Clinical Edge Journal Scan

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: Eptinezumab vs placebo reduced the monthly migraine days by ≥30% in a significantly higher proportion of patients with migraine during the first infusion (weeks 1-12), with further improvements in migraine response following the second infusion (weeks 13-24).

Major finding: A significantly higher proportion of patients receiving 100 mg and 300 mg eptinezumab vs placebo achieved ≥30% reduction in monthly migraine days during weeks 1-12 (65.9% and 71.0% vs 36.9%, respectively; P < .0001) and weeks 13-24 (70.4% and 74.5% vs 43.1%, respectively; P < .0001).

Study details: This post hoc analysis of the DELIVER trial included 890 patients with migraine who had experienced 2-4 prior preventive treatment failures and were randomly assigned to receive 100 mg or 300 mg eptinezumab or placebo every 12 weeks.

Disclosures: This study was funded by H. Lundbeck A/S. Three authors declared being full-time employees of H. Lundbeck A/S or one of its subsidiary companies. Other authors declared having ties with various sources including H. Lundbeck A/S.

Source: Ashina M et al. Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: Post hoc analysis of the DELIVER randomized clinical trial. Eur J Neurol. 2023 (Nov 13). doi: 10.1111/ene.16131

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: When taken during the prodrome, ubrogepant was more effective than placebo in reducing headaches in patients with a ≥1-year history of migraine and had a tolerable safety profile.

Major finding: A significantly higher proportion of patients reported the absence of moderate or severe headaches within 24 hours of receiving ubrogepant vs placebo (46% vs 29%; odds ratio 2.09; P < .0001). Nausea, fatigue, dizziness, and somnolence were reported by ≤5% of patients receiving ubrogepant.

Study details: The PRODROME trial included 518 patients with migraine who were randomly assigned to receive placebo followed by 100 mg ubrogepant to treat the first and second qualifying prodrome events, respectively, or 100 mg ubrogepant followed by placebo to treat the first and second qualifying prodrome events, respectively.

Disclosures: This study was funded by AbbVie. Six authors declared being current or former employees of or holding stocks in AbbVie. Other authors declared having ties with various sources including AbbVie.

Source: Dodick DW et al. Ubrogepant for the treatment of migraine attacks during the prodrome: A phase 3, multicentre, randomised, double-blind, placebo-controlled, crossover trial in the USA. Lancet. 2023 (Nov 15). doi: 10.1016/S0140-6736(23)01683-5

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

Key clinical point: Patients with psoriatic arthritis (PsA) who responded to tumor necrosis factor inhibitors (TNFi), such as adalimumab and etanercept, had higher serum drug levels (SDL), with non-trough SDL being able to differentiate responders from non-responders with substantial efficacy.

Major finding: At 3 months, patients with higher etanercept SDL (odds ratio [OR] 1.24; P = .018) or higher adalimumab SDL (OR 1.08; P = .047) were significantly more likely to be responders according to the European Alliance of Associations for Rheumatology criteria. A non-trough etanercept SDL of 2.0 µg/mL and adalimumab SDL of 3.6 µg/mL could differentiate between responders and non-responders with ~50% specificity and >60% sensitivity.

Study details: This study included patients with PsA who initiated treatment with adalimumab (n = 104) or etanercept (n = 97).

Disclosures: This study was supported by the UK National Institute for Health and Care Research Manchester Biomedical Research Centre and Versus Arthritis. Two authors declared receiving grant support, consulting fees, or travel fees from various sources, including the sponsors.

Source: Curry PDK et al. Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Dec 09) doi: 10.1093/rheumatology/kead666

Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m² vs 28.33 kg/m²), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428

Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m² vs 28.33 kg/m²), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428

Key clinical point: Patients with psoriatic arthritis (PsA) who had hyperuricemia (baseline serum uric acid level ≥ 360 µmol/L) presented with worsened clinical characteristics than those with normouricemia; however, secukinumab was equally effective in patients with and without hyperuricemia.

Major finding: Patients with hyperuricemia vs normouricemia presented with higher mean body mass index values (30.90 kg/m² vs 28.33 kg/m²), more frequent hypertension (43.8% vs 31.3%), diabetes mellitus (10.3% vs 8.6%), and dactylitis (34.5% vs 25.9%). More than 40% of patients achieved ≥ 50% improvement in the American College of Rheumatology scores with secukinumab, irrespective of the presence of hyperuricemia.

Study details: This post hoc analysis of the pooled data from five phase 3 clinical trials included 2504 patients with active PsA who received secukinumab, 32.8% of whom had hyperuricemia.

Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Four authors declared being employees, shareholders, or advisory board members of or receiving consulting fees from Novartis.

Source: Felten R et al. Impact of hyperuricaemia on patients with psoriatic arthritis treated with secukinumab in the FUTURE 2-5 and MAXIMISE studies. RMD Open. 2023;9(4):e003428. (Nov 9) doi: 10.1136/rmdopen-2023-003428