Clinical Edge Journal Scan

Key clinical point: In patients with psoriasis, the German Psoriasis Arthritis Diagnostic (GEPARD) questionnaire followed by a dermatological assessment can detect psoriatic arthritis (PsA) risk almost accurately, and entheseal ultrasound by dermatologists shows no additional benefits in this regard.

Major finding: PsA was diagnosed in 6 out of 40 patients, with a sensitivity of 100%; however, dermatologic ultrasound evaluation of the entheses alone was unable to confirm these findings. Of the remaining 34 patients with psoriasis, 8 were deemed by dermatologists as possibly having PsA based on the ultrasound examination although rheumatologists detected ultrasound abnormalities in only 3 patients.

Study details: Findings are from a cross-sectional study including 40 patients with psoriasis who completed the GEPARD questionnaire and subsequently underwent an assessment for PsA by a dermatologist and an ultrasound examination.

Disclosures: This study was supported by a conditional research grant from Rheumazentrum Erlangen-Nuremberg e.V. and AGJR Verbundprojekt. The authors declared no conflicts of interest.

Source: Bartsch V et al. Screening for psoriatic arthritis in dermatological settings—Are handheld ultrasound devices the gamechangers we hoped for? Rheumatology (Oxford). 2023 (Nov 3). doi: 10.1093/rheumatology/kead592

Key clinical point: In patients with psoriasis, the German Psoriasis Arthritis Diagnostic (GEPARD) questionnaire followed by a dermatological assessment can detect psoriatic arthritis (PsA) risk almost accurately, and entheseal ultrasound by dermatologists shows no additional benefits in this regard.

Major finding: PsA was diagnosed in 6 out of 40 patients, with a sensitivity of 100%; however, dermatologic ultrasound evaluation of the entheses alone was unable to confirm these findings. Of the remaining 34 patients with psoriasis, 8 were deemed by dermatologists as possibly having PsA based on the ultrasound examination although rheumatologists detected ultrasound abnormalities in only 3 patients.

Study details: Findings are from a cross-sectional study including 40 patients with psoriasis who completed the GEPARD questionnaire and subsequently underwent an assessment for PsA by a dermatologist and an ultrasound examination.

Disclosures: This study was supported by a conditional research grant from Rheumazentrum Erlangen-Nuremberg e.V. and AGJR Verbundprojekt. The authors declared no conflicts of interest.

Source: Bartsch V et al. Screening for psoriatic arthritis in dermatological settings—Are handheld ultrasound devices the gamechangers we hoped for? Rheumatology (Oxford). 2023 (Nov 3). doi: 10.1093/rheumatology/kead592

Key clinical point: In patients with psoriasis, the German Psoriasis Arthritis Diagnostic (GEPARD) questionnaire followed by a dermatological assessment can detect psoriatic arthritis (PsA) risk almost accurately, and entheseal ultrasound by dermatologists shows no additional benefits in this regard.

Major finding: PsA was diagnosed in 6 out of 40 patients, with a sensitivity of 100%; however, dermatologic ultrasound evaluation of the entheses alone was unable to confirm these findings. Of the remaining 34 patients with psoriasis, 8 were deemed by dermatologists as possibly having PsA based on the ultrasound examination although rheumatologists detected ultrasound abnormalities in only 3 patients.

Study details: Findings are from a cross-sectional study including 40 patients with psoriasis who completed the GEPARD questionnaire and subsequently underwent an assessment for PsA by a dermatologist and an ultrasound examination.

Disclosures: This study was supported by a conditional research grant from Rheumazentrum Erlangen-Nuremberg e.V. and AGJR Verbundprojekt. The authors declared no conflicts of interest.

Source: Bartsch V et al. Screening for psoriatic arthritis in dermatological settings—Are handheld ultrasound devices the gamechangers we hoped for? Rheumatology (Oxford). 2023 (Nov 3). doi: 10.1093/rheumatology/kead592

Key clinical point: Patients with psoriatic arthritis (PsA), except those with elevated C-reactive protein (CRP) levels (≥10 mg/L) and radiographic sacroiliac involvement, generally had a very low likelihood of developing syndesmophytes.

Major finding: At 2 years of follow-up, the majority (~90%) of patients showed no new syndesmophyte development, with syndesmophyte development being reported in only 11 patients. The probability of developing vs not developing syndesmophytes increased numerically by 3 and 14 times in patients with radiographic sacroiliitis and in those with radiographic sacroiliitis plus elevated CRP levels, respectively.

Study details: Findings are from an analysis of the data of 150 patients with PsA from the Belgian Epidemiological Psoriatic Arthritis Study (BEPAS) trial who had baseline and 2-year follow-up radiographs available.

Disclosures: The BEPAS trial was funded by MSD Belgium. Some authors declared receiving consultancy fees, speaker fees, or research grants from or having other ties with various sources, including MSD.

Source: de Hooge M et al. Specific descriptions of axial involvement are associated with radiographic damage development after 2 years in psoriatic arthritis patients. Ann Rheum Dis. 2023 (Nov 2). doi: 10.1136/ard-2023-224501

Key clinical point: Patients with psoriatic arthritis (PsA), except those with elevated C-reactive protein (CRP) levels (≥10 mg/L) and radiographic sacroiliac involvement, generally had a very low likelihood of developing syndesmophytes.

Major finding: At 2 years of follow-up, the majority (~90%) of patients showed no new syndesmophyte development, with syndesmophyte development being reported in only 11 patients. The probability of developing vs not developing syndesmophytes increased numerically by 3 and 14 times in patients with radiographic sacroiliitis and in those with radiographic sacroiliitis plus elevated CRP levels, respectively.

Study details: Findings are from an analysis of the data of 150 patients with PsA from the Belgian Epidemiological Psoriatic Arthritis Study (BEPAS) trial who had baseline and 2-year follow-up radiographs available.

Disclosures: The BEPAS trial was funded by MSD Belgium. Some authors declared receiving consultancy fees, speaker fees, or research grants from or having other ties with various sources, including MSD.

Source: de Hooge M et al. Specific descriptions of axial involvement are associated with radiographic damage development after 2 years in psoriatic arthritis patients. Ann Rheum Dis. 2023 (Nov 2). doi: 10.1136/ard-2023-224501

Key clinical point: Patients with psoriatic arthritis (PsA), except those with elevated C-reactive protein (CRP) levels (≥10 mg/L) and radiographic sacroiliac involvement, generally had a very low likelihood of developing syndesmophytes.

Major finding: At 2 years of follow-up, the majority (~90%) of patients showed no new syndesmophyte development, with syndesmophyte development being reported in only 11 patients. The probability of developing vs not developing syndesmophytes increased numerically by 3 and 14 times in patients with radiographic sacroiliitis and in those with radiographic sacroiliitis plus elevated CRP levels, respectively.

Study details: Findings are from an analysis of the data of 150 patients with PsA from the Belgian Epidemiological Psoriatic Arthritis Study (BEPAS) trial who had baseline and 2-year follow-up radiographs available.

Disclosures: The BEPAS trial was funded by MSD Belgium. Some authors declared receiving consultancy fees, speaker fees, or research grants from or having other ties with various sources, including MSD.

Source: de Hooge M et al. Specific descriptions of axial involvement are associated with radiographic damage development after 2 years in psoriatic arthritis patients. Ann Rheum Dis. 2023 (Nov 2). doi: 10.1136/ard-2023-224501

Key clinical point: Improvement in the Disease Activity Index in PsA (DAPSA) scores as early as week 8 was associated with a lower progression of structural joint damage at 2 years in biologic-naive patients with psoriatic arthritis (PsA) who were treated with guselkumab.

Major finding: A greater improvement in DAPSA scores as early as week 8 (parameter estimate [β] −0.03, P = .0096) and the achievement of DAPSA low disease activity at week 8 (least squares mean difference −1.44; P = .0151) were associated with a significantly lower radiographic progression of joint damage through week 100.

Study details: This post hoc analysis included 449 biologic-naive patients with PsA from the DISCOVER-2 trial who received 100 mg guselkumab every 4 or 8 weeks.

Disclosures: The DISCOVER-2 trial was funded by Janssen Research & Development, LLC. Five authors declared being employees of Janssen or owning stock or stock options in Johnson & Johnson. The other authors declared ties with various sources, including Janssen.

Source: Mease PJ et al. Earlier clinical response predicts low rates of radiographic progression in biologic-naïve patients with active psoriatic arthritis receiving guselkumab treatment. Clin Rheumatol. 2023 (Oct 3). doi: 10.1007/s10067-023-06745-y

Key clinical point: Improvement in the Disease Activity Index in PsA (DAPSA) scores as early as week 8 was associated with a lower progression of structural joint damage at 2 years in biologic-naive patients with psoriatic arthritis (PsA) who were treated with guselkumab.

Major finding: A greater improvement in DAPSA scores as early as week 8 (parameter estimate [β] −0.03, P = .0096) and the achievement of DAPSA low disease activity at week 8 (least squares mean difference −1.44; P = .0151) were associated with a significantly lower radiographic progression of joint damage through week 100.

Study details: This post hoc analysis included 449 biologic-naive patients with PsA from the DISCOVER-2 trial who received 100 mg guselkumab every 4 or 8 weeks.

Disclosures: The DISCOVER-2 trial was funded by Janssen Research & Development, LLC. Five authors declared being employees of Janssen or owning stock or stock options in Johnson & Johnson. The other authors declared ties with various sources, including Janssen.

Source: Mease PJ et al. Earlier clinical response predicts low rates of radiographic progression in biologic-naïve patients with active psoriatic arthritis receiving guselkumab treatment. Clin Rheumatol. 2023 (Oct 3). doi: 10.1007/s10067-023-06745-y

Key clinical point: Improvement in the Disease Activity Index in PsA (DAPSA) scores as early as week 8 was associated with a lower progression of structural joint damage at 2 years in biologic-naive patients with psoriatic arthritis (PsA) who were treated with guselkumab.

Major finding: A greater improvement in DAPSA scores as early as week 8 (parameter estimate [β] −0.03, P = .0096) and the achievement of DAPSA low disease activity at week 8 (least squares mean difference −1.44; P = .0151) were associated with a significantly lower radiographic progression of joint damage through week 100.

Study details: This post hoc analysis included 449 biologic-naive patients with PsA from the DISCOVER-2 trial who received 100 mg guselkumab every 4 or 8 weeks.

Disclosures: The DISCOVER-2 trial was funded by Janssen Research & Development, LLC. Five authors declared being employees of Janssen or owning stock or stock options in Johnson & Johnson. The other authors declared ties with various sources, including Janssen.

Source: Mease PJ et al. Earlier clinical response predicts low rates of radiographic progression in biologic-naïve patients with active psoriatic arthritis receiving guselkumab treatment. Clin Rheumatol. 2023 (Oct 3). doi: 10.1007/s10067-023-06745-y

Key clinical point: The risk for infections in patients with psoriatic arthritis (PsA) did not increase with most biologic and small-molecule therapies, except bimekizumab, apremilast, and 30 mg upadacitinib.

Major finding: In patients with PsA, bimekizumab (relative risk [RR] 14.23; 95% CI 1.97-102.60), apremilast (RR 1.41; 95% CI 1.08-1.83) and 30 mg upadacitinib (RR 1.37; 95% CI 1.05-1.80) led to a significantly higher risk of infections compared to placebo, with 30 mg upadacitinib vs placebo also increasing the risk for serious infections (RR 3.66; 95% CI 1.43-9.38).

Study details: Findings are from a network meta-analysis of 94 randomized controlled trials including 54,369 patients with PsA or psoriasis who were treated with 14 biologics, five small molecules, or placebo.

Disclosures: This study was partly funded by grants from the National Taiwan University Hospital and Chang Gung Memorial Hospital. HY Chiu and YH Huang declared receiving speaking fees or honoraria from, serving as principal investigator for, or having other ties with various sources.

Source: Chiu HY et al. Comparative short-term risks of infection and serious infection in patients receiving biologic and small-molecule therapies for psoriasis and psoriatic arthritis: A systemic review and network meta-analysis of randomized controlled trials. Ther Adv Chronic Dis. 2023;14:20406223231206225. (Oct 27). doi: 10.1177/20406223231206225

Key clinical point: The risk for infections in patients with psoriatic arthritis (PsA) did not increase with most biologic and small-molecule therapies, except bimekizumab, apremilast, and 30 mg upadacitinib.

Major finding: In patients with PsA, bimekizumab (relative risk [RR] 14.23; 95% CI 1.97-102.60), apremilast (RR 1.41; 95% CI 1.08-1.83) and 30 mg upadacitinib (RR 1.37; 95% CI 1.05-1.80) led to a significantly higher risk of infections compared to placebo, with 30 mg upadacitinib vs placebo also increasing the risk for serious infections (RR 3.66; 95% CI 1.43-9.38).

Study details: Findings are from a network meta-analysis of 94 randomized controlled trials including 54,369 patients with PsA or psoriasis who were treated with 14 biologics, five small molecules, or placebo.

Disclosures: This study was partly funded by grants from the National Taiwan University Hospital and Chang Gung Memorial Hospital. HY Chiu and YH Huang declared receiving speaking fees or honoraria from, serving as principal investigator for, or having other ties with various sources.

Source: Chiu HY et al. Comparative short-term risks of infection and serious infection in patients receiving biologic and small-molecule therapies for psoriasis and psoriatic arthritis: A systemic review and network meta-analysis of randomized controlled trials. Ther Adv Chronic Dis. 2023;14:20406223231206225. (Oct 27). doi: 10.1177/20406223231206225

Key clinical point: The risk for infections in patients with psoriatic arthritis (PsA) did not increase with most biologic and small-molecule therapies, except bimekizumab, apremilast, and 30 mg upadacitinib.

Major finding: In patients with PsA, bimekizumab (relative risk [RR] 14.23; 95% CI 1.97-102.60), apremilast (RR 1.41; 95% CI 1.08-1.83) and 30 mg upadacitinib (RR 1.37; 95% CI 1.05-1.80) led to a significantly higher risk of infections compared to placebo, with 30 mg upadacitinib vs placebo also increasing the risk for serious infections (RR 3.66; 95% CI 1.43-9.38).

Study details: Findings are from a network meta-analysis of 94 randomized controlled trials including 54,369 patients with PsA or psoriasis who were treated with 14 biologics, five small molecules, or placebo.

Disclosures: This study was partly funded by grants from the National Taiwan University Hospital and Chang Gung Memorial Hospital. HY Chiu and YH Huang declared receiving speaking fees or honoraria from, serving as principal investigator for, or having other ties with various sources.

Source: Chiu HY et al. Comparative short-term risks of infection and serious infection in patients receiving biologic and small-molecule therapies for psoriasis and psoriatic arthritis: A systemic review and network meta-analysis of randomized controlled trials. Ther Adv Chronic Dis. 2023;14:20406223231206225. (Oct 27). doi: 10.1177/20406223231206225

Key clinical point: A diagnosis of psoriatic arthritis (PsA) significantly increased the odds of functional impairment and the prevalence of depressive symptoms in patients with psoriatic disease.

Major finding: A diagnosis of PsA was associated with increased odds of functional impairment in everyday life (odds ratio [OR] 9.56, P = .005) and the presence of moderate-to-severe depressive symptoms (OR 2.69, P = .046).

Study details: Findings are from a cross-sectional study including 300 patients with psoriatic disease, of whom 189 patients had PsA.

Disclosures: This study was partly sponsored by Novartis Pharma GmbH, Germany. Some authors declared receiving speaker honoraria, travel grants, or research funding from or having other ties with various sources, including Novartis. The other authors declared no conflicts of interest.

Source: Frede N et al. Psoriasis and psoriatic arthritis have a major impact on quality of life and depressive symptoms: A cross-sectional study of 300 patients. Rheumatol Ther. 2023 (Oct 15). doi: 10.1007/s40744-023-00602-9

Key clinical point: A diagnosis of psoriatic arthritis (PsA) significantly increased the odds of functional impairment and the prevalence of depressive symptoms in patients with psoriatic disease.

Major finding: A diagnosis of PsA was associated with increased odds of functional impairment in everyday life (odds ratio [OR] 9.56, P = .005) and the presence of moderate-to-severe depressive symptoms (OR 2.69, P = .046).

Study details: Findings are from a cross-sectional study including 300 patients with psoriatic disease, of whom 189 patients had PsA.

Disclosures: This study was partly sponsored by Novartis Pharma GmbH, Germany. Some authors declared receiving speaker honoraria, travel grants, or research funding from or having other ties with various sources, including Novartis. The other authors declared no conflicts of interest.

Source: Frede N et al. Psoriasis and psoriatic arthritis have a major impact on quality of life and depressive symptoms: A cross-sectional study of 300 patients. Rheumatol Ther. 2023 (Oct 15). doi: 10.1007/s40744-023-00602-9

Key clinical point: A diagnosis of psoriatic arthritis (PsA) significantly increased the odds of functional impairment and the prevalence of depressive symptoms in patients with psoriatic disease.

Major finding: A diagnosis of PsA was associated with increased odds of functional impairment in everyday life (odds ratio [OR] 9.56, P = .005) and the presence of moderate-to-severe depressive symptoms (OR 2.69, P = .046).

Study details: Findings are from a cross-sectional study including 300 patients with psoriatic disease, of whom 189 patients had PsA.

Disclosures: This study was partly sponsored by Novartis Pharma GmbH, Germany. Some authors declared receiving speaker honoraria, travel grants, or research funding from or having other ties with various sources, including Novartis. The other authors declared no conflicts of interest.

Source: Frede N et al. Psoriasis and psoriatic arthritis have a major impact on quality of life and depressive symptoms: A cross-sectional study of 300 patients. Rheumatol Ther. 2023 (Oct 15). doi: 10.1007/s40744-023-00602-9

Key clinical point: Patients with psoriatic arthritis (PsA) had higher levels of cathepsins G and K in the serum and synovial fluid than patients with gonarthrosis or control individuals having no physical findings related to their internal organs, skin, or joints.

Major finding: Cathepsin G and cathepsin K levels in the serum (P < .01) and synovial fluid (P < .02) were significantly higher in the PsA group than in the gonarthrosis or control group. Serum cathepsin G levels > 6 ng/mL and serum cathepsin K levels > 0.86 ng/mL showed 100% diagnostic accuracy in distinguishing patients with PsA from control individuals and patients with gonarthrosis, respectively, whereas synovial fluid cathepsin G levels > 2 ng/mL showed 100% accuracy in distinguishing PsA from gonarthrosis.

Study details: This retrospective case-control study included 156 patients having PsA with synovial effusion, 50 patients with gonarthrosis, and 30 control individuals.

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

Source: Popova-Belova SD et al. Serum and synovial levels of cathepsin G and cathepsin K in patients with psoriatic arthritis and their correlation with disease activity indices. Diagnostics (Basel). 2023;13(20):3250 (Oct 19). doi: 10.3390/diagnostics13203250

Key clinical point: Patients with psoriatic arthritis (PsA) had higher levels of cathepsins G and K in the serum and synovial fluid than patients with gonarthrosis or control individuals having no physical findings related to their internal organs, skin, or joints.

Major finding: Cathepsin G and cathepsin K levels in the serum (P < .01) and synovial fluid (P < .02) were significantly higher in the PsA group than in the gonarthrosis or control group. Serum cathepsin G levels > 6 ng/mL and serum cathepsin K levels > 0.86 ng/mL showed 100% diagnostic accuracy in distinguishing patients with PsA from control individuals and patients with gonarthrosis, respectively, whereas synovial fluid cathepsin G levels > 2 ng/mL showed 100% accuracy in distinguishing PsA from gonarthrosis.

Study details: This retrospective case-control study included 156 patients having PsA with synovial effusion, 50 patients with gonarthrosis, and 30 control individuals.

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

Source: Popova-Belova SD et al. Serum and synovial levels of cathepsin G and cathepsin K in patients with psoriatic arthritis and their correlation with disease activity indices. Diagnostics (Basel). 2023;13(20):3250 (Oct 19). doi: 10.3390/diagnostics13203250

Key clinical point: Patients with psoriatic arthritis (PsA) had higher levels of cathepsins G and K in the serum and synovial fluid than patients with gonarthrosis or control individuals having no physical findings related to their internal organs, skin, or joints.

Major finding: Cathepsin G and cathepsin K levels in the serum (P < .01) and synovial fluid (P < .02) were significantly higher in the PsA group than in the gonarthrosis or control group. Serum cathepsin G levels > 6 ng/mL and serum cathepsin K levels > 0.86 ng/mL showed 100% diagnostic accuracy in distinguishing patients with PsA from control individuals and patients with gonarthrosis, respectively, whereas synovial fluid cathepsin G levels > 2 ng/mL showed 100% accuracy in distinguishing PsA from gonarthrosis.

Study details: This retrospective case-control study included 156 patients having PsA with synovial effusion, 50 patients with gonarthrosis, and 30 control individuals.

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

Source: Popova-Belova SD et al. Serum and synovial levels of cathepsin G and cathepsin K in patients with psoriatic arthritis and their correlation with disease activity indices. Diagnostics (Basel). 2023;13(20):3250 (Oct 19). doi: 10.3390/diagnostics13203250

Key clinical point: Tildrakizumab was able to reduce the occurrence of psoriatic arthritis (PsA) in patients with psoriasis by improving nailfold bleeding (NFB) and capillary enlargement, which are well-known risk factors for the development of PsA.

Major finding: NFB (hazard ratio [HR] 2.92; P = .003) and capillary enlargement (HR 4.61; P < .0001) were recognized as risk factors for PsA development; however, both conditions improved significantly after 1 month of tildrakizumab initiation, with the improvements being sustained up to 13 months (all P < .01). Therefore, tildrakizumab treatment significantly reduced the risk for PsA (HR 0.06; P = .007) in patients with psoriasis.

Study details: Findings are from a prospective cohort study which included 246 patients with psoriasis vulgaris having no prior exposure to systemic treatments and topical treatments for distal interphalangeal joints and nails who received either tildrakizumab (n = 20) or topical agents (n = 226).

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

Source: Fukasawa T et al. The optimal use of tildrakizumab in the elderly via improvement of Treg function and its preventive effect of psoriatic arthritis. Front Immunol. 2023;14:1286251. (Oct 19) doi: 10.3389/fimmu.2023.1286251

Key clinical point: Tildrakizumab was able to reduce the occurrence of psoriatic arthritis (PsA) in patients with psoriasis by improving nailfold bleeding (NFB) and capillary enlargement, which are well-known risk factors for the development of PsA.

Major finding: NFB (hazard ratio [HR] 2.92; P = .003) and capillary enlargement (HR 4.61; P < .0001) were recognized as risk factors for PsA development; however, both conditions improved significantly after 1 month of tildrakizumab initiation, with the improvements being sustained up to 13 months (all P < .01). Therefore, tildrakizumab treatment significantly reduced the risk for PsA (HR 0.06; P = .007) in patients with psoriasis.

Study details: Findings are from a prospective cohort study which included 246 patients with psoriasis vulgaris having no prior exposure to systemic treatments and topical treatments for distal interphalangeal joints and nails who received either tildrakizumab (n = 20) or topical agents (n = 226).

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

Source: Fukasawa T et al. The optimal use of tildrakizumab in the elderly via improvement of Treg function and its preventive effect of psoriatic arthritis. Front Immunol. 2023;14:1286251. (Oct 19) doi: 10.3389/fimmu.2023.1286251

Key clinical point: Tildrakizumab was able to reduce the occurrence of psoriatic arthritis (PsA) in patients with psoriasis by improving nailfold bleeding (NFB) and capillary enlargement, which are well-known risk factors for the development of PsA.

Major finding: NFB (hazard ratio [HR] 2.92; P = .003) and capillary enlargement (HR 4.61; P < .0001) were recognized as risk factors for PsA development; however, both conditions improved significantly after 1 month of tildrakizumab initiation, with the improvements being sustained up to 13 months (all P < .01). Therefore, tildrakizumab treatment significantly reduced the risk for PsA (HR 0.06; P = .007) in patients with psoriasis.

Study details: Findings are from a prospective cohort study which included 246 patients with psoriasis vulgaris having no prior exposure to systemic treatments and topical treatments for distal interphalangeal joints and nails who received either tildrakizumab (n = 20) or topical agents (n = 226).

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

Source: Fukasawa T et al. The optimal use of tildrakizumab in the elderly via improvement of Treg function and its preventive effect of psoriatic arthritis. Front Immunol. 2023;14:1286251. (Oct 19) doi: 10.3389/fimmu.2023.1286251

Key clinical point: Treatment with ixekizumab for 24 weeks improved disease activity outcomes without causing any new adverse events (AE) in patients with severe peripheral psoriatic arthritis (PsA).

Major finding: At week 24, a significantly higher proportion of patients with severe PsA receiving ixekizumab every 4 weeks and ixekizumab every 2 weeks vs placebo achieved ≥20% improvement in the American College of Rheumatology scores (63.3% and 60.4% vs 24.5%, P ≤ .001). No new AE were reported.

Study details: Findings are from a post hoc analysis of the SPIRIT-P1 trial including 204 patients with severe peripheral PsA who received ixekizumab, adalimumab, or placebo for 24 weeks.

Disclosures: This study was funded by Eli Lilly and Company. Four authors declared being employees or stockholders of Eli Lilly Japan KK, Lilly Deutschland GmbH, or Eli Lilly and Company. The other authors declared ties with various sources, including Eli Lilly.

Source: Kameda H et al. Ixekizumab efficacy in patients with severe peripheral psoriatic arthritis: A post hoc analysis of a phase 3, randomized, double-blind, placebo-controlled study (SPIRIT-P1). Rheumatol Ther. 2023 (Oct 19). doi: 10.1007/s40744-023-00605-6

Key clinical point: Treatment with ixekizumab for 24 weeks improved disease activity outcomes without causing any new adverse events (AE) in patients with severe peripheral psoriatic arthritis (PsA).

Major finding: At week 24, a significantly higher proportion of patients with severe PsA receiving ixekizumab every 4 weeks and ixekizumab every 2 weeks vs placebo achieved ≥20% improvement in the American College of Rheumatology scores (63.3% and 60.4% vs 24.5%, P ≤ .001). No new AE were reported.

Study details: Findings are from a post hoc analysis of the SPIRIT-P1 trial including 204 patients with severe peripheral PsA who received ixekizumab, adalimumab, or placebo for 24 weeks.

Disclosures: This study was funded by Eli Lilly and Company. Four authors declared being employees or stockholders of Eli Lilly Japan KK, Lilly Deutschland GmbH, or Eli Lilly and Company. The other authors declared ties with various sources, including Eli Lilly.

Source: Kameda H et al. Ixekizumab efficacy in patients with severe peripheral psoriatic arthritis: A post hoc analysis of a phase 3, randomized, double-blind, placebo-controlled study (SPIRIT-P1). Rheumatol Ther. 2023 (Oct 19). doi: 10.1007/s40744-023-00605-6

Key clinical point: Treatment with ixekizumab for 24 weeks improved disease activity outcomes without causing any new adverse events (AE) in patients with severe peripheral psoriatic arthritis (PsA).

Major finding: At week 24, a significantly higher proportion of patients with severe PsA receiving ixekizumab every 4 weeks and ixekizumab every 2 weeks vs placebo achieved ≥20% improvement in the American College of Rheumatology scores (63.3% and 60.4% vs 24.5%, P ≤ .001). No new AE were reported.

Study details: Findings are from a post hoc analysis of the SPIRIT-P1 trial including 204 patients with severe peripheral PsA who received ixekizumab, adalimumab, or placebo for 24 weeks.

Disclosures: This study was funded by Eli Lilly and Company. Four authors declared being employees or stockholders of Eli Lilly Japan KK, Lilly Deutschland GmbH, or Eli Lilly and Company. The other authors declared ties with various sources, including Eli Lilly.

Source: Kameda H et al. Ixekizumab efficacy in patients with severe peripheral psoriatic arthritis: A post hoc analysis of a phase 3, randomized, double-blind, placebo-controlled study (SPIRIT-P1). Rheumatol Ther. 2023 (Oct 19). doi: 10.1007/s40744-023-00605-6

Key clinical point: Dual targeted therapy (DTT) combining two biological disease-modifying antirheumatic drugs (bDMARD) or targeted synthetic (ts) DMARD led to satisfactory clinical improvements and no serious adverse events in patients with difficult-to-treat refractory psoriatic arthritis (PsA).

Major finding: At a median exposure of 14.86 months, the DTT retention rate in patients with PsA was 42.8%, with 40.0% and 53.3% of patients achieving remission or low activity and major clinical improvements, respectively. Treatment discontinuation due to adverse events was reported in one patient with PsA and multiple comorbidities.

Study details: Findings are from an observational, retrospective, cross-sectional study including patients with refractory PsA (n = 14) or spondyloarthritis (n = 22) who simultaneously received two bDMARD or tsDMARD with different therapeutic targets.

Disclosures: This study did not receive any funding. R García-Vicuña declared receiving educational grants, research grants, consultancies, speaking fees, or support for attending meetings from various sources.

Source: Valero-Martinez C et al. Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: A real-world multicenter experience from Spain. Front Immunol. 2023;14:1283251 (Oct 23). doi: 10.3389/fimmu.2023.1283251

Key clinical point: Dual targeted therapy (DTT) combining two biological disease-modifying antirheumatic drugs (bDMARD) or targeted synthetic (ts) DMARD led to satisfactory clinical improvements and no serious adverse events in patients with difficult-to-treat refractory psoriatic arthritis (PsA).

Major finding: At a median exposure of 14.86 months, the DTT retention rate in patients with PsA was 42.8%, with 40.0% and 53.3% of patients achieving remission or low activity and major clinical improvements, respectively. Treatment discontinuation due to adverse events was reported in one patient with PsA and multiple comorbidities.

Study details: Findings are from an observational, retrospective, cross-sectional study including patients with refractory PsA (n = 14) or spondyloarthritis (n = 22) who simultaneously received two bDMARD or tsDMARD with different therapeutic targets.

Disclosures: This study did not receive any funding. R García-Vicuña declared receiving educational grants, research grants, consultancies, speaking fees, or support for attending meetings from various sources.

Source: Valero-Martinez C et al. Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: A real-world multicenter experience from Spain. Front Immunol. 2023;14:1283251 (Oct 23). doi: 10.3389/fimmu.2023.1283251

Key clinical point: Dual targeted therapy (DTT) combining two biological disease-modifying antirheumatic drugs (bDMARD) or targeted synthetic (ts) DMARD led to satisfactory clinical improvements and no serious adverse events in patients with difficult-to-treat refractory psoriatic arthritis (PsA).

Major finding: At a median exposure of 14.86 months, the DTT retention rate in patients with PsA was 42.8%, with 40.0% and 53.3% of patients achieving remission or low activity and major clinical improvements, respectively. Treatment discontinuation due to adverse events was reported in one patient with PsA and multiple comorbidities.

Study details: Findings are from an observational, retrospective, cross-sectional study including patients with refractory PsA (n = 14) or spondyloarthritis (n = 22) who simultaneously received two bDMARD or tsDMARD with different therapeutic targets.

Disclosures: This study did not receive any funding. R García-Vicuña declared receiving educational grants, research grants, consultancies, speaking fees, or support for attending meetings from various sources.

Source: Valero-Martinez C et al. Dual targeted therapy in patients with psoriatic arthritis and spondyloarthritis: A real-world multicenter experience from Spain. Front Immunol. 2023;14:1283251 (Oct 23). doi: 10.3389/fimmu.2023.1283251

Key clinical point: This real-world study validated the efficacy of upadacitinib and elucidated the variables influencing the attainment of minimal disease activity (MDA) in response to upadacitinib therapy in patients with psoriatic arthritis (PsA).

Major finding: At week 24, nearly half (47%) of the patients treated with upadacitinib achieved MDA, with males (odds ratio [OR] 2.54; P = .043), patients naive to biologic disease-modifying antirheumatic drugs (OR 4.13; P = .013), and patients with high baseline C-reactive protein levels (OR 2.49; P = .046) having higher odds of achieving MDA.

Study details: Findings are from the preliminary results of the ongoing UPREAL-PsA study including 126 patients with peripheral or axial PsA who received 15 mg upadacitinib once daily.

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

Source: Luchetti Gentiloni MM et al. Upadacitinib effectiveness and factors associated with minimal disease activity achievement in patients with psoriatic arthritis: Preliminary data of a real-life multicenter study. Arthritis Res Ther. 2023;25:196. (Oct 11). doi: 10.1186/s13075-023-03182-9

Key clinical point: This real-world study validated the efficacy of upadacitinib and elucidated the variables influencing the attainment of minimal disease activity (MDA) in response to upadacitinib therapy in patients with psoriatic arthritis (PsA).

Major finding: At week 24, nearly half (47%) of the patients treated with upadacitinib achieved MDA, with males (odds ratio [OR] 2.54; P = .043), patients naive to biologic disease-modifying antirheumatic drugs (OR 4.13; P = .013), and patients with high baseline C-reactive protein levels (OR 2.49; P = .046) having higher odds of achieving MDA.

Study details: Findings are from the preliminary results of the ongoing UPREAL-PsA study including 126 patients with peripheral or axial PsA who received 15 mg upadacitinib once daily.

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

Source: Luchetti Gentiloni MM et al. Upadacitinib effectiveness and factors associated with minimal disease activity achievement in patients with psoriatic arthritis: Preliminary data of a real-life multicenter study. Arthritis Res Ther. 2023;25:196. (Oct 11). doi: 10.1186/s13075-023-03182-9

Key clinical point: This real-world study validated the efficacy of upadacitinib and elucidated the variables influencing the attainment of minimal disease activity (MDA) in response to upadacitinib therapy in patients with psoriatic arthritis (PsA).

Major finding: At week 24, nearly half (47%) of the patients treated with upadacitinib achieved MDA, with males (odds ratio [OR] 2.54; P = .043), patients naive to biologic disease-modifying antirheumatic drugs (OR 4.13; P = .013), and patients with high baseline C-reactive protein levels (OR 2.49; P = .046) having higher odds of achieving MDA.

Study details: Findings are from the preliminary results of the ongoing UPREAL-PsA study including 126 patients with peripheral or axial PsA who received 15 mg upadacitinib once daily.

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

Source: Luchetti Gentiloni MM et al. Upadacitinib effectiveness and factors associated with minimal disease activity achievement in patients with psoriatic arthritis: Preliminary data of a real-life multicenter study. Arthritis Res Ther. 2023;25:196. (Oct 11). doi: 10.1186/s13075-023-03182-9