Psoriatic Arthritis

Key clinical point: Patients with psoriatic arthritis (PsA) reported a low cumulative incidence of opportunistic infections (OIs) after treatment with either biologic (bDMARDs) or targeted synthetic (tsDMARDs) disease-modifying antirheumatic drugs.

Major finding: The cumulative incidence of OIs was <3% when stratified by the mechanism of action: Janus Kinase inhibitors (2.72%; 95% CI, 1.05%-5.04%), anti-interleukin (IL)-17s (1.18%; 95% CI, 0.60%-1.90%), anti-IL-23s (0.24%; 95% CI, 0.04%-0.54%), and anti-tumor necrosis factors (0.01%; 95% CI, 0.00%-0.21%).

Study details: Findings are from a meta-analysis of 47 randomized controlled trials and 26 follow-up extension studies including patients with PsA who were assigned to receive ≥1 dose of bDMARD or tsDMARD (n=11,790) or placebo (n=6,425) during the placebo-controlled period; 17,197 patients received ≥1 dose of bDMARD or tsDMARD considering the extension period.

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

Source: Vassilopoulos A et al. The incidence of opportunistic infections in patients with psoriatic arthritis treated with biologic and targeted synthetic agents: A systematic review and meta-analysis. Front. Pharmacol. 2022;13:992713 (Oct 5). Doi: 10.3389/fphar.2022.992713.

Key clinical point: Patients with psoriatic arthritis (PsA) reported a low cumulative incidence of opportunistic infections (OIs) after treatment with either biologic (bDMARDs) or targeted synthetic (tsDMARDs) disease-modifying antirheumatic drugs.

Major finding: The cumulative incidence of OIs was <3% when stratified by the mechanism of action: Janus Kinase inhibitors (2.72%; 95% CI, 1.05%-5.04%), anti-interleukin (IL)-17s (1.18%; 95% CI, 0.60%-1.90%), anti-IL-23s (0.24%; 95% CI, 0.04%-0.54%), and anti-tumor necrosis factors (0.01%; 95% CI, 0.00%-0.21%).

Study details: Findings are from a meta-analysis of 47 randomized controlled trials and 26 follow-up extension studies including patients with PsA who were assigned to receive ≥1 dose of bDMARD or tsDMARD (n=11,790) or placebo (n=6,425) during the placebo-controlled period; 17,197 patients received ≥1 dose of bDMARD or tsDMARD considering the extension period.

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

Source: Vassilopoulos A et al. The incidence of opportunistic infections in patients with psoriatic arthritis treated with biologic and targeted synthetic agents: A systematic review and meta-analysis. Front. Pharmacol. 2022;13:992713 (Oct 5). Doi: 10.3389/fphar.2022.992713.

Key clinical point: Patients with psoriatic arthritis (PsA) reported a low cumulative incidence of opportunistic infections (OIs) after treatment with either biologic (bDMARDs) or targeted synthetic (tsDMARDs) disease-modifying antirheumatic drugs.

Major finding: The cumulative incidence of OIs was <3% when stratified by the mechanism of action: Janus Kinase inhibitors (2.72%; 95% CI, 1.05%-5.04%), anti-interleukin (IL)-17s (1.18%; 95% CI, 0.60%-1.90%), anti-IL-23s (0.24%; 95% CI, 0.04%-0.54%), and anti-tumor necrosis factors (0.01%; 95% CI, 0.00%-0.21%).

Study details: Findings are from a meta-analysis of 47 randomized controlled trials and 26 follow-up extension studies including patients with PsA who were assigned to receive ≥1 dose of bDMARD or tsDMARD (n=11,790) or placebo (n=6,425) during the placebo-controlled period; 17,197 patients received ≥1 dose of bDMARD or tsDMARD considering the extension period.

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

Source: Vassilopoulos A et al. The incidence of opportunistic infections in patients with psoriatic arthritis treated with biologic and targeted synthetic agents: A systematic review and meta-analysis. Front. Pharmacol. 2022;13:992713 (Oct 5). Doi: 10.3389/fphar.2022.992713.

Key clinical point: Janus Kinase (JAK) inhibitors demonstrated promising efficacy in reducing disease severity in patients with psoriatic arthritis (PsA).

Major finding: Treatment with JAK inhibitors vs. placebo was associated with higher odds of achieving ≥20% improvement in American College of Rheumatology (ACR) score (odds ratio [OR], 4.45; 95% CI, 3.64-5.44), with similar outcomes observed with tofacitinib vs. placebo (OR, 2.96; 95% CI, 2.01-4.35) and non-tofacitinib JAK inhibitors vs. placebo (OR, 5.41; 95% CI, 3.95-7.40).

Study details: Findings are from a meta-analysis of 15 randomized controlled trials including 6,757 patients with moderate-to-severe plaque psoriasis or PsA who received treatment with a JAK inhibitor or placebo.

Disclosures: S Sarabia declared receiving summer student grant from the Queen’s University Faculty of Medicine. The authors declared no conflicts of interest.

Source: Sarabia S et al. Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: A systematic review and meta-analysis. BMC Rheumatol. 2022;6(1):71 (Sep 27). Doi: 10.1186/s41927-022-00287-7.

Key clinical point: Janus Kinase (JAK) inhibitors demonstrated promising efficacy in reducing disease severity in patients with psoriatic arthritis (PsA).

Major finding: Treatment with JAK inhibitors vs. placebo was associated with higher odds of achieving ≥20% improvement in American College of Rheumatology (ACR) score (odds ratio [OR], 4.45; 95% CI, 3.64-5.44), with similar outcomes observed with tofacitinib vs. placebo (OR, 2.96; 95% CI, 2.01-4.35) and non-tofacitinib JAK inhibitors vs. placebo (OR, 5.41; 95% CI, 3.95-7.40).

Study details: Findings are from a meta-analysis of 15 randomized controlled trials including 6,757 patients with moderate-to-severe plaque psoriasis or PsA who received treatment with a JAK inhibitor or placebo.

Disclosures: S Sarabia declared receiving summer student grant from the Queen’s University Faculty of Medicine. The authors declared no conflicts of interest.

Source: Sarabia S et al. Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: A systematic review and meta-analysis. BMC Rheumatol. 2022;6(1):71 (Sep 27). Doi: 10.1186/s41927-022-00287-7.

Key clinical point: Janus Kinase (JAK) inhibitors demonstrated promising efficacy in reducing disease severity in patients with psoriatic arthritis (PsA).

Major finding: Treatment with JAK inhibitors vs. placebo was associated with higher odds of achieving ≥20% improvement in American College of Rheumatology (ACR) score (odds ratio [OR], 4.45; 95% CI, 3.64-5.44), with similar outcomes observed with tofacitinib vs. placebo (OR, 2.96; 95% CI, 2.01-4.35) and non-tofacitinib JAK inhibitors vs. placebo (OR, 5.41; 95% CI, 3.95-7.40).

Study details: Findings are from a meta-analysis of 15 randomized controlled trials including 6,757 patients with moderate-to-severe plaque psoriasis or PsA who received treatment with a JAK inhibitor or placebo.

Disclosures: S Sarabia declared receiving summer student grant from the Queen’s University Faculty of Medicine. The authors declared no conflicts of interest.

Source: Sarabia S et al. Efficacy and safety of JAK inhibitors in the treatment of psoriasis and psoriatic arthritis: A systematic review and meta-analysis. BMC Rheumatol. 2022;6(1):71 (Sep 27). Doi: 10.1186/s41927-022-00287-7.

Key clinical point: Pain alleviation by tofacitinib in patients with psoriatic arthritis (PsA) was mostly due to improvement in itch, enthesitis, and C-reactive protein (CRP) levels.

Major finding: Tofacitinib predominantly reduced pain indirectly (70.5%; P < .0001), as indicated by improvements in the Itch Severity Item score (37.4%; P = .0002), Leeds Enthesitis Index score (17.8%; P = .0157), and CRP levels (15.3%; P = .0107).

Study details: Findings are from a mediation analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) including 474 patients with active PsA who received tofacitinib 5 mg twice daily or placebo.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer, and the other authors reported ties with several sources.

Source: de Vlam K et al. Identifying and quantifying the role of inflammation in pain reduction for patients with psoriatic arthritis treated with tofacitinib: A mediation analysis. Rheumatol Ther. 2022;9(5):1451-1464 (Sep 8). Doi: 10.1007/s40744-022-00482-5.

Key clinical point: Pain alleviation by tofacitinib in patients with psoriatic arthritis (PsA) was mostly due to improvement in itch, enthesitis, and C-reactive protein (CRP) levels.

Major finding: Tofacitinib predominantly reduced pain indirectly (70.5%; P < .0001), as indicated by improvements in the Itch Severity Item score (37.4%; P = .0002), Leeds Enthesitis Index score (17.8%; P = .0157), and CRP levels (15.3%; P = .0107).

Study details: Findings are from a mediation analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) including 474 patients with active PsA who received tofacitinib 5 mg twice daily or placebo.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer, and the other authors reported ties with several sources.

Source: de Vlam K et al. Identifying and quantifying the role of inflammation in pain reduction for patients with psoriatic arthritis treated with tofacitinib: A mediation analysis. Rheumatol Ther. 2022;9(5):1451-1464 (Sep 8). Doi: 10.1007/s40744-022-00482-5.

Key clinical point: Pain alleviation by tofacitinib in patients with psoriatic arthritis (PsA) was mostly due to improvement in itch, enthesitis, and C-reactive protein (CRP) levels.

Major finding: Tofacitinib predominantly reduced pain indirectly (70.5%; P < .0001), as indicated by improvements in the Itch Severity Item score (37.4%; P = .0002), Leeds Enthesitis Index score (17.8%; P = .0157), and CRP levels (15.3%; P = .0107).

Study details: Findings are from a mediation analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) including 474 patients with active PsA who received tofacitinib 5 mg twice daily or placebo.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer, and the other authors reported ties with several sources.

Source: de Vlam K et al. Identifying and quantifying the role of inflammation in pain reduction for patients with psoriatic arthritis treated with tofacitinib: A mediation analysis. Rheumatol Ther. 2022;9(5):1451-1464 (Sep 8). Doi: 10.1007/s40744-022-00482-5.

Key clinical point: Biologics improved disease activity (DA) in a real-world population of patients with psoriatic arthritis (PsA) in Italy.

Major finding: At 6 months, a substantially high proportion of patients receiving biologics achieved the European league against rheumatism (EULAR) DA Score 28 (71.8%; 95% CI, 66.7%-76.8%), with outcomes being similar with secukinumab (73.4%; 95% CI, 65.8%-81.1%) and tumor necrosis factor-inhibitors (71.9%; 95% CI, 64.9%-78.8%). The responder rate was 68.0% at year 1.

Study details: Findings are from a multicenter, noninterventional, cohort study including 399 patients with PsA, of which 308 were evaluable at 6 months and 297 patients were evaluable at 1 year. Most patients received biologics for ≥6 months.

Disclosures: This study was supported by a grant from Novartis Farma S.p.A. Origgio. Three authors declared being part-time/regular employees of Novartis Farma or MediNeos Observational Research, hired by Novartis Farma. The authors declared receiving honoraria, speaker fees, and/or scientific support from other sources.

Source: Colombo D et al. Real-world evidence of biologic treatments in psoriatic arthritis in Italy: Results of the CHRONOS (EffeCtiveness of biologic treatments for psoriatic artHRitis in Italy: An ObservatioNal lOngitudinal Study of real-life clinical practice) observational longitudinal study. BMC Rheumatol. 2022;6(1):57 (Sep 12). Doi: 10.1186/s41927-022-00284-w.

Key clinical point: Biologics improved disease activity (DA) in a real-world population of patients with psoriatic arthritis (PsA) in Italy.

Major finding: At 6 months, a substantially high proportion of patients receiving biologics achieved the European league against rheumatism (EULAR) DA Score 28 (71.8%; 95% CI, 66.7%-76.8%), with outcomes being similar with secukinumab (73.4%; 95% CI, 65.8%-81.1%) and tumor necrosis factor-inhibitors (71.9%; 95% CI, 64.9%-78.8%). The responder rate was 68.0% at year 1.

Study details: Findings are from a multicenter, noninterventional, cohort study including 399 patients with PsA, of which 308 were evaluable at 6 months and 297 patients were evaluable at 1 year. Most patients received biologics for ≥6 months.

Disclosures: This study was supported by a grant from Novartis Farma S.p.A. Origgio. Three authors declared being part-time/regular employees of Novartis Farma or MediNeos Observational Research, hired by Novartis Farma. The authors declared receiving honoraria, speaker fees, and/or scientific support from other sources.

Source: Colombo D et al. Real-world evidence of biologic treatments in psoriatic arthritis in Italy: Results of the CHRONOS (EffeCtiveness of biologic treatments for psoriatic artHRitis in Italy: An ObservatioNal lOngitudinal Study of real-life clinical practice) observational longitudinal study. BMC Rheumatol. 2022;6(1):57 (Sep 12). Doi: 10.1186/s41927-022-00284-w.

Key clinical point: Biologics improved disease activity (DA) in a real-world population of patients with psoriatic arthritis (PsA) in Italy.

Major finding: At 6 months, a substantially high proportion of patients receiving biologics achieved the European league against rheumatism (EULAR) DA Score 28 (71.8%; 95% CI, 66.7%-76.8%), with outcomes being similar with secukinumab (73.4%; 95% CI, 65.8%-81.1%) and tumor necrosis factor-inhibitors (71.9%; 95% CI, 64.9%-78.8%). The responder rate was 68.0% at year 1.

Study details: Findings are from a multicenter, noninterventional, cohort study including 399 patients with PsA, of which 308 were evaluable at 6 months and 297 patients were evaluable at 1 year. Most patients received biologics for ≥6 months.

Disclosures: This study was supported by a grant from Novartis Farma S.p.A. Origgio. Three authors declared being part-time/regular employees of Novartis Farma or MediNeos Observational Research, hired by Novartis Farma. The authors declared receiving honoraria, speaker fees, and/or scientific support from other sources.

Source: Colombo D et al. Real-world evidence of biologic treatments in psoriatic arthritis in Italy: Results of the CHRONOS (EffeCtiveness of biologic treatments for psoriatic artHRitis in Italy: An ObservatioNal lOngitudinal Study of real-life clinical practice) observational longitudinal study. BMC Rheumatol. 2022;6(1):57 (Sep 12). Doi: 10.1186/s41927-022-00284-w.

Key clinical point: Patients with psoriatic arthritis (PsA) who had nail psoriasis were older and had higher disease burden and lower quality of life (QoL) than those without nail psoriasis.

Major finding: Patients with vs. without nail psoriasis had a higher median age (48 vs. 46 years; P = .001), body mass index (29 vs. 28 kg/m²; P = .02), tender (P < .001) and swollen (P = .011) joint counts, and PsAQoL score (6 vs. 4; P = .001).

Study details: Findings are from a cross-sectional, multicenter study including 1,22 patients with PsA, of which 57.5% had nail psoriasis.

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

Source: Cengiz G et al. The impact of nail psoriasis on disease activity, quality of life, and clinical variables in patients with psoriatic arthritis: A cross-sectional multicenter study. Int J Rheum Dis. 2022 (Sep 27). Doi:10.1111/1756-185X.14442

Key clinical point: Patients with psoriatic arthritis (PsA) who had nail psoriasis were older and had higher disease burden and lower quality of life (QoL) than those without nail psoriasis.

Major finding: Patients with vs. without nail psoriasis had a higher median age (48 vs. 46 years; P = .001), body mass index (29 vs. 28 kg/m²; P = .02), tender (P < .001) and swollen (P = .011) joint counts, and PsAQoL score (6 vs. 4; P = .001).

Study details: Findings are from a cross-sectional, multicenter study including 1,22 patients with PsA, of which 57.5% had nail psoriasis.

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

Source: Cengiz G et al. The impact of nail psoriasis on disease activity, quality of life, and clinical variables in patients with psoriatic arthritis: A cross-sectional multicenter study. Int J Rheum Dis. 2022 (Sep 27). Doi:10.1111/1756-185X.14442

Key clinical point: Patients with psoriatic arthritis (PsA) who had nail psoriasis were older and had higher disease burden and lower quality of life (QoL) than those without nail psoriasis.

Major finding: Patients with vs. without nail psoriasis had a higher median age (48 vs. 46 years; P = .001), body mass index (29 vs. 28 kg/m²; P = .02), tender (P < .001) and swollen (P = .011) joint counts, and PsAQoL score (6 vs. 4; P = .001).

Study details: Findings are from a cross-sectional, multicenter study including 1,22 patients with PsA, of which 57.5% had nail psoriasis.

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

Source: Cengiz G et al. The impact of nail psoriasis on disease activity, quality of life, and clinical variables in patients with psoriatic arthritis: A cross-sectional multicenter study. Int J Rheum Dis. 2022 (Sep 27). Doi:10.1111/1756-185X.14442

Key clinical point: Patients with psoriatic arthritis (PsA) and obesity had ~50% lower likelihood of achieving minimal disease activity (MDA) or remission within a year of initiating treatment with biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD).

Major finding: Odds of achieving MDA (adjusted odds ratio [aOR] 0.45; 95% CI 0.24-0.82) and DAPSA-remission (aOR 0.42; 95% CI 0.21-0.85) were lower in the obese vs normal weight group within the first year; similarly, the overweight group had reduced odds of achieving DAPSA-remission (aOR 0.44; 95% CI 0.24-0.79).

Study details: Findings are from an observational cohort study including 774 adult patients with PsA who started their first b/tsDMARD.

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

Source: Vallejo-Yague E et al. Minimal disease activity and remission in patients with psoriatic arthritis with elevated body mass index: An observational cohort study in the Swiss Clinical Quality Management cohort. BMJ Open. 2022;12(9):e061474 (Sep 17). Doi: 10.1136/bmjopen-2022-061474

Key clinical point: Patients with psoriatic arthritis (PsA) and obesity had ~50% lower likelihood of achieving minimal disease activity (MDA) or remission within a year of initiating treatment with biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD).

Major finding: Odds of achieving MDA (adjusted odds ratio [aOR] 0.45; 95% CI 0.24-0.82) and DAPSA-remission (aOR 0.42; 95% CI 0.21-0.85) were lower in the obese vs normal weight group within the first year; similarly, the overweight group had reduced odds of achieving DAPSA-remission (aOR 0.44; 95% CI 0.24-0.79).

Study details: Findings are from an observational cohort study including 774 adult patients with PsA who started their first b/tsDMARD.

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

Source: Vallejo-Yague E et al. Minimal disease activity and remission in patients with psoriatic arthritis with elevated body mass index: An observational cohort study in the Swiss Clinical Quality Management cohort. BMJ Open. 2022;12(9):e061474 (Sep 17). Doi: 10.1136/bmjopen-2022-061474

Key clinical point: Patients with psoriatic arthritis (PsA) and obesity had ~50% lower likelihood of achieving minimal disease activity (MDA) or remission within a year of initiating treatment with biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD).

Major finding: Odds of achieving MDA (adjusted odds ratio [aOR] 0.45; 95% CI 0.24-0.82) and DAPSA-remission (aOR 0.42; 95% CI 0.21-0.85) were lower in the obese vs normal weight group within the first year; similarly, the overweight group had reduced odds of achieving DAPSA-remission (aOR 0.44; 95% CI 0.24-0.79).

Study details: Findings are from an observational cohort study including 774 adult patients with PsA who started their first b/tsDMARD.

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

Source: Vallejo-Yague E et al. Minimal disease activity and remission in patients with psoriatic arthritis with elevated body mass index: An observational cohort study in the Swiss Clinical Quality Management cohort. BMJ Open. 2022;12(9):e061474 (Sep 17). Doi: 10.1136/bmjopen-2022-061474

Key clinical point: Preliminary results from this real-world study demonstrated efficacy of interleukin (IL)-23 inhibitors in patients with psoriatic arthritis (PsA).

Major finding: A substantial proportion of patients with PsA receiving either of the IL-23 inhibitors achieved complete (40.9%) or partial (36.4%) remission compared with only 18.2% of patients who demonstrated no improvement. A higher proportion of patients receiving guselkumab achieved remission or partial remission (38.5% and 46.1%, respectively) than treatment failure (15.4%), with similar outcomes being observed with risankizumab.

Study details: Findings are from a retrospective, observational study including 80 patients with psoriasis who received guselkumab, tildrakizumab, or risankizumab, of which 27.5% of patients had PsA.

Disclosures: This study did not receive any funding. The authors declared serving as consultants, paid speakers, and/or advisors and/or receiving speaking fees or grants from several sources.

Source: Elgaard CDB et al. Guselkumab, tildrakizumab and risankizumab in real-world setting: Drug survival and effectiveness in the treatment of psoriasis and psoriatic arthritis. J Dermatolog Treat. 2022;1-24 (Oct 6). Doi: 10.1080/09546634.2022.2133531.

Key clinical point: Preliminary results from this real-world study demonstrated efficacy of interleukin (IL)-23 inhibitors in patients with psoriatic arthritis (PsA).

Major finding: A substantial proportion of patients with PsA receiving either of the IL-23 inhibitors achieved complete (40.9%) or partial (36.4%) remission compared with only 18.2% of patients who demonstrated no improvement. A higher proportion of patients receiving guselkumab achieved remission or partial remission (38.5% and 46.1%, respectively) than treatment failure (15.4%), with similar outcomes being observed with risankizumab.

Study details: Findings are from a retrospective, observational study including 80 patients with psoriasis who received guselkumab, tildrakizumab, or risankizumab, of which 27.5% of patients had PsA.

Disclosures: This study did not receive any funding. The authors declared serving as consultants, paid speakers, and/or advisors and/or receiving speaking fees or grants from several sources.

Source: Elgaard CDB et al. Guselkumab, tildrakizumab and risankizumab in real-world setting: Drug survival and effectiveness in the treatment of psoriasis and psoriatic arthritis. J Dermatolog Treat. 2022;1-24 (Oct 6). Doi: 10.1080/09546634.2022.2133531.

Key clinical point: Preliminary results from this real-world study demonstrated efficacy of interleukin (IL)-23 inhibitors in patients with psoriatic arthritis (PsA).

Major finding: A substantial proportion of patients with PsA receiving either of the IL-23 inhibitors achieved complete (40.9%) or partial (36.4%) remission compared with only 18.2% of patients who demonstrated no improvement. A higher proportion of patients receiving guselkumab achieved remission or partial remission (38.5% and 46.1%, respectively) than treatment failure (15.4%), with similar outcomes being observed with risankizumab.

Study details: Findings are from a retrospective, observational study including 80 patients with psoriasis who received guselkumab, tildrakizumab, or risankizumab, of which 27.5% of patients had PsA.

Disclosures: This study did not receive any funding. The authors declared serving as consultants, paid speakers, and/or advisors and/or receiving speaking fees or grants from several sources.

Source: Elgaard CDB et al. Guselkumab, tildrakizumab and risankizumab in real-world setting: Drug survival and effectiveness in the treatment of psoriasis and psoriatic arthritis. J Dermatolog Treat. 2022;1-24 (Oct 6). Doi: 10.1080/09546634.2022.2133531.

Key clinical point: Guselkumab demonstrated promising efficacy and was well tolerated in a real-world population of patients with psoriatic arthritis (PsA) and psoriasis.

Major finding: Before starting guselkumab, 48% of patients had moderate/high disease activity in PsA (DAPSA). In this subgroup, the mean DAPSA score reduced from 29 to 20, 16, and 14 at weeks 12, 24, and 52, respectively (P < .0001). Only 2.2% of patients reported mild adverse events.

Study details: Findings are from a multicenter, retrospective, observational study including 90 patients with PsA and concomitant psoriasis who started treatment with guselkumab.

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

Source: Rocamora V et al. Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group. Dermatol Ther. 2022 (Sep 29). Doi: 10.1111/dth.15865

Key clinical point: Guselkumab demonstrated promising efficacy and was well tolerated in a real-world population of patients with psoriatic arthritis (PsA) and psoriasis.

Major finding: Before starting guselkumab, 48% of patients had moderate/high disease activity in PsA (DAPSA). In this subgroup, the mean DAPSA score reduced from 29 to 20, 16, and 14 at weeks 12, 24, and 52, respectively (P < .0001). Only 2.2% of patients reported mild adverse events.

Study details: Findings are from a multicenter, retrospective, observational study including 90 patients with PsA and concomitant psoriasis who started treatment with guselkumab.

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

Source: Rocamora V et al. Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group. Dermatol Ther. 2022 (Sep 29). Doi: 10.1111/dth.15865

Key clinical point: Guselkumab demonstrated promising efficacy and was well tolerated in a real-world population of patients with psoriatic arthritis (PsA) and psoriasis.

Major finding: Before starting guselkumab, 48% of patients had moderate/high disease activity in PsA (DAPSA). In this subgroup, the mean DAPSA score reduced from 29 to 20, 16, and 14 at weeks 12, 24, and 52, respectively (P < .0001). Only 2.2% of patients reported mild adverse events.

Study details: Findings are from a multicenter, retrospective, observational study including 90 patients with PsA and concomitant psoriasis who started treatment with guselkumab.

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

Source: Rocamora V et al. Guselkumab effectiveness and survival in patients with psoriasis and psoriatic arthritis: Multicenter analysis in daily clinical practice by the Spanish Psoriasis Group. Dermatol Ther. 2022 (Sep 29). Doi: 10.1111/dth.15865

Key clinical point: Inflammatory bowel disease (IBD), particularly Crohn's disease, is a causal risk factor for psoriatic arthritis (PsA).

Major finding: Genetically predicted IBD was associated with a higher risk for PsA (pooled odds ratio [OR] 1.11; P = .003) with the risk being majorly mediated by Crohn’s disease (OR 1.12; P = .002) and not ulcerative colitis (P = .70).

Study details: Findings are from a bidirectional 2-sample mendelian randomization study including 12,882 patients with IBD and 21,770 matched-controls and 5621 patients with psoriasis and 2063 patients with PsA who were compared with 252,323 controls.

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

Source: Freuer D et al. Association between inflammatory bowel disease and both psoriasis and psoriatic arthritis: A bidirectional 2-sample mendelian randomization study. JAMA Dermatol. 2022 (Sep 14). Doi: 10.1001/jamadermatol.2022.3682

Key clinical point: Inflammatory bowel disease (IBD), particularly Crohn's disease, is a causal risk factor for psoriatic arthritis (PsA).

Major finding: Genetically predicted IBD was associated with a higher risk for PsA (pooled odds ratio [OR] 1.11; P = .003) with the risk being majorly mediated by Crohn’s disease (OR 1.12; P = .002) and not ulcerative colitis (P = .70).

Study details: Findings are from a bidirectional 2-sample mendelian randomization study including 12,882 patients with IBD and 21,770 matched-controls and 5621 patients with psoriasis and 2063 patients with PsA who were compared with 252,323 controls.

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

Source: Freuer D et al. Association between inflammatory bowel disease and both psoriasis and psoriatic arthritis: A bidirectional 2-sample mendelian randomization study. JAMA Dermatol. 2022 (Sep 14). Doi: 10.1001/jamadermatol.2022.3682

Key clinical point: Inflammatory bowel disease (IBD), particularly Crohn's disease, is a causal risk factor for psoriatic arthritis (PsA).

Major finding: Genetically predicted IBD was associated with a higher risk for PsA (pooled odds ratio [OR] 1.11; P = .003) with the risk being majorly mediated by Crohn’s disease (OR 1.12; P = .002) and not ulcerative colitis (P = .70).

Study details: Findings are from a bidirectional 2-sample mendelian randomization study including 12,882 patients with IBD and 21,770 matched-controls and 5621 patients with psoriasis and 2063 patients with PsA who were compared with 252,323 controls.

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

Source: Freuer D et al. Association between inflammatory bowel disease and both psoriasis and psoriatic arthritis: A bidirectional 2-sample mendelian randomization study. JAMA Dermatol. 2022 (Sep 14). Doi: 10.1001/jamadermatol.2022.3682

The United States Food and Drug Administration has approved the Janus kinase (JAK) inhibitor upadacitinib (Rinvoq) for adults with nonradiographic axial spondyloarthritis (nr-axSpA) who have objective signs of inflammation and who have had an inadequate response to or are intolerant of one or more tumor necrosis factor (TNF) inhibitors, according to an announcement from the manufacturer, AbbVie.

The indication is the sixth in the United States for the JAK inhibitor. Upadacitinib 15 mg once daily is already approved in the United States for adults with moderately to severely active rheumatoid arthritis, active psoriatic arthritis (PsA), and active ankylosing spondylitis (AS). All these indications are for patients who have had an inadequate response to or are intolerant of one or more TNF inhibitors.

Upadacitinib is now the only JAK inhibitor that has been approved for both nr-axSpA and AS.

“Many patients living with nr-axSpA continue to experience symptoms and are unable to control disease with current treatments. In the SELECT-AXIS 2 trials, Rinvoq demonstrated efficacy in both nr-axSpA and AS with safety that was consistent across indications,” Atul Deodhar, MD, lead investigator of the trial, said in the announcement. “Today’s FDA approval offers an important new therapeutic option for patients and their caregivers to help take control of their symptoms and disease.”

Upadacitinib is also approved at a dose of 15 mg once daily for adults and children 12 years of age and older who weigh at least 40 kg and who have refractory, moderate to severe atopic dermatitis that is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.

It is approved as well at 45 mg once daily for 8 weeks as an induction therapy for adult patients with moderately to severely active ulcerative colitis who have had an inadequate response to or are intolerant of one or more TNF blockers. Following induction therapy for patients with ulcerative colitis, the recommended dose for maintenance treatment is 15 mg once daily, but a dose of 30 mg once daily may be considered for patients with refractory, severe, or extensive disease.

The FDA’s decision is supported by data from the phase 3 SELECT-AXIS 2 clinical trial, which assessed the efficacy, safety, and tolerability of upadacitinib in adults with active nr-axSpA.

Nearly half of patients treated with upadacitinib had achieved 40% improvement in Assessment of Spondyloarthritis International Society response criteria (ASAS 40), the primary endpoint, at week 14, compared with placebo (44.9% vs. 22.3%). These responses were observed as early as 2 weeks after initiation of therapy. The safety profile was consistent with what’s known in patients with RA, PsA, and AS.

Upadacitinib can lower the ability to fight infections. Serious infections, some fatal, have occurred, including tuberculosis and infections caused by bacteria, fungi, or viruses. It is associated with an increased risk of death and major cardiovascular events in people aged 50 and older who have at least one heart disease risk factor, and it is associated with an increased risk of some cancers, including lymphoma and skin cancers.

A version of this article first appeared on Medscape.com.

The United States Food and Drug Administration has approved the Janus kinase (JAK) inhibitor upadacitinib (Rinvoq) for adults with nonradiographic axial spondyloarthritis (nr-axSpA) who have objective signs of inflammation and who have had an inadequate response to or are intolerant of one or more tumor necrosis factor (TNF) inhibitors, according to an announcement from the manufacturer, AbbVie.

The indication is the sixth in the United States for the JAK inhibitor. Upadacitinib 15 mg once daily is already approved in the United States for adults with moderately to severely active rheumatoid arthritis, active psoriatic arthritis (PsA), and active ankylosing spondylitis (AS). All these indications are for patients who have had an inadequate response to or are intolerant of one or more TNF inhibitors.

Upadacitinib is now the only JAK inhibitor that has been approved for both nr-axSpA and AS.

“Many patients living with nr-axSpA continue to experience symptoms and are unable to control disease with current treatments. In the SELECT-AXIS 2 trials, Rinvoq demonstrated efficacy in both nr-axSpA and AS with safety that was consistent across indications,” Atul Deodhar, MD, lead investigator of the trial, said in the announcement. “Today’s FDA approval offers an important new therapeutic option for patients and their caregivers to help take control of their symptoms and disease.”

Upadacitinib is also approved at a dose of 15 mg once daily for adults and children 12 years of age and older who weigh at least 40 kg and who have refractory, moderate to severe atopic dermatitis that is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.

It is approved as well at 45 mg once daily for 8 weeks as an induction therapy for adult patients with moderately to severely active ulcerative colitis who have had an inadequate response to or are intolerant of one or more TNF blockers. Following induction therapy for patients with ulcerative colitis, the recommended dose for maintenance treatment is 15 mg once daily, but a dose of 30 mg once daily may be considered for patients with refractory, severe, or extensive disease.

The FDA’s decision is supported by data from the phase 3 SELECT-AXIS 2 clinical trial, which assessed the efficacy, safety, and tolerability of upadacitinib in adults with active nr-axSpA.

Nearly half of patients treated with upadacitinib had achieved 40% improvement in Assessment of Spondyloarthritis International Society response criteria (ASAS 40), the primary endpoint, at week 14, compared with placebo (44.9% vs. 22.3%). These responses were observed as early as 2 weeks after initiation of therapy. The safety profile was consistent with what’s known in patients with RA, PsA, and AS.

Upadacitinib can lower the ability to fight infections. Serious infections, some fatal, have occurred, including tuberculosis and infections caused by bacteria, fungi, or viruses. It is associated with an increased risk of death and major cardiovascular events in people aged 50 and older who have at least one heart disease risk factor, and it is associated with an increased risk of some cancers, including lymphoma and skin cancers.

A version of this article first appeared on Medscape.com.

The United States Food and Drug Administration has approved the Janus kinase (JAK) inhibitor upadacitinib (Rinvoq) for adults with nonradiographic axial spondyloarthritis (nr-axSpA) who have objective signs of inflammation and who have had an inadequate response to or are intolerant of one or more tumor necrosis factor (TNF) inhibitors, according to an announcement from the manufacturer, AbbVie.

The indication is the sixth in the United States for the JAK inhibitor. Upadacitinib 15 mg once daily is already approved in the United States for adults with moderately to severely active rheumatoid arthritis, active psoriatic arthritis (PsA), and active ankylosing spondylitis (AS). All these indications are for patients who have had an inadequate response to or are intolerant of one or more TNF inhibitors.

Upadacitinib is now the only JAK inhibitor that has been approved for both nr-axSpA and AS.

“Many patients living with nr-axSpA continue to experience symptoms and are unable to control disease with current treatments. In the SELECT-AXIS 2 trials, Rinvoq demonstrated efficacy in both nr-axSpA and AS with safety that was consistent across indications,” Atul Deodhar, MD, lead investigator of the trial, said in the announcement. “Today’s FDA approval offers an important new therapeutic option for patients and their caregivers to help take control of their symptoms and disease.”

Upadacitinib is also approved at a dose of 15 mg once daily for adults and children 12 years of age and older who weigh at least 40 kg and who have refractory, moderate to severe atopic dermatitis that is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.

It is approved as well at 45 mg once daily for 8 weeks as an induction therapy for adult patients with moderately to severely active ulcerative colitis who have had an inadequate response to or are intolerant of one or more TNF blockers. Following induction therapy for patients with ulcerative colitis, the recommended dose for maintenance treatment is 15 mg once daily, but a dose of 30 mg once daily may be considered for patients with refractory, severe, or extensive disease.

The FDA’s decision is supported by data from the phase 3 SELECT-AXIS 2 clinical trial, which assessed the efficacy, safety, and tolerability of upadacitinib in adults with active nr-axSpA.

Nearly half of patients treated with upadacitinib had achieved 40% improvement in Assessment of Spondyloarthritis International Society response criteria (ASAS 40), the primary endpoint, at week 14, compared with placebo (44.9% vs. 22.3%). These responses were observed as early as 2 weeks after initiation of therapy. The safety profile was consistent with what’s known in patients with RA, PsA, and AS.

Upadacitinib can lower the ability to fight infections. Serious infections, some fatal, have occurred, including tuberculosis and infections caused by bacteria, fungi, or viruses. It is associated with an increased risk of death and major cardiovascular events in people aged 50 and older who have at least one heart disease risk factor, and it is associated with an increased risk of some cancers, including lymphoma and skin cancers.

A version of this article first appeared on Medscape.com.