In 2021, Tim Chevalier received the first of many coverage denials from his insurance company for the hair-removal procedure he needed as part of a phalloplasty, the creation of a penis.

Electrolysis is a common procedure among transgender people like Mr. Chevalier, a software developer in Oakland, Calif.. In some cases, it’s used to remove unwanted hair from the face or body. But it’s also required for a phalloplasty or a vaginoplasty, the creation of a vagina, because all hair must be removed from the tissue that will be relocated during surgery.

Mr. Chevalier’s insurer, Anthem Blue Cross, told him he needed what’s known as a prior authorization for the procedure. Even after Mr. Chevalier received the authorization, he said, his reimbursement claims kept getting denied. According to Mr. Chevalier, Anthem said the procedure was considered cosmetic.

Many trans patients have trouble getting their insurers to cover gender-affirming care. One reason is transphobia within the U.S. health care system, but another involves how medical diagnoses and procedures are coded for insurance companies. Nationwide, health care providers use a list of diagnostic codes provided by the ICD-10. And many of those, advocates for transgender people say, haven’t caught up to the needs of patients. Such diagnostic codes provide the basis for determining which procedures, such as electrolysis or surgery, insurance will cover.

“It’s widely regarded that the codes are very limited in ICD-10,” said Johanna Olson-Kennedy, MD, medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.

She advocates for a move to the 11th edition of the coding system, which was endorsed by the World Health Organization in 2019 and began to be adopted around the globe in February. Today, more than 34 countries use ICD-11.

The new edition has replaced outdated terms like “transsexualism” and “gender identity disorder” with “gender incongruence,” which is no longer classified as a mental health condition, but as a sexual health one. This is crucial in reducing the stigmatization of trans people in health care, said Dr. Olson-Kennedy.

A move away from the mental health classification may also mean more coverage of gender-affirming care by insurance companies, which sometimes question mental health claims more rigorously than those for physical illnesses. WHO officials have said they hope that adding gender incongruence to a sexual health chapter will “help increase access to care for health interventions” and “destigmatize the condition,” according to the WHO website.

However, history suggests that ICD-11 likely won’t be implemented in the United States for years. The WHO first endorsed ICD-10 in 1990, but the United States didn’t implement it for 25 years.

Meanwhile, patients who identify as transgender and their doctors are spending hours trying to get coverage – or using crowdfunding to cover big out-of-pocket bills. Mr. Chevalier estimated he has received 78 hours of electrolysis at $140 per hour, costing $10,920.

Anthem spokesperson Michael Bowman wrote in an email that “there has been no medical denials or denial of coverage” because Anthem “preapproved coverage for these services.”

However, even after the preapproval was given, Anthem responded to Mr. Chevalier’s claims by stating the electrolysis would not be reimbursed because the procedure is considered cosmetic, rather than medically necessary. This is regardless of Mr. Chevalier’s diagnosis of gender dysphoria – the psychological distress felt when someone’s biological sex and gender identity don’t match – which many doctors consider a medically legitimate reason for hair removal.

Bowman wrote that “once this issue was identified, Anthem implemented an internal process which included a manual override in the billing system.”

Still, Mr. Chevalier filed a complaint with the California Department of Managed Health Care, and the state declared Anthem Blue Cross out of compliance. Additionally, after KHN started asking Anthem questions about Chevalier’s bills, two claims that had not been addressed since April were resolved in July. So far, Anthem has reimbursed Chevalier around $8,000.

Some procedures that trans patients receive can also be excluded from coverage because insurance companies consider them “sex specific.” For example, a transgender man’s gynecological visit may not be covered because his insurance plan covers those visits only for people enrolled as women.

“There is always this question of: What gender should you tell the insurance company?” said Nick Gorton, MD, an emergency medicine physician in Davis, Calif. Dr. Gorton, who is trans, recommends his patients with insurance plans that exclude trans care calculate the out-of-pocket costs that would be required for certain procedures based on whether the patient lists themselves as male or female on their insurance paperwork. For example, Dr. Gorton said, the question for a trans man becomes “what’s more expensive – paying for testosterone or paying for a Pap smear?” – since insurance likely won’t cover both.

For years, some physicians helped trans patients get coverage by finding other medical reasons for their trans-related care. Dr. Gorton said that if, for instance, a transgender man wanted a hysterectomy but his insurance didn’t cover gender-affirming care, Dr. Gorton would enter the ICD-10 code for pelvic pain, as opposed to gender dysphoria, into the patient’s billing record. Pelvic pain is a legitimate reason for the surgery and is commonly accepted by insurance providers, Dr. Gorton said. But some insurance companies pushed back, and he had to find other ways to help his patients.

In 2005, California passed a first-of-its-kind law that prohibits discrimination by health insurance on the basis of gender or gender identity. Now, 24 states and Washington, D.C., forbid private insurance from excluding transgender-related health care benefits.

Consequently, Dr. Gorton no longer needs to use different codes for patients seeking gender-affirming care at his practice in California. But physicians in other states are still struggling.

When Eric Meininger, MD, MPH, an internist and pediatrician at Indiana University Health’s gender health program in Indianapolis, treats a trans kid seeking hormone therapy, he commonly uses the ICD-10 code for “medication management” as the primary reason for the patient’s visit. That’s because Indiana has no law providing insurance protections for LGBTQ+ people, and when gender dysphoria is listed as the primary reason, insurance companies have denied coverage.

“It’s frustrating,” Dr. Meininger said. In a patient’s billing record, he sometimes provides multiple diagnoses, including gender dysphoria, to increase the likelihood that a procedure will be covered. “It’s not hard usually to come up with five or seven or eight diagnoses for someone because there’s lots of vague ones out there.”

Implementing ICD-11 won’t fix all the coding problems, as insurance companies may still refuse to cover procedures related to gender incongruence even though it is listed as a sexual health condition. It also won’t change the fact that many states still allow insurance to exclude gender-affirming care. But in terms of reducing stigma, it’s a step forward, Dr. Olson-Kennedy said.

One reason the United States took so long to switch to ICD-10 is that the American Medical Association strongly opposed the move. It argued the new system would put an incredible burden on doctors. Physicians would have to “contend with 68,000 diagnosis codes – a fivefold increase from the approximately 13,000 diagnosis codes in use today,” the AMA wrote in a 2014 letter. Implementing software to update providers’ coding systems would also be costly, dealing a financial blow to small medical practices, the association argued.

Unlike past coding systems, ICD-11 is fully electronic, with no physical manual of codes, and can be incorporated into a medical facility’s current coding system without requiring a new rollout, said Christian Lindmeier, a WHO spokesperson.

Whether these changes will make the adoption of the new edition easier in the United States is yet to be seen. For now, many trans patients in need of gender-affirming care must pay their bills out of pocket, fight their insurance company for coverage, or rely on the generosity of others.

“Even though I did get reimbursed eventually, the reimbursements were delayed, and it burned up a lot of my time,” Mr. Chevalier said. “Most people would have just given up.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

In 2021, Tim Chevalier received the first of many coverage denials from his insurance company for the hair-removal procedure he needed as part of a phalloplasty, the creation of a penis.

Electrolysis is a common procedure among transgender people like Mr. Chevalier, a software developer in Oakland, Calif.. In some cases, it’s used to remove unwanted hair from the face or body. But it’s also required for a phalloplasty or a vaginoplasty, the creation of a vagina, because all hair must be removed from the tissue that will be relocated during surgery.

Mr. Chevalier’s insurer, Anthem Blue Cross, told him he needed what’s known as a prior authorization for the procedure. Even after Mr. Chevalier received the authorization, he said, his reimbursement claims kept getting denied. According to Mr. Chevalier, Anthem said the procedure was considered cosmetic.

Many trans patients have trouble getting their insurers to cover gender-affirming care. One reason is transphobia within the U.S. health care system, but another involves how medical diagnoses and procedures are coded for insurance companies. Nationwide, health care providers use a list of diagnostic codes provided by the ICD-10. And many of those, advocates for transgender people say, haven’t caught up to the needs of patients. Such diagnostic codes provide the basis for determining which procedures, such as electrolysis or surgery, insurance will cover.

“It’s widely regarded that the codes are very limited in ICD-10,” said Johanna Olson-Kennedy, MD, medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.

She advocates for a move to the 11th edition of the coding system, which was endorsed by the World Health Organization in 2019 and began to be adopted around the globe in February. Today, more than 34 countries use ICD-11.

The new edition has replaced outdated terms like “transsexualism” and “gender identity disorder” with “gender incongruence,” which is no longer classified as a mental health condition, but as a sexual health one. This is crucial in reducing the stigmatization of trans people in health care, said Dr. Olson-Kennedy.

A move away from the mental health classification may also mean more coverage of gender-affirming care by insurance companies, which sometimes question mental health claims more rigorously than those for physical illnesses. WHO officials have said they hope that adding gender incongruence to a sexual health chapter will “help increase access to care for health interventions” and “destigmatize the condition,” according to the WHO website.

However, history suggests that ICD-11 likely won’t be implemented in the United States for years. The WHO first endorsed ICD-10 in 1990, but the United States didn’t implement it for 25 years.

Meanwhile, patients who identify as transgender and their doctors are spending hours trying to get coverage – or using crowdfunding to cover big out-of-pocket bills. Mr. Chevalier estimated he has received 78 hours of electrolysis at $140 per hour, costing $10,920.

Anthem spokesperson Michael Bowman wrote in an email that “there has been no medical denials or denial of coverage” because Anthem “preapproved coverage for these services.”

However, even after the preapproval was given, Anthem responded to Mr. Chevalier’s claims by stating the electrolysis would not be reimbursed because the procedure is considered cosmetic, rather than medically necessary. This is regardless of Mr. Chevalier’s diagnosis of gender dysphoria – the psychological distress felt when someone’s biological sex and gender identity don’t match – which many doctors consider a medically legitimate reason for hair removal.

Bowman wrote that “once this issue was identified, Anthem implemented an internal process which included a manual override in the billing system.”

Still, Mr. Chevalier filed a complaint with the California Department of Managed Health Care, and the state declared Anthem Blue Cross out of compliance. Additionally, after KHN started asking Anthem questions about Chevalier’s bills, two claims that had not been addressed since April were resolved in July. So far, Anthem has reimbursed Chevalier around $8,000.

Some procedures that trans patients receive can also be excluded from coverage because insurance companies consider them “sex specific.” For example, a transgender man’s gynecological visit may not be covered because his insurance plan covers those visits only for people enrolled as women.

“There is always this question of: What gender should you tell the insurance company?” said Nick Gorton, MD, an emergency medicine physician in Davis, Calif. Dr. Gorton, who is trans, recommends his patients with insurance plans that exclude trans care calculate the out-of-pocket costs that would be required for certain procedures based on whether the patient lists themselves as male or female on their insurance paperwork. For example, Dr. Gorton said, the question for a trans man becomes “what’s more expensive – paying for testosterone or paying for a Pap smear?” – since insurance likely won’t cover both.

For years, some physicians helped trans patients get coverage by finding other medical reasons for their trans-related care. Dr. Gorton said that if, for instance, a transgender man wanted a hysterectomy but his insurance didn’t cover gender-affirming care, Dr. Gorton would enter the ICD-10 code for pelvic pain, as opposed to gender dysphoria, into the patient’s billing record. Pelvic pain is a legitimate reason for the surgery and is commonly accepted by insurance providers, Dr. Gorton said. But some insurance companies pushed back, and he had to find other ways to help his patients.

In 2005, California passed a first-of-its-kind law that prohibits discrimination by health insurance on the basis of gender or gender identity. Now, 24 states and Washington, D.C., forbid private insurance from excluding transgender-related health care benefits.

Consequently, Dr. Gorton no longer needs to use different codes for patients seeking gender-affirming care at his practice in California. But physicians in other states are still struggling.

When Eric Meininger, MD, MPH, an internist and pediatrician at Indiana University Health’s gender health program in Indianapolis, treats a trans kid seeking hormone therapy, he commonly uses the ICD-10 code for “medication management” as the primary reason for the patient’s visit. That’s because Indiana has no law providing insurance protections for LGBTQ+ people, and when gender dysphoria is listed as the primary reason, insurance companies have denied coverage.

“It’s frustrating,” Dr. Meininger said. In a patient’s billing record, he sometimes provides multiple diagnoses, including gender dysphoria, to increase the likelihood that a procedure will be covered. “It’s not hard usually to come up with five or seven or eight diagnoses for someone because there’s lots of vague ones out there.”

Implementing ICD-11 won’t fix all the coding problems, as insurance companies may still refuse to cover procedures related to gender incongruence even though it is listed as a sexual health condition. It also won’t change the fact that many states still allow insurance to exclude gender-affirming care. But in terms of reducing stigma, it’s a step forward, Dr. Olson-Kennedy said.

One reason the United States took so long to switch to ICD-10 is that the American Medical Association strongly opposed the move. It argued the new system would put an incredible burden on doctors. Physicians would have to “contend with 68,000 diagnosis codes – a fivefold increase from the approximately 13,000 diagnosis codes in use today,” the AMA wrote in a 2014 letter. Implementing software to update providers’ coding systems would also be costly, dealing a financial blow to small medical practices, the association argued.

Unlike past coding systems, ICD-11 is fully electronic, with no physical manual of codes, and can be incorporated into a medical facility’s current coding system without requiring a new rollout, said Christian Lindmeier, a WHO spokesperson.

Whether these changes will make the adoption of the new edition easier in the United States is yet to be seen. For now, many trans patients in need of gender-affirming care must pay their bills out of pocket, fight their insurance company for coverage, or rely on the generosity of others.

“Even though I did get reimbursed eventually, the reimbursements were delayed, and it burned up a lot of my time,” Mr. Chevalier said. “Most people would have just given up.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

In 2021, Tim Chevalier received the first of many coverage denials from his insurance company for the hair-removal procedure he needed as part of a phalloplasty, the creation of a penis.

Electrolysis is a common procedure among transgender people like Mr. Chevalier, a software developer in Oakland, Calif.. In some cases, it’s used to remove unwanted hair from the face or body. But it’s also required for a phalloplasty or a vaginoplasty, the creation of a vagina, because all hair must be removed from the tissue that will be relocated during surgery.

Mr. Chevalier’s insurer, Anthem Blue Cross, told him he needed what’s known as a prior authorization for the procedure. Even after Mr. Chevalier received the authorization, he said, his reimbursement claims kept getting denied. According to Mr. Chevalier, Anthem said the procedure was considered cosmetic.

Many trans patients have trouble getting their insurers to cover gender-affirming care. One reason is transphobia within the U.S. health care system, but another involves how medical diagnoses and procedures are coded for insurance companies. Nationwide, health care providers use a list of diagnostic codes provided by the ICD-10. And many of those, advocates for transgender people say, haven’t caught up to the needs of patients. Such diagnostic codes provide the basis for determining which procedures, such as electrolysis or surgery, insurance will cover.

“It’s widely regarded that the codes are very limited in ICD-10,” said Johanna Olson-Kennedy, MD, medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.

She advocates for a move to the 11th edition of the coding system, which was endorsed by the World Health Organization in 2019 and began to be adopted around the globe in February. Today, more than 34 countries use ICD-11.

The new edition has replaced outdated terms like “transsexualism” and “gender identity disorder” with “gender incongruence,” which is no longer classified as a mental health condition, but as a sexual health one. This is crucial in reducing the stigmatization of trans people in health care, said Dr. Olson-Kennedy.

A move away from the mental health classification may also mean more coverage of gender-affirming care by insurance companies, which sometimes question mental health claims more rigorously than those for physical illnesses. WHO officials have said they hope that adding gender incongruence to a sexual health chapter will “help increase access to care for health interventions” and “destigmatize the condition,” according to the WHO website.

However, history suggests that ICD-11 likely won’t be implemented in the United States for years. The WHO first endorsed ICD-10 in 1990, but the United States didn’t implement it for 25 years.

Meanwhile, patients who identify as transgender and their doctors are spending hours trying to get coverage – or using crowdfunding to cover big out-of-pocket bills. Mr. Chevalier estimated he has received 78 hours of electrolysis at $140 per hour, costing $10,920.

Anthem spokesperson Michael Bowman wrote in an email that “there has been no medical denials or denial of coverage” because Anthem “preapproved coverage for these services.”

However, even after the preapproval was given, Anthem responded to Mr. Chevalier’s claims by stating the electrolysis would not be reimbursed because the procedure is considered cosmetic, rather than medically necessary. This is regardless of Mr. Chevalier’s diagnosis of gender dysphoria – the psychological distress felt when someone’s biological sex and gender identity don’t match – which many doctors consider a medically legitimate reason for hair removal.

Bowman wrote that “once this issue was identified, Anthem implemented an internal process which included a manual override in the billing system.”

Still, Mr. Chevalier filed a complaint with the California Department of Managed Health Care, and the state declared Anthem Blue Cross out of compliance. Additionally, after KHN started asking Anthem questions about Chevalier’s bills, two claims that had not been addressed since April were resolved in July. So far, Anthem has reimbursed Chevalier around $8,000.

Some procedures that trans patients receive can also be excluded from coverage because insurance companies consider them “sex specific.” For example, a transgender man’s gynecological visit may not be covered because his insurance plan covers those visits only for people enrolled as women.

“There is always this question of: What gender should you tell the insurance company?” said Nick Gorton, MD, an emergency medicine physician in Davis, Calif. Dr. Gorton, who is trans, recommends his patients with insurance plans that exclude trans care calculate the out-of-pocket costs that would be required for certain procedures based on whether the patient lists themselves as male or female on their insurance paperwork. For example, Dr. Gorton said, the question for a trans man becomes “what’s more expensive – paying for testosterone or paying for a Pap smear?” – since insurance likely won’t cover both.

For years, some physicians helped trans patients get coverage by finding other medical reasons for their trans-related care. Dr. Gorton said that if, for instance, a transgender man wanted a hysterectomy but his insurance didn’t cover gender-affirming care, Dr. Gorton would enter the ICD-10 code for pelvic pain, as opposed to gender dysphoria, into the patient’s billing record. Pelvic pain is a legitimate reason for the surgery and is commonly accepted by insurance providers, Dr. Gorton said. But some insurance companies pushed back, and he had to find other ways to help his patients.

In 2005, California passed a first-of-its-kind law that prohibits discrimination by health insurance on the basis of gender or gender identity. Now, 24 states and Washington, D.C., forbid private insurance from excluding transgender-related health care benefits.

Consequently, Dr. Gorton no longer needs to use different codes for patients seeking gender-affirming care at his practice in California. But physicians in other states are still struggling.

When Eric Meininger, MD, MPH, an internist and pediatrician at Indiana University Health’s gender health program in Indianapolis, treats a trans kid seeking hormone therapy, he commonly uses the ICD-10 code for “medication management” as the primary reason for the patient’s visit. That’s because Indiana has no law providing insurance protections for LGBTQ+ people, and when gender dysphoria is listed as the primary reason, insurance companies have denied coverage.

“It’s frustrating,” Dr. Meininger said. In a patient’s billing record, he sometimes provides multiple diagnoses, including gender dysphoria, to increase the likelihood that a procedure will be covered. “It’s not hard usually to come up with five or seven or eight diagnoses for someone because there’s lots of vague ones out there.”

Implementing ICD-11 won’t fix all the coding problems, as insurance companies may still refuse to cover procedures related to gender incongruence even though it is listed as a sexual health condition. It also won’t change the fact that many states still allow insurance to exclude gender-affirming care. But in terms of reducing stigma, it’s a step forward, Dr. Olson-Kennedy said.

One reason the United States took so long to switch to ICD-10 is that the American Medical Association strongly opposed the move. It argued the new system would put an incredible burden on doctors. Physicians would have to “contend with 68,000 diagnosis codes – a fivefold increase from the approximately 13,000 diagnosis codes in use today,” the AMA wrote in a 2014 letter. Implementing software to update providers’ coding systems would also be costly, dealing a financial blow to small medical practices, the association argued.

Unlike past coding systems, ICD-11 is fully electronic, with no physical manual of codes, and can be incorporated into a medical facility’s current coding system without requiring a new rollout, said Christian Lindmeier, a WHO spokesperson.

Whether these changes will make the adoption of the new edition easier in the United States is yet to be seen. For now, many trans patients in need of gender-affirming care must pay their bills out of pocket, fight their insurance company for coverage, or rely on the generosity of others.

“Even though I did get reimbursed eventually, the reimbursements were delayed, and it burned up a lot of my time,” Mr. Chevalier said. “Most people would have just given up.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Tofacitinib improved dactylitis irrespective of the location and prevented its emergence in the majority of patients with psoriatic arthritis (PsA).

Major finding: In patients with Dactylitis Severity Scores (DSS) > 0, 10 mg tofacitinib twice daily vs placebo led to greater improvements in DSS for feet and other locations at month 1. By month 6, ≤15% of patients with DSS > 0 and <2% of patients with DSS = 0 reported the presence of dactylitis in all digits in the tofacitinib group.

Study details: Findings are from a post hoc analysis of two phase 3 trials including 710 patients with active PsA and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (OPAL Broaden) or tumor necrosis factor inhibitors (OPAL Beyond) and who received 5/10 mg tofacitinib twice daily or placebo.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer. The other authors reported ties with several sources, including Pfizer.

Source: Orbai AM et al. Effect of tofacitinib on dactylitis and patient-reported outcomes in patients with active psoriatic arthritis: Post-hoc analysis of phase III studies. BMC Rheumatol. 2022;6(1):68 (Sep 1). Doi: 10.1186/s41927-022-00298-4

Key clinical point: Patients with psoriatic arthritis (PsA) who received strategic treatment with biological disease-modifying anti-rheumatic drugs (bDMARD) based on peripheral T-lymphocyte phenotyping achieved greater reduction in disease activity than patients who did not undergo phenotyping or bDMARD selection strategy.

Major finding: A significantly higher proportion of patients in the strategic vs standard bDMARD treatment group achieved disease activity of PsA-remission (90.2% vs 67.8%; P  =  .0132) and minimal disease activity (80.5% vs 60.7%; P  =  .0464) by month 6.

Study details: Findings are from a real-world, retrospective study that included 97 patients with PsA who received bDMARD for ≥1 year and compared 1-year treatment response between the strategic (n = 41) and standard (n = 56) bDMARD treatment groups.

Disclosures: This work was supported by Research on Rare and Intractable Diseases and Research Grant-In-Aid for Scientific Research by the Ministry of Health, Labor, and Welfare of Japan, and other sources. The authors declared receiving grants, honoraria, speaking fees, or consulting fees from several sources.

Source: Miyagawa I et al. Precision medicine based on the phenotypic differences in peripheral T helper cells in patients with psoriatic arthritis: One year follow-up outcomes. Front Med (Lausanne). 2022;9:934937 (Jul 27). Doi: 10.3389/fmed.2022.934937

Key clinical point: Patients with psoriatic arthritis (PsA) who received strategic treatment with biological disease-modifying anti-rheumatic drugs (bDMARD) based on peripheral T-lymphocyte phenotyping achieved greater reduction in disease activity than patients who did not undergo phenotyping or bDMARD selection strategy.

Major finding: A significantly higher proportion of patients in the strategic vs standard bDMARD treatment group achieved disease activity of PsA-remission (90.2% vs 67.8%; P  =  .0132) and minimal disease activity (80.5% vs 60.7%; P  =  .0464) by month 6.

Study details: Findings are from a real-world, retrospective study that included 97 patients with PsA who received bDMARD for ≥1 year and compared 1-year treatment response between the strategic (n = 41) and standard (n = 56) bDMARD treatment groups.

Disclosures: This work was supported by Research on Rare and Intractable Diseases and Research Grant-In-Aid for Scientific Research by the Ministry of Health, Labor, and Welfare of Japan, and other sources. The authors declared receiving grants, honoraria, speaking fees, or consulting fees from several sources.

Source: Miyagawa I et al. Precision medicine based on the phenotypic differences in peripheral T helper cells in patients with psoriatic arthritis: One year follow-up outcomes. Front Med (Lausanne). 2022;9:934937 (Jul 27). Doi: 10.3389/fmed.2022.934937

Key clinical point: Patients with psoriatic arthritis (PsA) who received strategic treatment with biological disease-modifying anti-rheumatic drugs (bDMARD) based on peripheral T-lymphocyte phenotyping achieved greater reduction in disease activity than patients who did not undergo phenotyping or bDMARD selection strategy.

Major finding: A significantly higher proportion of patients in the strategic vs standard bDMARD treatment group achieved disease activity of PsA-remission (90.2% vs 67.8%; P  =  .0132) and minimal disease activity (80.5% vs 60.7%; P  =  .0464) by month 6.

Study details: Findings are from a real-world, retrospective study that included 97 patients with PsA who received bDMARD for ≥1 year and compared 1-year treatment response between the strategic (n = 41) and standard (n = 56) bDMARD treatment groups.

Disclosures: This work was supported by Research on Rare and Intractable Diseases and Research Grant-In-Aid for Scientific Research by the Ministry of Health, Labor, and Welfare of Japan, and other sources. The authors declared receiving grants, honoraria, speaking fees, or consulting fees from several sources.

Source: Miyagawa I et al. Precision medicine based on the phenotypic differences in peripheral T helper cells in patients with psoriatic arthritis: One year follow-up outcomes. Front Med (Lausanne). 2022;9:934937 (Jul 27). Doi: 10.3389/fmed.2022.934937

Key clinical point: Tools like Psoriasis Epidemiology Screening Tool (PEST) and body mass index (BMI) can predict the 2-year risk of developing psoriatic arthritis (PsA) in patients with psoriasis (PsO).

Major finding: Approximately 10% of patients with PsO developed PsA after 2 years. PEST, BMI, modified Rheumatic Disease Comorbidity Index, work status, alcohol use, and fatigue (area under the curve [AUC] 68.9%; sensitivity 82.9%; specificity 48.8%) were most efficient in predicting PsA development; however, another model including only PEST and BMI produced similar results (AUC 68.8%; sensitivity 92.7%; specificity 36.5%).

Study details: The findings are from a prospective cohort study including 1489 patients with PsO and no prior diagnosis of PsA from the CorEvitas Psoriasis Registry who were followed-up for 24 months.

Disclosures: This study was sponsored by CorEvitas, LLC. Three authors declared being employees of CorEvitas, LLC, and the other authors reported ties with several sources, including CorEvitas.

Source: Ogdie A et al. Prospective cohort study of psoriatic arthritis risk in patients with psoriasis in a real-world psoriasis registry. J Am Acad Dermatol. 2022 (Aug 17). Doi: 10.1016/j.jaad.2022.07.060

Key clinical point: Tools like Psoriasis Epidemiology Screening Tool (PEST) and body mass index (BMI) can predict the 2-year risk of developing psoriatic arthritis (PsA) in patients with psoriasis (PsO).

Major finding: Approximately 10% of patients with PsO developed PsA after 2 years. PEST, BMI, modified Rheumatic Disease Comorbidity Index, work status, alcohol use, and fatigue (area under the curve [AUC] 68.9%; sensitivity 82.9%; specificity 48.8%) were most efficient in predicting PsA development; however, another model including only PEST and BMI produced similar results (AUC 68.8%; sensitivity 92.7%; specificity 36.5%).

Study details: The findings are from a prospective cohort study including 1489 patients with PsO and no prior diagnosis of PsA from the CorEvitas Psoriasis Registry who were followed-up for 24 months.

Disclosures: This study was sponsored by CorEvitas, LLC. Three authors declared being employees of CorEvitas, LLC, and the other authors reported ties with several sources, including CorEvitas.

Source: Ogdie A et al. Prospective cohort study of psoriatic arthritis risk in patients with psoriasis in a real-world psoriasis registry. J Am Acad Dermatol. 2022 (Aug 17). Doi: 10.1016/j.jaad.2022.07.060

Key clinical point: Tools like Psoriasis Epidemiology Screening Tool (PEST) and body mass index (BMI) can predict the 2-year risk of developing psoriatic arthritis (PsA) in patients with psoriasis (PsO).

Major finding: Approximately 10% of patients with PsO developed PsA after 2 years. PEST, BMI, modified Rheumatic Disease Comorbidity Index, work status, alcohol use, and fatigue (area under the curve [AUC] 68.9%; sensitivity 82.9%; specificity 48.8%) were most efficient in predicting PsA development; however, another model including only PEST and BMI produced similar results (AUC 68.8%; sensitivity 92.7%; specificity 36.5%).

Study details: The findings are from a prospective cohort study including 1489 patients with PsO and no prior diagnosis of PsA from the CorEvitas Psoriasis Registry who were followed-up for 24 months.

Disclosures: This study was sponsored by CorEvitas, LLC. Three authors declared being employees of CorEvitas, LLC, and the other authors reported ties with several sources, including CorEvitas.

Source: Ogdie A et al. Prospective cohort study of psoriatic arthritis risk in patients with psoriasis in a real-world psoriasis registry. J Am Acad Dermatol. 2022 (Aug 17). Doi: 10.1016/j.jaad.2022.07.060

Key clinical point: Patients with psoriatic arthritis (PsA) who were currently experiencing flares had worse quality of life (QoL), greater disability, and impaired work productivity compared with those who had not experienced flare ever or in the last 12 months.

Major finding: Currently, 168 patients were diagnosed with flare by a physician. Compared with patients who had not experienced flare ever or in the last 12 months, those who were currently experiencing flares had lower QoL scores and higher overall work impairment, disability, and a greater disease impact on patient’s QoL (all P < .01).

Study details: Findings are from the Adelphi PsA Disease Specific Programme, a cross-sectional survey including 2238 patients with PsA and physician-reported flare status data.

Disclosures: The Adelphi SpA IV Disease Specific Programme was funded by Janssen. Two authors declared being employees of Adelphi Real World, and two authors declared being employees of Janssen Pharmaceuticals. The other authors reported receiving research grants and consulting fees from several sources.

Source: Orbai AM et al. Impact of physician-defined flares on quality of life and work impairment: An international survey of 2,238 psoriatic arthritis patients. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.211302

Key clinical point: Patients with psoriatic arthritis (PsA) who were currently experiencing flares had worse quality of life (QoL), greater disability, and impaired work productivity compared with those who had not experienced flare ever or in the last 12 months.

Major finding: Currently, 168 patients were diagnosed with flare by a physician. Compared with patients who had not experienced flare ever or in the last 12 months, those who were currently experiencing flares had lower QoL scores and higher overall work impairment, disability, and a greater disease impact on patient’s QoL (all P < .01).

Study details: Findings are from the Adelphi PsA Disease Specific Programme, a cross-sectional survey including 2238 patients with PsA and physician-reported flare status data.

Disclosures: The Adelphi SpA IV Disease Specific Programme was funded by Janssen. Two authors declared being employees of Adelphi Real World, and two authors declared being employees of Janssen Pharmaceuticals. The other authors reported receiving research grants and consulting fees from several sources.

Source: Orbai AM et al. Impact of physician-defined flares on quality of life and work impairment: An international survey of 2,238 psoriatic arthritis patients. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.211302

Key clinical point: Patients with psoriatic arthritis (PsA) who were currently experiencing flares had worse quality of life (QoL), greater disability, and impaired work productivity compared with those who had not experienced flare ever or in the last 12 months.

Major finding: Currently, 168 patients were diagnosed with flare by a physician. Compared with patients who had not experienced flare ever or in the last 12 months, those who were currently experiencing flares had lower QoL scores and higher overall work impairment, disability, and a greater disease impact on patient’s QoL (all P < .01).

Study details: Findings are from the Adelphi PsA Disease Specific Programme, a cross-sectional survey including 2238 patients with PsA and physician-reported flare status data.

Disclosures: The Adelphi SpA IV Disease Specific Programme was funded by Janssen. Two authors declared being employees of Adelphi Real World, and two authors declared being employees of Janssen Pharmaceuticals. The other authors reported receiving research grants and consulting fees from several sources.

Source: Orbai AM et al. Impact of physician-defined flares on quality of life and work impairment: An international survey of 2,238 psoriatic arthritis patients. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.211302

Key clinical point: Methotrexate (MTX)-related side effects were more prevalent in patients with psoriatic arthritis (PsA) vs rheumatoid arthritis (RA), whereas tumor necrosis factor inhibitor (TNFi)-related side effects were equally prevalent in patients with PsA and RA.

Major finding: In the first year, a higher proportion of patients with PsA vs RA reported MTX-related side effects (44.8% vs 29.4%), but similar proportions of patients with PsA (24.2%) and RA (22.8%) reported TNFi-related side effects. Patients with PsA vs RA were 1.8 times more likely to experience side effects with MTX (odds ratio 1.77; 95% CI 1.21-2.60).

Study details: Findings are from a retrospective cohort study including new initiators of MTX (PsA: n = 116 and RA: n = 4247) and TNFi (PsA: n = 124 and RA: n = 4361).

Disclosures: This study was funded by Amgen Inc. Two authors declared being employees or owning stocks in Amgen. The other authors declared receiving grants, funding, honoraria, or consulting fees from several sources, including Amgen.

Source: Ogdie A et al. Side effects of methotrexate and tumor necrosis factor inhibitors: Differences in tolerability among patients with psoriatic arthritis and rheumatoid arthritis. ACR Open Rheumatol. 2022 (Aug 15). Doi: 10.1002/acr2.11467

Key clinical point: Methotrexate (MTX)-related side effects were more prevalent in patients with psoriatic arthritis (PsA) vs rheumatoid arthritis (RA), whereas tumor necrosis factor inhibitor (TNFi)-related side effects were equally prevalent in patients with PsA and RA.

Major finding: In the first year, a higher proportion of patients with PsA vs RA reported MTX-related side effects (44.8% vs 29.4%), but similar proportions of patients with PsA (24.2%) and RA (22.8%) reported TNFi-related side effects. Patients with PsA vs RA were 1.8 times more likely to experience side effects with MTX (odds ratio 1.77; 95% CI 1.21-2.60).

Study details: Findings are from a retrospective cohort study including new initiators of MTX (PsA: n = 116 and RA: n = 4247) and TNFi (PsA: n = 124 and RA: n = 4361).

Disclosures: This study was funded by Amgen Inc. Two authors declared being employees or owning stocks in Amgen. The other authors declared receiving grants, funding, honoraria, or consulting fees from several sources, including Amgen.

Source: Ogdie A et al. Side effects of methotrexate and tumor necrosis factor inhibitors: Differences in tolerability among patients with psoriatic arthritis and rheumatoid arthritis. ACR Open Rheumatol. 2022 (Aug 15). Doi: 10.1002/acr2.11467

Key clinical point: Methotrexate (MTX)-related side effects were more prevalent in patients with psoriatic arthritis (PsA) vs rheumatoid arthritis (RA), whereas tumor necrosis factor inhibitor (TNFi)-related side effects were equally prevalent in patients with PsA and RA.

Major finding: In the first year, a higher proportion of patients with PsA vs RA reported MTX-related side effects (44.8% vs 29.4%), but similar proportions of patients with PsA (24.2%) and RA (22.8%) reported TNFi-related side effects. Patients with PsA vs RA were 1.8 times more likely to experience side effects with MTX (odds ratio 1.77; 95% CI 1.21-2.60).

Study details: Findings are from a retrospective cohort study including new initiators of MTX (PsA: n = 116 and RA: n = 4247) and TNFi (PsA: n = 124 and RA: n = 4361).

Disclosures: This study was funded by Amgen Inc. Two authors declared being employees or owning stocks in Amgen. The other authors declared receiving grants, funding, honoraria, or consulting fees from several sources, including Amgen.

Source: Ogdie A et al. Side effects of methotrexate and tumor necrosis factor inhibitors: Differences in tolerability among patients with psoriatic arthritis and rheumatoid arthritis. ACR Open Rheumatol. 2022 (Aug 15). Doi: 10.1002/acr2.11467

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Among patients with psoriatic arthritis (PsA) women experienced significantly higher disease burden than men despite similar disease activity and comparable treatments.

Major finding: Despite similar disease duration (P  =  .42), disease presentation, and biologic use (P  =  .38), women vs men had worse mean quality-of-life (0.80 vs 0.82; P  =  .02) and disability and physical functioning (0.56 vs 0.41; P < .01) scores, greater degree of work activity impairment (27.9% vs 24.6%; P < .01), and higher pain and fatigue scores (P < .01).

Study details: This study analyzed the data of 2270 patients with PsA (1223 men and 1047 women) from the Adelphi PsA Disease Specific Programme.

Disclosures: This study was funded by Janssen Research & Development, LLC. Three authors declared being employees of Janssen and owning stocks in Janssen/Johnson and Johnson. Some authors declared receiving research grants and consulting fees from several sources, including Janssen.

Source: Gossec L et al. Women with psoriatic arthritis experience higher disease burden than men: Findings from a real-world survey in the USA and Europe. J Rheumatol. 2022 (Aug 15). Doi: 10.3899/jrheum.220154

Key clinical point: Levels of C-reactive protein (CRP), a classic inflammatory marker, do not adequately reflect the level of disease activity (DA) in patients with psoriatic arthritis (PsA).

Major finding: CRP status was only associated with the erythrocyte sedimentation rate (odds ratio 1.04; P  =  .005) and not with any DA-related parameter. Among patients with normal CRP levels, a substantial proportion (45.9%) of patients were in non-minimal DA state, with 21.2% having moderate DA and 5.9% having high DA.

Study details: Findings are from a cross-sectional study including 128 patients with PsA, of which 66.4% had normal CRP levels (≤0.5 mg/dL) and the remaining had high CRP levels (>0.5 mg/dL).

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

Source: Gialouri CG et al. Normal C-reactive protein in active psoriatic arthritis: Results from real-world clinical practice. Ther Adv Musculoskelet Dis. 2022 (Sep 5). Doi: 10.1177/1759720X221122417

Key clinical point: Levels of C-reactive protein (CRP), a classic inflammatory marker, do not adequately reflect the level of disease activity (DA) in patients with psoriatic arthritis (PsA).

Major finding: CRP status was only associated with the erythrocyte sedimentation rate (odds ratio 1.04; P  =  .005) and not with any DA-related parameter. Among patients with normal CRP levels, a substantial proportion (45.9%) of patients were in non-minimal DA state, with 21.2% having moderate DA and 5.9% having high DA.

Study details: Findings are from a cross-sectional study including 128 patients with PsA, of which 66.4% had normal CRP levels (≤0.5 mg/dL) and the remaining had high CRP levels (>0.5 mg/dL).

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

Source: Gialouri CG et al. Normal C-reactive protein in active psoriatic arthritis: Results from real-world clinical practice. Ther Adv Musculoskelet Dis. 2022 (Sep 5). Doi: 10.1177/1759720X221122417

Key clinical point: Levels of C-reactive protein (CRP), a classic inflammatory marker, do not adequately reflect the level of disease activity (DA) in patients with psoriatic arthritis (PsA).

Major finding: CRP status was only associated with the erythrocyte sedimentation rate (odds ratio 1.04; P  =  .005) and not with any DA-related parameter. Among patients with normal CRP levels, a substantial proportion (45.9%) of patients were in non-minimal DA state, with 21.2% having moderate DA and 5.9% having high DA.

Study details: Findings are from a cross-sectional study including 128 patients with PsA, of which 66.4% had normal CRP levels (≤0.5 mg/dL) and the remaining had high CRP levels (>0.5 mg/dL).

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

Source: Gialouri CG et al. Normal C-reactive protein in active psoriatic arthritis: Results from real-world clinical practice. Ther Adv Musculoskelet Dis. 2022 (Sep 5). Doi: 10.1177/1759720X221122417