR [aHR] 2.25; 95% CI 1.15-4.38) and three times higher risk for stroke (aHR 3.15; 95% CI 1.35-7.34; both P < .05). These associations, however, diminished after adjustment for cigarette use and levels of glucose, cholesterol, and blood pressure.

Study details: This secondary analysis of a subset of the CARDIA study included 1954 women with 15-year follow-up data.

Disclosures: This study was supported by the US National Heart, Lung, and Blood Institute. The authors declared no conflicts of interest.

Source: Kim C, Schreiner PJ, Yin Z, et al. Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study. Menopause. 2024;31(3):202-208 (Feb 13). doi: 10.1097/GME.0000000000002311 Source

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Meta-analysis Shows Link Between Shift Work and Risk for Headache and Migraine

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Key clinical point: Shift work was associated with significantly increased risks for headache and migraine, whereas night shifts only increased the risk for headaches.

Major finding: Shift work was significantly associated with an increased risk for headaches (hazard ratio [HR] 1.32; P < .001) and migraine (HR 1.63; P < .001), with the risk for headaches being further elevated in individuals who worked night shifts (HR 1.44; P = .011).

Study details: Findings are from a meta-analysis of seven cross-sectional studies that included 422,869 participants.

Disclosures: This study was supported by the Sichuan Youth Science and Technology Innovation Research Team. The authors declared no conflicts of interest.

Source: Wang Z, Zhu T, Gong M, et al. Relationship between shift work, night work, and headache and migraine risk: A meta-analysis of observational studies. Sleep Med. 2024;115:218-225 (Feb 19). doi: 10.1016/j.sleep.2024.02.011 Source

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Key clinical point: Shift work was associated with significantly increased risks for headache and migraine, whereas night shifts only increased the risk for headaches.

Major finding: Shift work was significantly associated with an increased risk for headaches (hazard ratio [HR] 1.32; P < .001) and migraine (HR 1.63; P < .001), with the risk for headaches being further elevated in individuals who worked night shifts (HR 1.44; P = .011).

Study details: Findings are from a meta-analysis of seven cross-sectional studies that included 422,869 participants.

Disclosures: This study was supported by the Sichuan Youth Science and Technology Innovation Research Team. The authors declared no conflicts of interest.

Source: Wang Z, Zhu T, Gong M, et al. Relationship between shift work, night work, and headache and migraine risk: A meta-analysis of observational studies. Sleep Med. 2024;115:218-225 (Feb 19). doi: 10.1016/j.sleep.2024.02.011 Source

Key clinical point: Shift work was associated with significantly increased risks for headache and migraine, whereas night shifts only increased the risk for headaches.

Major finding: Shift work was significantly associated with an increased risk for headaches (hazard ratio [HR] 1.32; P < .001) and migraine (HR 1.63; P < .001), with the risk for headaches being further elevated in individuals who worked night shifts (HR 1.44; P = .011).

Study details: Findings are from a meta-analysis of seven cross-sectional studies that included 422,869 participants.

Disclosures: This study was supported by the Sichuan Youth Science and Technology Innovation Research Team. The authors declared no conflicts of interest.

Source: Wang Z, Zhu T, Gong M, et al. Relationship between shift work, night work, and headache and migraine risk: A meta-analysis of observational studies. Sleep Med. 2024;115:218-225 (Feb 19). doi: 10.1016/j.sleep.2024.02.011 Source

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Factors Associated with Patient-Reported Treatment Success in PsA

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Key clinical point: Improvements in inflammatory arthritis, pain, physical functioning, and the use of tumor necrosis factor (TNF) inhibitors were associated with patient-reported treatment success in patients with psoriatic arthritis (PsA).

Major finding: Increased odds for patient-reported treatment success was seen with TNF inhibitors therapy (odds ratio [OR] 12.86, 95% CI 1.50-110.47), while pain, fatigue, and swollen and tender joint counts reduced the odds of treatment success (OR < 1.00, P < .05). Each point increase in the physical function score was associated with 12%-14% increased odds of treatment success.

Study details: This single-center study included 178 patients with PsA, of which 116 patients reported treatment success.

Disclosures: This study was supported by Celgene; Amgen; Johns Hopkins School of Medicine Biostatistics, Epidemiology and Data Management Core; and others. Two authors declared serving as principal investigators or private consultants for or having other ties with various sources, including Amgen or John Hopkins University. The other authors declared no conflicts of interest.

Source: Samuel C, Finney A, Grader-Beck T, et al. Characteristics associated with patient-reported treatment success in psoriatic arthritis. Rheumatology (Oxford). 2024 (Mar 9). doi: 10.1093/rheumatology/keae149 Source

 

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Key clinical point: Improvements in inflammatory arthritis, pain, physical functioning, and the use of tumor necrosis factor (TNF) inhibitors were associated with patient-reported treatment success in patients with psoriatic arthritis (PsA).

Major finding: Increased odds for patient-reported treatment success was seen with TNF inhibitors therapy (odds ratio [OR] 12.86, 95% CI 1.50-110.47), while pain, fatigue, and swollen and tender joint counts reduced the odds of treatment success (OR < 1.00, P < .05). Each point increase in the physical function score was associated with 12%-14% increased odds of treatment success.

Study details: This single-center study included 178 patients with PsA, of which 116 patients reported treatment success.

Disclosures: This study was supported by Celgene; Amgen; Johns Hopkins School of Medicine Biostatistics, Epidemiology and Data Management Core; and others. Two authors declared serving as principal investigators or private consultants for or having other ties with various sources, including Amgen or John Hopkins University. The other authors declared no conflicts of interest.

Source: Samuel C, Finney A, Grader-Beck T, et al. Characteristics associated with patient-reported treatment success in psoriatic arthritis. Rheumatology (Oxford). 2024 (Mar 9). doi: 10.1093/rheumatology/keae149 Source

 

Key clinical point: Improvements in inflammatory arthritis, pain, physical functioning, and the use of tumor necrosis factor (TNF) inhibitors were associated with patient-reported treatment success in patients with psoriatic arthritis (PsA).

Major finding: Increased odds for patient-reported treatment success was seen with TNF inhibitors therapy (odds ratio [OR] 12.86, 95% CI 1.50-110.47), while pain, fatigue, and swollen and tender joint counts reduced the odds of treatment success (OR < 1.00, P < .05). Each point increase in the physical function score was associated with 12%-14% increased odds of treatment success.

Study details: This single-center study included 178 patients with PsA, of which 116 patients reported treatment success.

Disclosures: This study was supported by Celgene; Amgen; Johns Hopkins School of Medicine Biostatistics, Epidemiology and Data Management Core; and others. Two authors declared serving as principal investigators or private consultants for or having other ties with various sources, including Amgen or John Hopkins University. The other authors declared no conflicts of interest.

Source: Samuel C, Finney A, Grader-Beck T, et al. Characteristics associated with patient-reported treatment success in psoriatic arthritis. Rheumatology (Oxford). 2024 (Mar 9). doi: 10.1093/rheumatology/keae149 Source

 

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Cytokine Profiles and Response to TNFα Inhibitor And IL-17A Inhibitor In PsA: Any Link?

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Key clinical point: Patients with psoriatic arthritis (PsA) who did or did not respond to treatment with tumor necrosis factor alpha inhibitor (TNFi) and interleukin-17A inhibitor (IL-17Ai) showed different profiles of pro- and anti- inflammatory cytokines.

Major finding: At 4 months of follow up, a significant decrease in IL-6 (P  =  .032) and an increase in IL-10 (P  =  .010) was seen in patients achieving ≥ 50% improvement in Disease Activity in PsA (DAPSA50) response with TNFi treatment. IL-17Ai treatment showed decrease in IL-1α and IL-27 levels in DAPSA50 responders and increase in IL-17A in both DAPSA 50 responders and non-responders (all P < .05).  

Study details: This study included 68 patients with PsA who were initiated with TNFi (n = 29), IL-17Ai (n = 19), or methotrexate (n = 20) treatment and were followed for 4 months.

Disclosure: This study was supported by Eli Lilly and Co., the Danish Rheumatism Association, and others. Two authors declared receiving research funding, speaker fees, and other ties with various sources, including Eli Lilly and the Danish Rheumatism Association. Two authors declared no conflicts of interest.

Source: Skougaard M, Sondergaard MF, Ditlev SB, Kristensen LE. Changes in inflammatory cytokines in responders and non-responders to TNFα inhibitor and IL-17A inhibitor: A study examining psoriatic arthritis patients. Int J Mol Sci. 2024:25(5);3002 (Mar 5). doi: 10.3390/ijms25053002 Source

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Key clinical point: Patients with psoriatic arthritis (PsA) who did or did not respond to treatment with tumor necrosis factor alpha inhibitor (TNFi) and interleukin-17A inhibitor (IL-17Ai) showed different profiles of pro- and anti- inflammatory cytokines.

Major finding: At 4 months of follow up, a significant decrease in IL-6 (P  =  .032) and an increase in IL-10 (P  =  .010) was seen in patients achieving ≥ 50% improvement in Disease Activity in PsA (DAPSA50) response with TNFi treatment. IL-17Ai treatment showed decrease in IL-1α and IL-27 levels in DAPSA50 responders and increase in IL-17A in both DAPSA 50 responders and non-responders (all P < .05).  

Study details: This study included 68 patients with PsA who were initiated with TNFi (n = 29), IL-17Ai (n = 19), or methotrexate (n = 20) treatment and were followed for 4 months.

Disclosure: This study was supported by Eli Lilly and Co., the Danish Rheumatism Association, and others. Two authors declared receiving research funding, speaker fees, and other ties with various sources, including Eli Lilly and the Danish Rheumatism Association. Two authors declared no conflicts of interest.

Source: Skougaard M, Sondergaard MF, Ditlev SB, Kristensen LE. Changes in inflammatory cytokines in responders and non-responders to TNFα inhibitor and IL-17A inhibitor: A study examining psoriatic arthritis patients. Int J Mol Sci. 2024:25(5);3002 (Mar 5). doi: 10.3390/ijms25053002 Source

Key clinical point: Patients with psoriatic arthritis (PsA) who did or did not respond to treatment with tumor necrosis factor alpha inhibitor (TNFi) and interleukin-17A inhibitor (IL-17Ai) showed different profiles of pro- and anti- inflammatory cytokines.

Major finding: At 4 months of follow up, a significant decrease in IL-6 (P  =  .032) and an increase in IL-10 (P  =  .010) was seen in patients achieving ≥ 50% improvement in Disease Activity in PsA (DAPSA50) response with TNFi treatment. IL-17Ai treatment showed decrease in IL-1α and IL-27 levels in DAPSA50 responders and increase in IL-17A in both DAPSA 50 responders and non-responders (all P < .05).  

Study details: This study included 68 patients with PsA who were initiated with TNFi (n = 29), IL-17Ai (n = 19), or methotrexate (n = 20) treatment and were followed for 4 months.

Disclosure: This study was supported by Eli Lilly and Co., the Danish Rheumatism Association, and others. Two authors declared receiving research funding, speaker fees, and other ties with various sources, including Eli Lilly and the Danish Rheumatism Association. Two authors declared no conflicts of interest.

Source: Skougaard M, Sondergaard MF, Ditlev SB, Kristensen LE. Changes in inflammatory cytokines in responders and non-responders to TNFα inhibitor and IL-17A inhibitor: A study examining psoriatic arthritis patients. Int J Mol Sci. 2024:25(5);3002 (Mar 5). doi: 10.3390/ijms25053002 Source

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Bimekizumab More Favorable in PsA than Secukinumab

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Key clinical point: Bimekizumab (160 mg/4 weeks) demonstrated favorable efficacy outcomes over secukinumab (150 mg or 300 mg/4 weeks) in patients with psoriatic arthritis (PsA) who were naive to biologic disease-modifying anti-rheumatic drugs (bDMARD) or had prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: In the bDMARD naive subgroup, the probability of achieving at least 70% improvement in American College of Rheumatology (ACR) response was higher with bimekizumab vs secukinumab (odds ratio > 2; P < .05) at week 52, with similar response in the TNFi-IR subgroup for ACR70 and minimal disease activity outcomes (all P < .05).

Study details: This study included data of bDMARD naive or TNFi-IR patients with PsA who received bimekizumab from BE OPTIMAL (n = 236) and BE COMPLETE (n = 146) and secukinumab from FUTURE 2 trial (n = 200).

Disclosures: This study was sponsored by UCB Pharma. Four authors declared being employees and stockholders of UCB Pharma. Several authors declared receiving research grants, and other ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and secukinumab in patients with psoriatic arthritis at 52 weeks using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Mar 6). Source 

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Key clinical point: Bimekizumab (160 mg/4 weeks) demonstrated favorable efficacy outcomes over secukinumab (150 mg or 300 mg/4 weeks) in patients with psoriatic arthritis (PsA) who were naive to biologic disease-modifying anti-rheumatic drugs (bDMARD) or had prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: In the bDMARD naive subgroup, the probability of achieving at least 70% improvement in American College of Rheumatology (ACR) response was higher with bimekizumab vs secukinumab (odds ratio > 2; P < .05) at week 52, with similar response in the TNFi-IR subgroup for ACR70 and minimal disease activity outcomes (all P < .05).

Study details: This study included data of bDMARD naive or TNFi-IR patients with PsA who received bimekizumab from BE OPTIMAL (n = 236) and BE COMPLETE (n = 146) and secukinumab from FUTURE 2 trial (n = 200).

Disclosures: This study was sponsored by UCB Pharma. Four authors declared being employees and stockholders of UCB Pharma. Several authors declared receiving research grants, and other ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and secukinumab in patients with psoriatic arthritis at 52 weeks using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Mar 6). Source 

Key clinical point: Bimekizumab (160 mg/4 weeks) demonstrated favorable efficacy outcomes over secukinumab (150 mg or 300 mg/4 weeks) in patients with psoriatic arthritis (PsA) who were naive to biologic disease-modifying anti-rheumatic drugs (bDMARD) or had prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: In the bDMARD naive subgroup, the probability of achieving at least 70% improvement in American College of Rheumatology (ACR) response was higher with bimekizumab vs secukinumab (odds ratio > 2; P < .05) at week 52, with similar response in the TNFi-IR subgroup for ACR70 and minimal disease activity outcomes (all P < .05).

Study details: This study included data of bDMARD naive or TNFi-IR patients with PsA who received bimekizumab from BE OPTIMAL (n = 236) and BE COMPLETE (n = 146) and secukinumab from FUTURE 2 trial (n = 200).

Disclosures: This study was sponsored by UCB Pharma. Four authors declared being employees and stockholders of UCB Pharma. Several authors declared receiving research grants, and other ties with various sources, including UCB Pharma.

Source: Mease PJ, Warren RB, Nash P, et al. Comparative effectiveness of bimekizumab and secukinumab in patients with psoriatic arthritis at 52 weeks using a matching-adjusted indirect comparison. Rheumatol Ther. 2024 (Mar 6). Source 

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Real-World Study Confirms Benefits of Guselkumab in Active Longstanding PsA

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Key clinical point: Real-world treatment with guselkumab for ≥6 months was effective and safe in patients with longstanding active psoriatic arthritis (PsA) who had median disease duration of 6 years.

Major finding: Disease Activity Index for Psoriatic Arthritis (DAPSA) scores reduced significantly by 15.47 points in guselkumab-treated patients with PsA (P  =  .001), with 39.6% of patients achieving low disease activity, as assessed by achievement of DAPSA ≤ 14 at 6 months of follow-up. Guselkumab was well tolerated, with no reports of new safety signals.

Study details: This was a prospective real-world cohort study including 111 patients with active, longstanding PsA with a median disease duration of 6 years, who received guselkumab for ≥6 months.

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

Source: Ruscitti P, Cataldi G, Gentile M, et al. The evaluation of effectiveness and safety of guselkumab in patients with psoriatic arthritis in a prospective multicentre "real-life" cohort study. Rheumatol Ther. 2024 (Mar 4). doi: 10.1007/s40744-024-00649-2 Source

 

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Key clinical point: Real-world treatment with guselkumab for ≥6 months was effective and safe in patients with longstanding active psoriatic arthritis (PsA) who had median disease duration of 6 years.

Major finding: Disease Activity Index for Psoriatic Arthritis (DAPSA) scores reduced significantly by 15.47 points in guselkumab-treated patients with PsA (P  =  .001), with 39.6% of patients achieving low disease activity, as assessed by achievement of DAPSA ≤ 14 at 6 months of follow-up. Guselkumab was well tolerated, with no reports of new safety signals.

Study details: This was a prospective real-world cohort study including 111 patients with active, longstanding PsA with a median disease duration of 6 years, who received guselkumab for ≥6 months.

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

Source: Ruscitti P, Cataldi G, Gentile M, et al. The evaluation of effectiveness and safety of guselkumab in patients with psoriatic arthritis in a prospective multicentre "real-life" cohort study. Rheumatol Ther. 2024 (Mar 4). doi: 10.1007/s40744-024-00649-2 Source

 

Key clinical point: Real-world treatment with guselkumab for ≥6 months was effective and safe in patients with longstanding active psoriatic arthritis (PsA) who had median disease duration of 6 years.

Major finding: Disease Activity Index for Psoriatic Arthritis (DAPSA) scores reduced significantly by 15.47 points in guselkumab-treated patients with PsA (P  =  .001), with 39.6% of patients achieving low disease activity, as assessed by achievement of DAPSA ≤ 14 at 6 months of follow-up. Guselkumab was well tolerated, with no reports of new safety signals.

Study details: This was a prospective real-world cohort study including 111 patients with active, longstanding PsA with a median disease duration of 6 years, who received guselkumab for ≥6 months.

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

Source: Ruscitti P, Cataldi G, Gentile M, et al. The evaluation of effectiveness and safety of guselkumab in patients with psoriatic arthritis in a prospective multicentre "real-life" cohort study. Rheumatol Ther. 2024 (Mar 4). doi: 10.1007/s40744-024-00649-2 Source

 

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