Clinical Edge Journal Scan

Key clinical point: Guselkumab was more effective than ustekinumab in improving joint and skin outcomes in patients with psoriatic arthritis (PsA), regardless of prior exposure to biologics.

Major finding: A higher proportion of patients with prior exposure to biologics receiving guselkumab (dosage 100 mg/2 weeks or 100 mg/4 weeks) vs ustekinumab (dosage 45/90 mg) achieved the American College of Rheumatology-20 response (> 58% vs 35.6%) and Psoriasis Area Severity Index-90 response (> 50.0% vs 25.9%) at week 52, with similar outcomes in patients naive to biologics.

Study details: This study included pooled individual data from four trials of patients having PsA with (n  =  197) or without prior exposure to biologics (n  =  1170) who received either guselkumab or ustekinumab.

Disclosures: This study was sponsored by Janssen Research and Development (HEMAR Department, High Wycombe, United Kingdom). All authors reported being employees of Janssen Research and Development or EVERSANA, which received funding from Janssen Research and Development for this study.

Source: Thilakarathne P, Schubert A, Peterson S, et al. Comparing efficacy of guselkumab versus ustekinumab in patients with psoriatic arthritis: An adjusted comparison using individual patient data from the DISCOVER and PSUMMIT trials. Rheumatol Ther. 2024;11:457-474 (Feb 28). doi: 10.1007/s40744-024-00644-7 Source

Key clinical point: Guselkumab was more effective than ustekinumab in improving joint and skin outcomes in patients with psoriatic arthritis (PsA), regardless of prior exposure to biologics.

Major finding: A higher proportion of patients with prior exposure to biologics receiving guselkumab (dosage 100 mg/2 weeks or 100 mg/4 weeks) vs ustekinumab (dosage 45/90 mg) achieved the American College of Rheumatology-20 response (> 58% vs 35.6%) and Psoriasis Area Severity Index-90 response (> 50.0% vs 25.9%) at week 52, with similar outcomes in patients naive to biologics.

Study details: This study included pooled individual data from four trials of patients having PsA with (n  =  197) or without prior exposure to biologics (n  =  1170) who received either guselkumab or ustekinumab.

Disclosures: This study was sponsored by Janssen Research and Development (HEMAR Department, High Wycombe, United Kingdom). All authors reported being employees of Janssen Research and Development or EVERSANA, which received funding from Janssen Research and Development for this study.

Source: Thilakarathne P, Schubert A, Peterson S, et al. Comparing efficacy of guselkumab versus ustekinumab in patients with psoriatic arthritis: An adjusted comparison using individual patient data from the DISCOVER and PSUMMIT trials. Rheumatol Ther. 2024;11:457-474 (Feb 28). doi: 10.1007/s40744-024-00644-7 Source

Key clinical point: Guselkumab was more effective than ustekinumab in improving joint and skin outcomes in patients with psoriatic arthritis (PsA), regardless of prior exposure to biologics.

Major finding: A higher proportion of patients with prior exposure to biologics receiving guselkumab (dosage 100 mg/2 weeks or 100 mg/4 weeks) vs ustekinumab (dosage 45/90 mg) achieved the American College of Rheumatology-20 response (> 58% vs 35.6%) and Psoriasis Area Severity Index-90 response (> 50.0% vs 25.9%) at week 52, with similar outcomes in patients naive to biologics.

Study details: This study included pooled individual data from four trials of patients having PsA with (n  =  197) or without prior exposure to biologics (n  =  1170) who received either guselkumab or ustekinumab.

Disclosures: This study was sponsored by Janssen Research and Development (HEMAR Department, High Wycombe, United Kingdom). All authors reported being employees of Janssen Research and Development or EVERSANA, which received funding from Janssen Research and Development for this study.

Source: Thilakarathne P, Schubert A, Peterson S, et al. Comparing efficacy of guselkumab versus ustekinumab in patients with psoriatic arthritis: An adjusted comparison using individual patient data from the DISCOVER and PSUMMIT trials. Rheumatol Ther. 2024;11:457-474 (Feb 28). doi: 10.1007/s40744-024-00644-7 Source

Key clinical point: A long delay (>1 year) in diagnosing psoriatic arthritis (PsA) is associated with worse clinical outcomes, especially in women and patients with enthesitis, chronic back pain, and lower C-reactive protein (CRP) levels.

Major finding: Patients with a short (<12 weeks) vs long delay (>1 year) in PsA diagnosis after symptom onset was more likely to achieve minimum disease activity (odds ratio 2.55; 95% CI 1.37-4.76). Female sex, chronic back pain (age < 45 years), enthesitis, and lower CRP levels were associated with a diagnostic delay > 1 year in patients with PsA (all P < .05).

Study details: This study included 708 newly diagnosed patients with PsA who were followed up for ≥3 years; were naive to disease-modifying antirheumatic drugs; and were categorized into groups having short (n  =  136), intermediate (12 weeks to 1 year; n  =  237), or long (n  =  335) delay to diagnosis after symptom onset.

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

Source: Snoeck Henkemans SVJ, de Jong PHP, Luime JJ, et al. Window of opportunity in psoriatic arthritis: The earlier the better? RMD Open. 2024;10:e004062 (Feb 27). doi: 10.1136/rmdopen-2023-004062 Source

Key clinical point: A long delay (>1 year) in diagnosing psoriatic arthritis (PsA) is associated with worse clinical outcomes, especially in women and patients with enthesitis, chronic back pain, and lower C-reactive protein (CRP) levels.

Major finding: Patients with a short (<12 weeks) vs long delay (>1 year) in PsA diagnosis after symptom onset was more likely to achieve minimum disease activity (odds ratio 2.55; 95% CI 1.37-4.76). Female sex, chronic back pain (age < 45 years), enthesitis, and lower CRP levels were associated with a diagnostic delay > 1 year in patients with PsA (all P < .05).

Study details: This study included 708 newly diagnosed patients with PsA who were followed up for ≥3 years; were naive to disease-modifying antirheumatic drugs; and were categorized into groups having short (n  =  136), intermediate (12 weeks to 1 year; n  =  237), or long (n  =  335) delay to diagnosis after symptom onset.

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

Source: Snoeck Henkemans SVJ, de Jong PHP, Luime JJ, et al. Window of opportunity in psoriatic arthritis: The earlier the better? RMD Open. 2024;10:e004062 (Feb 27). doi: 10.1136/rmdopen-2023-004062 Source

Key clinical point: A long delay (>1 year) in diagnosing psoriatic arthritis (PsA) is associated with worse clinical outcomes, especially in women and patients with enthesitis, chronic back pain, and lower C-reactive protein (CRP) levels.

Major finding: Patients with a short (<12 weeks) vs long delay (>1 year) in PsA diagnosis after symptom onset was more likely to achieve minimum disease activity (odds ratio 2.55; 95% CI 1.37-4.76). Female sex, chronic back pain (age < 45 years), enthesitis, and lower CRP levels were associated with a diagnostic delay > 1 year in patients with PsA (all P < .05).

Study details: This study included 708 newly diagnosed patients with PsA who were followed up for ≥3 years; were naive to disease-modifying antirheumatic drugs; and were categorized into groups having short (n  =  136), intermediate (12 weeks to 1 year; n  =  237), or long (n  =  335) delay to diagnosis after symptom onset.

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

Source: Snoeck Henkemans SVJ, de Jong PHP, Luime JJ, et al. Window of opportunity in psoriatic arthritis: The earlier the better? RMD Open. 2024;10:e004062 (Feb 27). doi: 10.1136/rmdopen-2023-004062 Source

Key clinical point: Higher relative abundance of gut microbiota belonging to family Rikenellaceae and an unidentified metabolite X-11538 were associated with a reduced risk for psoriatic arthritis (PsA), highlighting the potential of gut microbiota taxa and metabolites as biomarkers for treatment and prevention of PsA.

Major finding: Adjusted multivariable Mendelian randomization analysis showed that a higher relative abundance of microbiota belonging to the family Rikenellaceae (odds ratio [OR] 0.5; 95% CI 0.320-0.780) and elevated serum levels of X-11538 (OR 0.448; 95% CI 0.244-0.821) were causally associated with a reduced risk for PsA.

Study details: This Mendelian randomization study included summary level data of gut microbiota taxa (n  =  18,340), PsA (n  =  339,050), and metabolites (n  =  7824) from participants included in the MiBioGen consortium, FinnGen Biobank, and TwinsUK and KORA cohorts, respectively.

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

Source: Xu X, Wu LY, Wang SY, et al. Investigating causal associations among gut microbiota, metabolites, and psoriatic arthritis: A Mendelian randomization study. Front Microbiol. 2024;15:1287637 (Feb 14). doi: 10.3389/fmicb.2024.1287637 Source

Key clinical point: Higher relative abundance of gut microbiota belonging to family Rikenellaceae and an unidentified metabolite X-11538 were associated with a reduced risk for psoriatic arthritis (PsA), highlighting the potential of gut microbiota taxa and metabolites as biomarkers for treatment and prevention of PsA.

Major finding: Adjusted multivariable Mendelian randomization analysis showed that a higher relative abundance of microbiota belonging to the family Rikenellaceae (odds ratio [OR] 0.5; 95% CI 0.320-0.780) and elevated serum levels of X-11538 (OR 0.448; 95% CI 0.244-0.821) were causally associated with a reduced risk for PsA.

Study details: This Mendelian randomization study included summary level data of gut microbiota taxa (n  =  18,340), PsA (n  =  339,050), and metabolites (n  =  7824) from participants included in the MiBioGen consortium, FinnGen Biobank, and TwinsUK and KORA cohorts, respectively.

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

Source: Xu X, Wu LY, Wang SY, et al. Investigating causal associations among gut microbiota, metabolites, and psoriatic arthritis: A Mendelian randomization study. Front Microbiol. 2024;15:1287637 (Feb 14). doi: 10.3389/fmicb.2024.1287637 Source

Key clinical point: Higher relative abundance of gut microbiota belonging to family Rikenellaceae and an unidentified metabolite X-11538 were associated with a reduced risk for psoriatic arthritis (PsA), highlighting the potential of gut microbiota taxa and metabolites as biomarkers for treatment and prevention of PsA.

Major finding: Adjusted multivariable Mendelian randomization analysis showed that a higher relative abundance of microbiota belonging to the family Rikenellaceae (odds ratio [OR] 0.5; 95% CI 0.320-0.780) and elevated serum levels of X-11538 (OR 0.448; 95% CI 0.244-0.821) were causally associated with a reduced risk for PsA.

Study details: This Mendelian randomization study included summary level data of gut microbiota taxa (n  =  18,340), PsA (n  =  339,050), and metabolites (n  =  7824) from participants included in the MiBioGen consortium, FinnGen Biobank, and TwinsUK and KORA cohorts, respectively.

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

Source: Xu X, Wu LY, Wang SY, et al. Investigating causal associations among gut microbiota, metabolites, and psoriatic arthritis: A Mendelian randomization study. Front Microbiol. 2024;15:1287637 (Feb 14). doi: 10.3389/fmicb.2024.1287637 Source

Key clinical point: Bimekizumab led to long-term improvements in efficacy outcomes and had a manageable safety profile in patients with active psoriatic arthritis (PsA) and prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 16, a significantly higher number of patients achieved ≥50% improvement in American College of Rheumatology response with bimekizumab vs placebo (43.4% vs 6.8%; P < .0001), with improvements sustained up to week 52 by >40% of patients receiving bimekizumab. No new safety signals were observed.

Study details: Findings are from the BE VITAL open-label extension study including 377 patients with active PsA and TNFi-IR who received bimekizumab or placebo for 16 weeks followed by only bimekizumab up to week 52.

Disclosures: This study was sponsored by UCB Pharma. Four authors reported being employees or shareholders of UCB Pharma. Several authors declared receiving research support or consulting fees or having other ties with various sources, including UCB Pharma.

Source: Coates LC, Landewe R, McInnes IB, et al. Bimekizumab treatment in patients with active psoriatic arthritis and prior inadequate response to tumour necrosis factor inhibitors: 52-week safety and efficacy from the phase III BE COMPLETE study and its open-label extension BE VITAL. RMD Open. 2024;10:e003855 (Feb 22). doi: 10.1136/rmdopen-2023-003855 Source

Key clinical point: Bimekizumab led to long-term improvements in efficacy outcomes and had a manageable safety profile in patients with active psoriatic arthritis (PsA) and prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 16, a significantly higher number of patients achieved ≥50% improvement in American College of Rheumatology response with bimekizumab vs placebo (43.4% vs 6.8%; P < .0001), with improvements sustained up to week 52 by >40% of patients receiving bimekizumab. No new safety signals were observed.

Study details: Findings are from the BE VITAL open-label extension study including 377 patients with active PsA and TNFi-IR who received bimekizumab or placebo for 16 weeks followed by only bimekizumab up to week 52.

Disclosures: This study was sponsored by UCB Pharma. Four authors reported being employees or shareholders of UCB Pharma. Several authors declared receiving research support or consulting fees or having other ties with various sources, including UCB Pharma.

Source: Coates LC, Landewe R, McInnes IB, et al. Bimekizumab treatment in patients with active psoriatic arthritis and prior inadequate response to tumour necrosis factor inhibitors: 52-week safety and efficacy from the phase III BE COMPLETE study and its open-label extension BE VITAL. RMD Open. 2024;10:e003855 (Feb 22). doi: 10.1136/rmdopen-2023-003855 Source

Key clinical point: Bimekizumab led to long-term improvements in efficacy outcomes and had a manageable safety profile in patients with active psoriatic arthritis (PsA) and prior inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 16, a significantly higher number of patients achieved ≥50% improvement in American College of Rheumatology response with bimekizumab vs placebo (43.4% vs 6.8%; P < .0001), with improvements sustained up to week 52 by >40% of patients receiving bimekizumab. No new safety signals were observed.

Study details: Findings are from the BE VITAL open-label extension study including 377 patients with active PsA and TNFi-IR who received bimekizumab or placebo for 16 weeks followed by only bimekizumab up to week 52.

Disclosures: This study was sponsored by UCB Pharma. Four authors reported being employees or shareholders of UCB Pharma. Several authors declared receiving research support or consulting fees or having other ties with various sources, including UCB Pharma.

Source: Coates LC, Landewe R, McInnes IB, et al. Bimekizumab treatment in patients with active psoriatic arthritis and prior inadequate response to tumour necrosis factor inhibitors: 52-week safety and efficacy from the phase III BE COMPLETE study and its open-label extension BE VITAL. RMD Open. 2024;10:e003855 (Feb 22). doi: 10.1136/rmdopen-2023-003855 Source

Key clinical point: The incidence rates of major adverse cardiovascular events (MACE) were similar in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), suggesting that both inflammatory disorders share a common atherogenic mechanism.

Major finding: After a total of 119,571 patient-years of follow-up, 6.7% of patients with RA or PsA developed MACE for the first time. The rates of MACE incidence (adjusted incidence rate ratio 0.96; P  =  .767) and MACE-free survival (P  =  .987) were comparable between patients with PsA and RA. Higher time-varying erythrocyte sedimentation rate, C-reactive protein levels, and exposure to glucocorticoids increased the risk for MACE in both patients with PsA and RA (all P < .05).

Study details: This population based retrospective cohort study included 13,905 patients with PsA (n  =  1672) or RA (n  =  12,233) who did not have any previous history of MACE.

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

Source: Meng H, Lam SH, So H, Tam LS. Incidence and risk factors of major cardiovascular events in rheumatoid arthritis and psoriatic arthritis: A population-based cohort study. Semin Arthritis Rheum. 2024;65:152416 (Feb 17). Source

Key clinical point: The incidence rates of major adverse cardiovascular events (MACE) were similar in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), suggesting that both inflammatory disorders share a common atherogenic mechanism.

Major finding: After a total of 119,571 patient-years of follow-up, 6.7% of patients with RA or PsA developed MACE for the first time. The rates of MACE incidence (adjusted incidence rate ratio 0.96; P  =  .767) and MACE-free survival (P  =  .987) were comparable between patients with PsA and RA. Higher time-varying erythrocyte sedimentation rate, C-reactive protein levels, and exposure to glucocorticoids increased the risk for MACE in both patients with PsA and RA (all P < .05).

Study details: This population based retrospective cohort study included 13,905 patients with PsA (n  =  1672) or RA (n  =  12,233) who did not have any previous history of MACE.

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

Source: Meng H, Lam SH, So H, Tam LS. Incidence and risk factors of major cardiovascular events in rheumatoid arthritis and psoriatic arthritis: A population-based cohort study. Semin Arthritis Rheum. 2024;65:152416 (Feb 17). Source

Key clinical point: The incidence rates of major adverse cardiovascular events (MACE) were similar in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), suggesting that both inflammatory disorders share a common atherogenic mechanism.

Major finding: After a total of 119,571 patient-years of follow-up, 6.7% of patients with RA or PsA developed MACE for the first time. The rates of MACE incidence (adjusted incidence rate ratio 0.96; P  =  .767) and MACE-free survival (P  =  .987) were comparable between patients with PsA and RA. Higher time-varying erythrocyte sedimentation rate, C-reactive protein levels, and exposure to glucocorticoids increased the risk for MACE in both patients with PsA and RA (all P < .05).

Study details: This population based retrospective cohort study included 13,905 patients with PsA (n  =  1672) or RA (n  =  12,233) who did not have any previous history of MACE.

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

Source: Meng H, Lam SH, So H, Tam LS. Incidence and risk factors of major cardiovascular events in rheumatoid arthritis and psoriatic arthritis: A population-based cohort study. Semin Arthritis Rheum. 2024;65:152416 (Feb 17). Source

Key clinical point: Ixekizumab was more effective than adalimumab in resolving distal interphalangeal (DIP) joint tenderness, swelling, and adjacent nail psoriasis in patients with psoriatic arthritis (PsA) and DIP joint involvement who nearly invariably had adjacent nail psoriasis.

Major finding: More than 96% of patients with PsA and simultaneous DIP joint involvement reported adjacent nail psoriasis in at least one digit in the finger unit. Ixekizumab vs adalimumab led to greater improvements in DIP involvement and adjacent nail psoriasis as early as week 12 (38.8% vs 28.4%; P < .0001), with improvements sustained up to week 52 (64.9% vs 57.5%; P  =  .0055).

Study details: This post hoc analysis of the SPIRIT-H2H study included 354 patients with PsA who had simultaneous DIP joint involvement and adjacent nail psoriasis and were randomly assigned to receive ixekizumab or adalimumab.

Disclosures: This study was supported by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. The other authors reported ties with various sources, including Eli Lilly and Company.

Source: McGonagle D, Kavanaugh A, McInnes IB, et al. Association of the clinical components in the distal interphalangeal joint synovio-entheseal complex and subsequent response to ixekizumab or adalimumab in psoriatic arthritis. Rheumatology (Oxford). 2024 (Feb 10). doi: 10.1093/rheumatology/keae060 Source

Key clinical point: Ixekizumab was more effective than adalimumab in resolving distal interphalangeal (DIP) joint tenderness, swelling, and adjacent nail psoriasis in patients with psoriatic arthritis (PsA) and DIP joint involvement who nearly invariably had adjacent nail psoriasis.

Major finding: More than 96% of patients with PsA and simultaneous DIP joint involvement reported adjacent nail psoriasis in at least one digit in the finger unit. Ixekizumab vs adalimumab led to greater improvements in DIP involvement and adjacent nail psoriasis as early as week 12 (38.8% vs 28.4%; P < .0001), with improvements sustained up to week 52 (64.9% vs 57.5%; P  =  .0055).

Study details: This post hoc analysis of the SPIRIT-H2H study included 354 patients with PsA who had simultaneous DIP joint involvement and adjacent nail psoriasis and were randomly assigned to receive ixekizumab or adalimumab.

Disclosures: This study was supported by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. The other authors reported ties with various sources, including Eli Lilly and Company.

Source: McGonagle D, Kavanaugh A, McInnes IB, et al. Association of the clinical components in the distal interphalangeal joint synovio-entheseal complex and subsequent response to ixekizumab or adalimumab in psoriatic arthritis. Rheumatology (Oxford). 2024 (Feb 10). doi: 10.1093/rheumatology/keae060 Source

Key clinical point: Ixekizumab was more effective than adalimumab in resolving distal interphalangeal (DIP) joint tenderness, swelling, and adjacent nail psoriasis in patients with psoriatic arthritis (PsA) and DIP joint involvement who nearly invariably had adjacent nail psoriasis.

Major finding: More than 96% of patients with PsA and simultaneous DIP joint involvement reported adjacent nail psoriasis in at least one digit in the finger unit. Ixekizumab vs adalimumab led to greater improvements in DIP involvement and adjacent nail psoriasis as early as week 12 (38.8% vs 28.4%; P < .0001), with improvements sustained up to week 52 (64.9% vs 57.5%; P  =  .0055).

Study details: This post hoc analysis of the SPIRIT-H2H study included 354 patients with PsA who had simultaneous DIP joint involvement and adjacent nail psoriasis and were randomly assigned to receive ixekizumab or adalimumab.

Disclosures: This study was supported by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. The other authors reported ties with various sources, including Eli Lilly and Company.

Source: McGonagle D, Kavanaugh A, McInnes IB, et al. Association of the clinical components in the distal interphalangeal joint synovio-entheseal complex and subsequent response to ixekizumab or adalimumab in psoriatic arthritis. Rheumatology (Oxford). 2024 (Feb 10). doi: 10.1093/rheumatology/keae060 Source

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source