Clinical Edge Journal Scan

Breast cancer in young women presents a unique set of challenges owing to life-stage at the time of diagnosis and treatment. Oncofertility, family planning, and pregnancy are essential issues to address at the time of initial consultation and throughout the survivorship setting. Various studies have provided supportive evidence regarding the safety of pregnancy after breast cancer diagnosis and treatment.³ HR+ breast cancer is associated with its own distinctive considerations related to pregnancy and its timing, including the use of endocrine therapy for 5-10 years, the role of female hormones during pregnancy, and late patterns of recurrence that characterize this subtype. A meta-analysis including eight eligible studies and 3805 women with HR+ early breast cancer investigated the prognostic impact of future pregnancy among these patients (Arecco et al). A total of 1285 women had a pregnancy after breast cancer diagnosis and treatment; there was no difference in disease-free survival (hazard ratio 0.96; 95% CI 0.75-1.24; P = .781) and better overall survival (OS; hazard ratio 0.46; 95% CI 0.27-0.77; P < .005) in those with vs those without subsequent pregnancy. Added to this body of data is the prospective POSITIVE trial, which showed that a temporary pause of endocrine therapy for an attempt at conceiving appears to be safe in young women with early HR+ breast cancer with short-term follow-up.⁴ Future research efforts investigating outcomes after assisted reproductive technologies in this population, those with germline mutations, and extended follow-up of studies, such as POSITIVE, will continue to inform guidance for and management of young women with breast cancer.

Guidelines favor the use of adjuvant chemotherapy for small, node-negative, triple-negative breast cancer (TNBC), specifically T1b and T1c tumors.⁵ However, high-quality data to inform this decision-making are sparse, and it is valuable to consider the magnitude of benefit weighed against possible risks and side effects of treatment, as well as patient comorbidities. A retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database including 11,510 patients (3388 with T1b and 8122 with T1c TNBC) evaluated the impact of adjuvant chemotherapy on OS and breast cancer–specific survival (BCSS) (Carbajal-Ochoa et al). The use of adjuvant chemotherapy was associated with improved OS (hazard ratio 0.54; 95% CI 0.47-0.62; P < .001) and BCSS (hazard ratio 0.79; 95% CI 0.63-0.99; P = .043) among T1c TNBC. For those with T1b tumors, adjuvant chemotherapy improved OS (hazard ratio 0.52; 95% CI 0.41-0.68; P < .001) but did not improve BCSS (hazard ratio 0.70; 95% CI 0.45-1.07; P = .10). A better understanding of the molecular drivers implicated in this heterogeneous subtype, and predictors of response and resistance, will aid in identifying those patients who have greater benefit and those who can potentially be spared chemotherapy-related toxicities.

Additional References

1. Anwar SL, Cahyono R, Prabowo D, et al. Metabolic comorbidities and the association with risks of recurrent metastatic disease in breast cancer survivors. BMC Cancer. 2021;21:590. doi: 10.1186/s12885-021-08343-0
2. Sestak I, Distler W, Forbes JF, et al. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: An exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28:3411-3415. doi: 10.1200/JCO.2009.27.2021
3. Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: A systematic review and meta-analysis. J Clin Oncol. 2021;39:3293-3305. doi: 10.1200/JCO.21.00535
4. Partridge AH, Niman SM, Ruggeri M, et al for the International Breast Cancer Study Group and POSITIVE Trial Collaborators. Interrupting endocrine therapy to attempt pregnancy after breast cancer. N Engl J Med. 2023;388:1645-1656. doi:10.1056/NEJMoa2212856
5. Curigliano G, Burstein HJ, Winer EP, et al. De-escalating and escalating treatments for early-stage breast cancer: The St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol. 2017;28:1700-1712. doi:10.1093/annonc/mdx308

Breast cancer in young women presents a unique set of challenges owing to life-stage at the time of diagnosis and treatment. Oncofertility, family planning, and pregnancy are essential issues to address at the time of initial consultation and throughout the survivorship setting. Various studies have provided supportive evidence regarding the safety of pregnancy after breast cancer diagnosis and treatment.³ HR+ breast cancer is associated with its own distinctive considerations related to pregnancy and its timing, including the use of endocrine therapy for 5-10 years, the role of female hormones during pregnancy, and late patterns of recurrence that characterize this subtype. A meta-analysis including eight eligible studies and 3805 women with HR+ early breast cancer investigated the prognostic impact of future pregnancy among these patients (Arecco et al). A total of 1285 women had a pregnancy after breast cancer diagnosis and treatment; there was no difference in disease-free survival (hazard ratio 0.96; 95% CI 0.75-1.24; P = .781) and better overall survival (OS; hazard ratio 0.46; 95% CI 0.27-0.77; P < .005) in those with vs those without subsequent pregnancy. Added to this body of data is the prospective POSITIVE trial, which showed that a temporary pause of endocrine therapy for an attempt at conceiving appears to be safe in young women with early HR+ breast cancer with short-term follow-up.⁴ Future research efforts investigating outcomes after assisted reproductive technologies in this population, those with germline mutations, and extended follow-up of studies, such as POSITIVE, will continue to inform guidance for and management of young women with breast cancer.

Guidelines favor the use of adjuvant chemotherapy for small, node-negative, triple-negative breast cancer (TNBC), specifically T1b and T1c tumors.⁵ However, high-quality data to inform this decision-making are sparse, and it is valuable to consider the magnitude of benefit weighed against possible risks and side effects of treatment, as well as patient comorbidities. A retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database including 11,510 patients (3388 with T1b and 8122 with T1c TNBC) evaluated the impact of adjuvant chemotherapy on OS and breast cancer–specific survival (BCSS) (Carbajal-Ochoa et al). The use of adjuvant chemotherapy was associated with improved OS (hazard ratio 0.54; 95% CI 0.47-0.62; P < .001) and BCSS (hazard ratio 0.79; 95% CI 0.63-0.99; P = .043) among T1c TNBC. For those with T1b tumors, adjuvant chemotherapy improved OS (hazard ratio 0.52; 95% CI 0.41-0.68; P < .001) but did not improve BCSS (hazard ratio 0.70; 95% CI 0.45-1.07; P = .10). A better understanding of the molecular drivers implicated in this heterogeneous subtype, and predictors of response and resistance, will aid in identifying those patients who have greater benefit and those who can potentially be spared chemotherapy-related toxicities.

Additional References

1. Anwar SL, Cahyono R, Prabowo D, et al. Metabolic comorbidities and the association with risks of recurrent metastatic disease in breast cancer survivors. BMC Cancer. 2021;21:590. doi: 10.1186/s12885-021-08343-0
2. Sestak I, Distler W, Forbes JF, et al. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: An exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28:3411-3415. doi: 10.1200/JCO.2009.27.2021
3. Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: A systematic review and meta-analysis. J Clin Oncol. 2021;39:3293-3305. doi: 10.1200/JCO.21.00535
4. Partridge AH, Niman SM, Ruggeri M, et al for the International Breast Cancer Study Group and POSITIVE Trial Collaborators. Interrupting endocrine therapy to attempt pregnancy after breast cancer. N Engl J Med. 2023;388:1645-1656. doi:10.1056/NEJMoa2212856
5. Curigliano G, Burstein HJ, Winer EP, et al. De-escalating and escalating treatments for early-stage breast cancer: The St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol. 2017;28:1700-1712. doi:10.1093/annonc/mdx308

Breast cancer in young women presents a unique set of challenges owing to life-stage at the time of diagnosis and treatment. Oncofertility, family planning, and pregnancy are essential issues to address at the time of initial consultation and throughout the survivorship setting. Various studies have provided supportive evidence regarding the safety of pregnancy after breast cancer diagnosis and treatment.³ HR+ breast cancer is associated with its own distinctive considerations related to pregnancy and its timing, including the use of endocrine therapy for 5-10 years, the role of female hormones during pregnancy, and late patterns of recurrence that characterize this subtype. A meta-analysis including eight eligible studies and 3805 women with HR+ early breast cancer investigated the prognostic impact of future pregnancy among these patients (Arecco et al). A total of 1285 women had a pregnancy after breast cancer diagnosis and treatment; there was no difference in disease-free survival (hazard ratio 0.96; 95% CI 0.75-1.24; P = .781) and better overall survival (OS; hazard ratio 0.46; 95% CI 0.27-0.77; P < .005) in those with vs those without subsequent pregnancy. Added to this body of data is the prospective POSITIVE trial, which showed that a temporary pause of endocrine therapy for an attempt at conceiving appears to be safe in young women with early HR+ breast cancer with short-term follow-up.⁴ Future research efforts investigating outcomes after assisted reproductive technologies in this population, those with germline mutations, and extended follow-up of studies, such as POSITIVE, will continue to inform guidance for and management of young women with breast cancer.

Guidelines favor the use of adjuvant chemotherapy for small, node-negative, triple-negative breast cancer (TNBC), specifically T1b and T1c tumors.⁵ However, high-quality data to inform this decision-making are sparse, and it is valuable to consider the magnitude of benefit weighed against possible risks and side effects of treatment, as well as patient comorbidities. A retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database including 11,510 patients (3388 with T1b and 8122 with T1c TNBC) evaluated the impact of adjuvant chemotherapy on OS and breast cancer–specific survival (BCSS) (Carbajal-Ochoa et al). The use of adjuvant chemotherapy was associated with improved OS (hazard ratio 0.54; 95% CI 0.47-0.62; P < .001) and BCSS (hazard ratio 0.79; 95% CI 0.63-0.99; P = .043) among T1c TNBC. For those with T1b tumors, adjuvant chemotherapy improved OS (hazard ratio 0.52; 95% CI 0.41-0.68; P < .001) but did not improve BCSS (hazard ratio 0.70; 95% CI 0.45-1.07; P = .10). A better understanding of the molecular drivers implicated in this heterogeneous subtype, and predictors of response and resistance, will aid in identifying those patients who have greater benefit and those who can potentially be spared chemotherapy-related toxicities.

Additional References

1. Anwar SL, Cahyono R, Prabowo D, et al. Metabolic comorbidities and the association with risks of recurrent metastatic disease in breast cancer survivors. BMC Cancer. 2021;21:590. doi: 10.1186/s12885-021-08343-0
2. Sestak I, Distler W, Forbes JF, et al. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: An exploratory analysis from the ATAC trial. J Clin Oncol. 2010;28:3411-3415. doi: 10.1200/JCO.2009.27.2021
3. Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: A systematic review and meta-analysis. J Clin Oncol. 2021;39:3293-3305. doi: 10.1200/JCO.21.00535
4. Partridge AH, Niman SM, Ruggeri M, et al for the International Breast Cancer Study Group and POSITIVE Trial Collaborators. Interrupting endocrine therapy to attempt pregnancy after breast cancer. N Engl J Med. 2023;388:1645-1656. doi:10.1056/NEJMoa2212856
5. Curigliano G, Burstein HJ, Winer EP, et al. De-escalating and escalating treatments for early-stage breast cancer: The St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol. 2017;28:1700-1712. doi:10.1093/annonc/mdx308

Schlösser and colleagues provide a real-world report of 48 patients treated with upadacitinib for atopic dermatitis, many of whom had previously been treated with cyclosporine and dupilumab. The upbeat authors concluded, "Overall, adverse events were mostly well tolerated." Being a cynical, glass-is-half-empty kind of person, I wondered what that meant. Most patients (56%) reported adverse events, the most common being acne (25% of patients treated), nausea (13%), respiratory tract infections (10%), and herpes virus (8%). The herpes virus signal is not just a bit of a concern for me, but it also makes it hard for me to convince patients to take a Janus kinase (JAK) inhibitor, as when I even mention herpes, patients reply, often rather emphatically, "I don't want herpes!" I'll be encouraging patients to get vaccinated for shingles when starting them on JAK inhibitors.

Dupilumab seems to work great in real-life use. In Martinez-Cabriales and colleagues' study of 62 children age < 12 with atopic dermatitis, only four discontinued the treatment. One of these was a nonresponder who took only one injection and had flushing, and one of the other three discontinued because their skin had completely cleared.

When I saw the title of Rand and colleagues' article, "Matching-Adjusted Indirect Comparison of the Long-Term Efficacy Maintenance and Adverse Event Rates of Lebrikizumab Versus Dupilumab in Moderate-to-Severe Atopic Dermatitis," I thought, Oh, this is great — a head-to-head, long-term trial comparing lebrikizumab and dupilumab. I was disappointed to find that this was simply a retrospective analysis of data reported from different studies. The study found little difference in efficacy or safety of the two drugs. Both seem to be excellent medications for atopic dermatitis.

Here's another study (Zhou et al) that reports possible increased risk for a comorbidity (cognitive dysfunction) associated with atopic dermatitis. This study reports that there is an elevated hazard ratio that is statistically significant; the article fails to report what the increased absolute risk is for cognitive dysfunction associated with atopic dermatitis. My guess is that it is small and probably clinically unimportant. The hazard ratio for developing dementia was 1.16. It's hard to know how that translates into absolute risk, but my brilliant friend and former partner, Dr Alan Fleischer, once told me that the odds ratio for smoking and lung cancer is something like 100; the hazard ratio is in the range of 20. On the basis of a hazard ratio of 1.16, I don't think patients with atopic dermatitis need to be any more worried about dementia than those without. (Though, to be honest, I think we can all be worried about developing dementia.)

In this tour de force analysis of 83 trials with over 20,000 participants, Drucker and colleagues determined that high doses of abrocitinib and upadacitinib are more effective than even dupilumab for atopic dermatitis. The standard doses of these JAK inhibitors were similar in efficacy to dupilumab. I think it's safe to say that JAK inhibitors are, at least at their high doses, more effective than dupilumab, but safety remains a critical factor in treatment decision-making. I think JAK inhibitors are a great option for patients who need the most effective treatment or who fail to respond to dupilumab.

The title of the article by Oh and colleagues, "Increased Risk of Renal Malignancy in Patients With Moderate to Severe Atopic Dermatitis," seems like it could terrify patients. The study involved an analysis of an enormous number of people, including tens of thousands with atopic dermatitis and millions of controls. The investigators did find statistically significant differences in the rate of malignancy. The rate of renal cancer was about 1.6 per 10,000 person-years for people without atopic dermatitis or people with mild atopic dermatitis; the rate was about 2.5 per 10,000 people for patients with moderate to severe atopic dermatitis. While the rate of renal cancer was statistically significantly higher in patients with moderate to severe atopic dermatitis (ie, the higher rate was unlikely to be occurring due to chance alone), these patients have very little risk for renal malignancy. The authors' conclusion that regular checkups for renal malignancy are recommended for patients with severe atopic dermatitis seems unnecessary to me.

Schlösser and colleagues provide a real-world report of 48 patients treated with upadacitinib for atopic dermatitis, many of whom had previously been treated with cyclosporine and dupilumab. The upbeat authors concluded, "Overall, adverse events were mostly well tolerated." Being a cynical, glass-is-half-empty kind of person, I wondered what that meant. Most patients (56%) reported adverse events, the most common being acne (25% of patients treated), nausea (13%), respiratory tract infections (10%), and herpes virus (8%). The herpes virus signal is not just a bit of a concern for me, but it also makes it hard for me to convince patients to take a Janus kinase (JAK) inhibitor, as when I even mention herpes, patients reply, often rather emphatically, "I don't want herpes!" I'll be encouraging patients to get vaccinated for shingles when starting them on JAK inhibitors.

Dupilumab seems to work great in real-life use. In Martinez-Cabriales and colleagues' study of 62 children age < 12 with atopic dermatitis, only four discontinued the treatment. One of these was a nonresponder who took only one injection and had flushing, and one of the other three discontinued because their skin had completely cleared.

When I saw the title of Rand and colleagues' article, "Matching-Adjusted Indirect Comparison of the Long-Term Efficacy Maintenance and Adverse Event Rates of Lebrikizumab Versus Dupilumab in Moderate-to-Severe Atopic Dermatitis," I thought, Oh, this is great — a head-to-head, long-term trial comparing lebrikizumab and dupilumab. I was disappointed to find that this was simply a retrospective analysis of data reported from different studies. The study found little difference in efficacy or safety of the two drugs. Both seem to be excellent medications for atopic dermatitis.

Here's another study (Zhou et al) that reports possible increased risk for a comorbidity (cognitive dysfunction) associated with atopic dermatitis. This study reports that there is an elevated hazard ratio that is statistically significant; the article fails to report what the increased absolute risk is for cognitive dysfunction associated with atopic dermatitis. My guess is that it is small and probably clinically unimportant. The hazard ratio for developing dementia was 1.16. It's hard to know how that translates into absolute risk, but my brilliant friend and former partner, Dr Alan Fleischer, once told me that the odds ratio for smoking and lung cancer is something like 100; the hazard ratio is in the range of 20. On the basis of a hazard ratio of 1.16, I don't think patients with atopic dermatitis need to be any more worried about dementia than those without. (Though, to be honest, I think we can all be worried about developing dementia.)

In this tour de force analysis of 83 trials with over 20,000 participants, Drucker and colleagues determined that high doses of abrocitinib and upadacitinib are more effective than even dupilumab for atopic dermatitis. The standard doses of these JAK inhibitors were similar in efficacy to dupilumab. I think it's safe to say that JAK inhibitors are, at least at their high doses, more effective than dupilumab, but safety remains a critical factor in treatment decision-making. I think JAK inhibitors are a great option for patients who need the most effective treatment or who fail to respond to dupilumab.

The title of the article by Oh and colleagues, "Increased Risk of Renal Malignancy in Patients With Moderate to Severe Atopic Dermatitis," seems like it could terrify patients. The study involved an analysis of an enormous number of people, including tens of thousands with atopic dermatitis and millions of controls. The investigators did find statistically significant differences in the rate of malignancy. The rate of renal cancer was about 1.6 per 10,000 person-years for people without atopic dermatitis or people with mild atopic dermatitis; the rate was about 2.5 per 10,000 people for patients with moderate to severe atopic dermatitis. While the rate of renal cancer was statistically significantly higher in patients with moderate to severe atopic dermatitis (ie, the higher rate was unlikely to be occurring due to chance alone), these patients have very little risk for renal malignancy. The authors' conclusion that regular checkups for renal malignancy are recommended for patients with severe atopic dermatitis seems unnecessary to me.

Schlösser and colleagues provide a real-world report of 48 patients treated with upadacitinib for atopic dermatitis, many of whom had previously been treated with cyclosporine and dupilumab. The upbeat authors concluded, "Overall, adverse events were mostly well tolerated." Being a cynical, glass-is-half-empty kind of person, I wondered what that meant. Most patients (56%) reported adverse events, the most common being acne (25% of patients treated), nausea (13%), respiratory tract infections (10%), and herpes virus (8%). The herpes virus signal is not just a bit of a concern for me, but it also makes it hard for me to convince patients to take a Janus kinase (JAK) inhibitor, as when I even mention herpes, patients reply, often rather emphatically, "I don't want herpes!" I'll be encouraging patients to get vaccinated for shingles when starting them on JAK inhibitors.

Dupilumab seems to work great in real-life use. In Martinez-Cabriales and colleagues' study of 62 children age < 12 with atopic dermatitis, only four discontinued the treatment. One of these was a nonresponder who took only one injection and had flushing, and one of the other three discontinued because their skin had completely cleared.

When I saw the title of Rand and colleagues' article, "Matching-Adjusted Indirect Comparison of the Long-Term Efficacy Maintenance and Adverse Event Rates of Lebrikizumab Versus Dupilumab in Moderate-to-Severe Atopic Dermatitis," I thought, Oh, this is great — a head-to-head, long-term trial comparing lebrikizumab and dupilumab. I was disappointed to find that this was simply a retrospective analysis of data reported from different studies. The study found little difference in efficacy or safety of the two drugs. Both seem to be excellent medications for atopic dermatitis.

Here's another study (Zhou et al) that reports possible increased risk for a comorbidity (cognitive dysfunction) associated with atopic dermatitis. This study reports that there is an elevated hazard ratio that is statistically significant; the article fails to report what the increased absolute risk is for cognitive dysfunction associated with atopic dermatitis. My guess is that it is small and probably clinically unimportant. The hazard ratio for developing dementia was 1.16. It's hard to know how that translates into absolute risk, but my brilliant friend and former partner, Dr Alan Fleischer, once told me that the odds ratio for smoking and lung cancer is something like 100; the hazard ratio is in the range of 20. On the basis of a hazard ratio of 1.16, I don't think patients with atopic dermatitis need to be any more worried about dementia than those without. (Though, to be honest, I think we can all be worried about developing dementia.)

In this tour de force analysis of 83 trials with over 20,000 participants, Drucker and colleagues determined that high doses of abrocitinib and upadacitinib are more effective than even dupilumab for atopic dermatitis. The standard doses of these JAK inhibitors were similar in efficacy to dupilumab. I think it's safe to say that JAK inhibitors are, at least at their high doses, more effective than dupilumab, but safety remains a critical factor in treatment decision-making. I think JAK inhibitors are a great option for patients who need the most effective treatment or who fail to respond to dupilumab.

The title of the article by Oh and colleagues, "Increased Risk of Renal Malignancy in Patients With Moderate to Severe Atopic Dermatitis," seems like it could terrify patients. The study involved an analysis of an enormous number of people, including tens of thousands with atopic dermatitis and millions of controls. The investigators did find statistically significant differences in the rate of malignancy. The rate of renal cancer was about 1.6 per 10,000 person-years for people without atopic dermatitis or people with mild atopic dermatitis; the rate was about 2.5 per 10,000 people for patients with moderate to severe atopic dermatitis. While the rate of renal cancer was statistically significantly higher in patients with moderate to severe atopic dermatitis (ie, the higher rate was unlikely to be occurring due to chance alone), these patients have very little risk for renal malignancy. The authors' conclusion that regular checkups for renal malignancy are recommended for patients with severe atopic dermatitis seems unnecessary to me.

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