In most patients with psoriatic arthritis (PsA), the musculoskeletal manifestations occur after the onset of cutaneous manifestations. The mechanisms underlying the triggering of joint disease is still not well understood, one burning question is whether early and effective treatment of cutaneous psoriasis will reduce the incidence of PsA. In a retrospective non-randomised study, Gisondi et al compared the incidence rates of PsA in patients with chronic plaque psoriasis receiving either continuous treatment with a biologic disease modifying anti-rheumatic drugs (bDMARD- infliximab, etanercept, adalimumab, ustekinumab and secukinumab) for at least 5 years (n=234, 1584 person-year of follow-up) or at least three courses of narrow band ultraviolet B (nb-UVB) phototherapy (n=230, 1478 person-year of follow-up). bDMARDs treatment was associated with a lower risk of incident PsA (adjusted hazard ratio 0.27, 95% Confidence Interval 0.11–0.66). However, analysis after propensity score matching found no significant difference between treatment with bDMARDs and nb-UVB phototherapy and the risk of incident PsA. Prospective studies are required to answer this important question. Interestingly, nail psoriasis was associated with higher risk of PsA, confirming previous observations.

Due to lack of disease activity biomarkers clinical assessment of disease activity in PsA patients with concomitant fibromyalgia can be challenging. Ultrasound (US) may however be useful in providing objective assessment of disease activity. Polachek et al compared 42 patients with PsA and coexisting fibromyalgia syndrome (FMS) (satisfying CASPAR criteria and the 2016 fibromyalgia classification criteria) to 114 PsA patients without FMS (satisfying CASPAR criteria alone). All patients underwent detailed US evaluation including 52 joints, 40 tendons and 14 entheses, and a scores for synovitis, tenosynovitis and enthesitis were summed to obtain a final US disease activity score for each patient. Those with FMS had higher scores of composite clinical disease activity indices. However, the total US score and its subcategories were similar for those with and without FMS. The total US score significantly correlated with composite indices in PsA patients without FMS but not in PsA patients with FMS. Thus, US is a tool that can be employed to determine PsA disease activity in patients with concomitant FMS. However, the scanning protocol as described is time consuming. A shortened protocol as well as training of rheumatologists and radiologists for reliably assessing synovitis, tenosynovitis and enthesitis is required before US can be feasibly and reliably used in clinical practice.

IL-23 inhibitors were not found to be efficacious in the treatment of axial spondyloarthritis. It is not clear whether these inhibitors improve axial disease in PsA patients, and if indeed axial PsA is distinct from primary axial spondyloarthritis. In a post-hoc analyses of the DISCOVER 1 and DISCOVER 2 studies that included 312 patients with PsA with imaging-confirmed sacroiliitis randomly assigned to either placebo (n=118), guselkumab Q4 (n=103), or Q8 (n=91), Mease et al demonstrated that at week 24, guselkumab Q4 and Q8 groups vs placebo showed higher least-squares mean changes in BASDAI (−2.7 and −2.7 vs −1.3; P less than .0001) and ASDAS (−1.4 and −1.4 vs −0.7; P less than .0001) scores, which were maintained until week 52. Thus, Guselkumab may improve axial PsA. However, axial PsA has not yet been formally defined, and BASDAI and ASDAS are not specific for axial PsA. Once axial PsA is defined, prospective randomised clinical trials with associated MRI studies will be required to determine if IL-23 inhibitors improve symptoms of axial PsA.

In most patients with psoriatic arthritis (PsA), the musculoskeletal manifestations occur after the onset of cutaneous manifestations. The mechanisms underlying the triggering of joint disease is still not well understood, one burning question is whether early and effective treatment of cutaneous psoriasis will reduce the incidence of PsA. In a retrospective non-randomised study, Gisondi et al compared the incidence rates of PsA in patients with chronic plaque psoriasis receiving either continuous treatment with a biologic disease modifying anti-rheumatic drugs (bDMARD- infliximab, etanercept, adalimumab, ustekinumab and secukinumab) for at least 5 years (n=234, 1584 person-year of follow-up) or at least three courses of narrow band ultraviolet B (nb-UVB) phototherapy (n=230, 1478 person-year of follow-up). bDMARDs treatment was associated with a lower risk of incident PsA (adjusted hazard ratio 0.27, 95% Confidence Interval 0.11–0.66). However, analysis after propensity score matching found no significant difference between treatment with bDMARDs and nb-UVB phototherapy and the risk of incident PsA. Prospective studies are required to answer this important question. Interestingly, nail psoriasis was associated with higher risk of PsA, confirming previous observations.

Due to lack of disease activity biomarkers clinical assessment of disease activity in PsA patients with concomitant fibromyalgia can be challenging. Ultrasound (US) may however be useful in providing objective assessment of disease activity. Polachek et al compared 42 patients with PsA and coexisting fibromyalgia syndrome (FMS) (satisfying CASPAR criteria and the 2016 fibromyalgia classification criteria) to 114 PsA patients without FMS (satisfying CASPAR criteria alone). All patients underwent detailed US evaluation including 52 joints, 40 tendons and 14 entheses, and a scores for synovitis, tenosynovitis and enthesitis were summed to obtain a final US disease activity score for each patient. Those with FMS had higher scores of composite clinical disease activity indices. However, the total US score and its subcategories were similar for those with and without FMS. The total US score significantly correlated with composite indices in PsA patients without FMS but not in PsA patients with FMS. Thus, US is a tool that can be employed to determine PsA disease activity in patients with concomitant FMS. However, the scanning protocol as described is time consuming. A shortened protocol as well as training of rheumatologists and radiologists for reliably assessing synovitis, tenosynovitis and enthesitis is required before US can be feasibly and reliably used in clinical practice.

IL-23 inhibitors were not found to be efficacious in the treatment of axial spondyloarthritis. It is not clear whether these inhibitors improve axial disease in PsA patients, and if indeed axial PsA is distinct from primary axial spondyloarthritis. In a post-hoc analyses of the DISCOVER 1 and DISCOVER 2 studies that included 312 patients with PsA with imaging-confirmed sacroiliitis randomly assigned to either placebo (n=118), guselkumab Q4 (n=103), or Q8 (n=91), Mease et al demonstrated that at week 24, guselkumab Q4 and Q8 groups vs placebo showed higher least-squares mean changes in BASDAI (−2.7 and −2.7 vs −1.3; P less than .0001) and ASDAS (−1.4 and −1.4 vs −0.7; P less than .0001) scores, which were maintained until week 52. Thus, Guselkumab may improve axial PsA. However, axial PsA has not yet been formally defined, and BASDAI and ASDAS are not specific for axial PsA. Once axial PsA is defined, prospective randomised clinical trials with associated MRI studies will be required to determine if IL-23 inhibitors improve symptoms of axial PsA.

In most patients with psoriatic arthritis (PsA), the musculoskeletal manifestations occur after the onset of cutaneous manifestations. The mechanisms underlying the triggering of joint disease is still not well understood, one burning question is whether early and effective treatment of cutaneous psoriasis will reduce the incidence of PsA. In a retrospective non-randomised study, Gisondi et al compared the incidence rates of PsA in patients with chronic plaque psoriasis receiving either continuous treatment with a biologic disease modifying anti-rheumatic drugs (bDMARD- infliximab, etanercept, adalimumab, ustekinumab and secukinumab) for at least 5 years (n=234, 1584 person-year of follow-up) or at least three courses of narrow band ultraviolet B (nb-UVB) phototherapy (n=230, 1478 person-year of follow-up). bDMARDs treatment was associated with a lower risk of incident PsA (adjusted hazard ratio 0.27, 95% Confidence Interval 0.11–0.66). However, analysis after propensity score matching found no significant difference between treatment with bDMARDs and nb-UVB phototherapy and the risk of incident PsA. Prospective studies are required to answer this important question. Interestingly, nail psoriasis was associated with higher risk of PsA, confirming previous observations.

Due to lack of disease activity biomarkers clinical assessment of disease activity in PsA patients with concomitant fibromyalgia can be challenging. Ultrasound (US) may however be useful in providing objective assessment of disease activity. Polachek et al compared 42 patients with PsA and coexisting fibromyalgia syndrome (FMS) (satisfying CASPAR criteria and the 2016 fibromyalgia classification criteria) to 114 PsA patients without FMS (satisfying CASPAR criteria alone). All patients underwent detailed US evaluation including 52 joints, 40 tendons and 14 entheses, and a scores for synovitis, tenosynovitis and enthesitis were summed to obtain a final US disease activity score for each patient. Those with FMS had higher scores of composite clinical disease activity indices. However, the total US score and its subcategories were similar for those with and without FMS. The total US score significantly correlated with composite indices in PsA patients without FMS but not in PsA patients with FMS. Thus, US is a tool that can be employed to determine PsA disease activity in patients with concomitant FMS. However, the scanning protocol as described is time consuming. A shortened protocol as well as training of rheumatologists and radiologists for reliably assessing synovitis, tenosynovitis and enthesitis is required before US can be feasibly and reliably used in clinical practice.

IL-23 inhibitors were not found to be efficacious in the treatment of axial spondyloarthritis. It is not clear whether these inhibitors improve axial disease in PsA patients, and if indeed axial PsA is distinct from primary axial spondyloarthritis. In a post-hoc analyses of the DISCOVER 1 and DISCOVER 2 studies that included 312 patients with PsA with imaging-confirmed sacroiliitis randomly assigned to either placebo (n=118), guselkumab Q4 (n=103), or Q8 (n=91), Mease et al demonstrated that at week 24, guselkumab Q4 and Q8 groups vs placebo showed higher least-squares mean changes in BASDAI (−2.7 and −2.7 vs −1.3; P less than .0001) and ASDAS (−1.4 and −1.4 vs −0.7; P less than .0001) scores, which were maintained until week 52. Thus, Guselkumab may improve axial PsA. However, axial PsA has not yet been formally defined, and BASDAI and ASDAS are not specific for axial PsA. Once axial PsA is defined, prospective randomised clinical trials with associated MRI studies will be required to determine if IL-23 inhibitors improve symptoms of axial PsA.

Key clinical point: Among patients with psoriatic arthritis (PsA), risk for major adverse cardiovascular events (MACEs) was higher in those who initiated interleukin (IL)12/23 and IL17 inhibitors vs tumor necrosis factor (TNF) inhibitors. However, risk for MACEs was not different among new-users of TNF inhibitors or apremilast.

Major finding: Overall, 51 MACEs (crude incidence rate, 3.4/1,000 patient-years) were observed. The risk of MACEs was higher (P less than .0001) with IL12/23 (weighted hazard ratio [wHR], 2.0; 95% confidence interval [CI], 1.3-3.0) and IL17 (wHR, 1.9; 95% CI, 1.2-3.0) inhibitors but not with apremilast (wHR, 1.3; 95% CI, 0.8-2.2) vs TNF inhibitors.

Study details: Findings are from a nationwide PsA cohort without a history of cardiovascular diseases involving 9,510 new users of biological disease-modifying anti-rheumatic drugs (TNF inhibitor, n=7289; IL12/23 inhibitor, n=1058; IL17 inhibitor, n=1,163) and 1,885 new users of apremilast.

Disclosures: The study did not receive any funding. P Claudepierre reported receiving consulting fees from and being an investigator for various pharmaceutical companies. Other authors declared no conflicts of interest.

Source: Vegas LP et al. Rheumatology. 2021 Jul 9. doi: 10.1093/rheumatology/keab522.

Key clinical point: Among patients with psoriatic arthritis (PsA), risk for major adverse cardiovascular events (MACEs) was higher in those who initiated interleukin (IL)12/23 and IL17 inhibitors vs tumor necrosis factor (TNF) inhibitors. However, risk for MACEs was not different among new-users of TNF inhibitors or apremilast.

Major finding: Overall, 51 MACEs (crude incidence rate, 3.4/1,000 patient-years) were observed. The risk of MACEs was higher (P less than .0001) with IL12/23 (weighted hazard ratio [wHR], 2.0; 95% confidence interval [CI], 1.3-3.0) and IL17 (wHR, 1.9; 95% CI, 1.2-3.0) inhibitors but not with apremilast (wHR, 1.3; 95% CI, 0.8-2.2) vs TNF inhibitors.

Study details: Findings are from a nationwide PsA cohort without a history of cardiovascular diseases involving 9,510 new users of biological disease-modifying anti-rheumatic drugs (TNF inhibitor, n=7289; IL12/23 inhibitor, n=1058; IL17 inhibitor, n=1,163) and 1,885 new users of apremilast.

Disclosures: The study did not receive any funding. P Claudepierre reported receiving consulting fees from and being an investigator for various pharmaceutical companies. Other authors declared no conflicts of interest.

Source: Vegas LP et al. Rheumatology. 2021 Jul 9. doi: 10.1093/rheumatology/keab522.

Key clinical point: Among patients with psoriatic arthritis (PsA), risk for major adverse cardiovascular events (MACEs) was higher in those who initiated interleukin (IL)12/23 and IL17 inhibitors vs tumor necrosis factor (TNF) inhibitors. However, risk for MACEs was not different among new-users of TNF inhibitors or apremilast.

Major finding: Overall, 51 MACEs (crude incidence rate, 3.4/1,000 patient-years) were observed. The risk of MACEs was higher (P less than .0001) with IL12/23 (weighted hazard ratio [wHR], 2.0; 95% confidence interval [CI], 1.3-3.0) and IL17 (wHR, 1.9; 95% CI, 1.2-3.0) inhibitors but not with apremilast (wHR, 1.3; 95% CI, 0.8-2.2) vs TNF inhibitors.

Study details: Findings are from a nationwide PsA cohort without a history of cardiovascular diseases involving 9,510 new users of biological disease-modifying anti-rheumatic drugs (TNF inhibitor, n=7289; IL12/23 inhibitor, n=1058; IL17 inhibitor, n=1,163) and 1,885 new users of apremilast.

Disclosures: The study did not receive any funding. P Claudepierre reported receiving consulting fees from and being an investigator for various pharmaceutical companies. Other authors declared no conflicts of interest.

Source: Vegas LP et al. Rheumatology. 2021 Jul 9. doi: 10.1093/rheumatology/keab522.

Key clinical point: The drug survival rate was good for the first biological disease-modifying antirheumatic drug (bDMARD) in patients with psoriatic arthritis (PsA). Moreover, female sex may be a predisposing risk factor for flares and therapeutic switches.

Major finding: Overall, 44.32% of patients switched to another bDMARD. The mean time to first bDMARD discontinuation was 72 months. Overall, the drug survival rate in patients treated with antitumor necrosis factor-α and anti-interleukin (IL)-12/23 or anti-IL17 was 75% at 2 years and 60% at 5 years without a significant difference between the biological agents (P = .66). Female sex was associated with a higher risk for first bDMARD discontinuation (hazard ratio, 2.39; 95% confidence interval, 1.50-3.81).

Study details: The data come from a 15-year, monocentric, real-life study involving 264 patients with PsA who received biologics treatment.

Disclosures: The study reported no external funding. R Ramonda and A Doria reported receiving honoraria and speaker fees from Novartis, AbbVie, Pfizer, MSD, and Janssen. All the other authors declared no conflicts of interest.

Source: Lorenzin M et al. Clin Rheumatol. 2021 Jun 16. doi: 10.1007/s10067-021-05799-0.

Key clinical point: The drug survival rate was good for the first biological disease-modifying antirheumatic drug (bDMARD) in patients with psoriatic arthritis (PsA). Moreover, female sex may be a predisposing risk factor for flares and therapeutic switches.

Major finding: Overall, 44.32% of patients switched to another bDMARD. The mean time to first bDMARD discontinuation was 72 months. Overall, the drug survival rate in patients treated with antitumor necrosis factor-α and anti-interleukin (IL)-12/23 or anti-IL17 was 75% at 2 years and 60% at 5 years without a significant difference between the biological agents (P = .66). Female sex was associated with a higher risk for first bDMARD discontinuation (hazard ratio, 2.39; 95% confidence interval, 1.50-3.81).

Study details: The data come from a 15-year, monocentric, real-life study involving 264 patients with PsA who received biologics treatment.

Disclosures: The study reported no external funding. R Ramonda and A Doria reported receiving honoraria and speaker fees from Novartis, AbbVie, Pfizer, MSD, and Janssen. All the other authors declared no conflicts of interest.

Source: Lorenzin M et al. Clin Rheumatol. 2021 Jun 16. doi: 10.1007/s10067-021-05799-0.

Key clinical point: The drug survival rate was good for the first biological disease-modifying antirheumatic drug (bDMARD) in patients with psoriatic arthritis (PsA). Moreover, female sex may be a predisposing risk factor for flares and therapeutic switches.

Major finding: Overall, 44.32% of patients switched to another bDMARD. The mean time to first bDMARD discontinuation was 72 months. Overall, the drug survival rate in patients treated with antitumor necrosis factor-α and anti-interleukin (IL)-12/23 or anti-IL17 was 75% at 2 years and 60% at 5 years without a significant difference between the biological agents (P = .66). Female sex was associated with a higher risk for first bDMARD discontinuation (hazard ratio, 2.39; 95% confidence interval, 1.50-3.81).

Study details: The data come from a 15-year, monocentric, real-life study involving 264 patients with PsA who received biologics treatment.

Disclosures: The study reported no external funding. R Ramonda and A Doria reported receiving honoraria and speaker fees from Novartis, AbbVie, Pfizer, MSD, and Janssen. All the other authors declared no conflicts of interest.

Source: Lorenzin M et al. Clin Rheumatol. 2021 Jun 16. doi: 10.1007/s10067-021-05799-0.

Key clinical point: Treatment with biological disease-modifying antirheumatic drugs (bDMARDs) was associated with a significantly lower incidence of psoriatic arthritis (PsA) compared with narrow-band ultraviolet light B (nb-UVB) phototherapy in patients with moderate-to-severe chronic plaque psoriasis.

Major finding: The annual incidence rate for PsA was lower in patients prescribed bDMARDs vs phototherapy (1.20 vs 2.17 cases per 100 patients/year; P = .006). Treatment with bDMARD was associated with a lower risk for incident PsA (adjusted hazard ratio, 0.27; P = .004).

Study details: The data come from a retrospective, nonrandomized study involving 464 patients with moderate-to-severe plaque psoriasis who were prescribed either at least 5 years of bDMARDs (n=234) or at least 3 nb-UVB phototherapy courses (n=230).

Disclosures: This work was supported by the European Union’s Horizon 2020 Research and Innovation Program. P Gisondi, L Idolazzi, and G Girolomoni reported receiving consultancy and/or speaker fees from various sources.

Source: Gisondi P et al. Ann Rheum Dis. 2021 Jun 18. doi: 10.1136/annrheumdis-2021-219961.

Key clinical point: Treatment with biological disease-modifying antirheumatic drugs (bDMARDs) was associated with a significantly lower incidence of psoriatic arthritis (PsA) compared with narrow-band ultraviolet light B (nb-UVB) phototherapy in patients with moderate-to-severe chronic plaque psoriasis.

Major finding: The annual incidence rate for PsA was lower in patients prescribed bDMARDs vs phototherapy (1.20 vs 2.17 cases per 100 patients/year; P = .006). Treatment with bDMARD was associated with a lower risk for incident PsA (adjusted hazard ratio, 0.27; P = .004).

Study details: The data come from a retrospective, nonrandomized study involving 464 patients with moderate-to-severe plaque psoriasis who were prescribed either at least 5 years of bDMARDs (n=234) or at least 3 nb-UVB phototherapy courses (n=230).

Disclosures: This work was supported by the European Union’s Horizon 2020 Research and Innovation Program. P Gisondi, L Idolazzi, and G Girolomoni reported receiving consultancy and/or speaker fees from various sources.

Source: Gisondi P et al. Ann Rheum Dis. 2021 Jun 18. doi: 10.1136/annrheumdis-2021-219961.

Key clinical point: Treatment with biological disease-modifying antirheumatic drugs (bDMARDs) was associated with a significantly lower incidence of psoriatic arthritis (PsA) compared with narrow-band ultraviolet light B (nb-UVB) phototherapy in patients with moderate-to-severe chronic plaque psoriasis.

Major finding: The annual incidence rate for PsA was lower in patients prescribed bDMARDs vs phototherapy (1.20 vs 2.17 cases per 100 patients/year; P = .006). Treatment with bDMARD was associated with a lower risk for incident PsA (adjusted hazard ratio, 0.27; P = .004).

Study details: The data come from a retrospective, nonrandomized study involving 464 patients with moderate-to-severe plaque psoriasis who were prescribed either at least 5 years of bDMARDs (n=234) or at least 3 nb-UVB phototherapy courses (n=230).

Disclosures: This work was supported by the European Union’s Horizon 2020 Research and Innovation Program. P Gisondi, L Idolazzi, and G Girolomoni reported receiving consultancy and/or speaker fees from various sources.

Source: Gisondi P et al. Ann Rheum Dis. 2021 Jun 18. doi: 10.1136/annrheumdis-2021-219961.

Key clinical point: Among patients with psoriatic arthritis (PsA), those receiving tofacitinib experienced more rapid pain improvement compared with placebo.

Major finding: Median days to 30% or higher and 50% or higher initial pain improvement in patients receiving tofacitinib vs those switching from placebo to tofacitinib was 55.0 (95% confidence interval [CI], 29.0-57.0) vs 106.0 (95% CI, 64.0-115.0) and 85.0 (95% CI, 57.0-92.0) vs 169.0 (95% CI, 120.0-189.0), respectively.

Study details: This was a post hoc analysis of 2 phase 3 OPAL Broaden and OPAL Beyond trials involving 238 patients with active PsA randomly assigned to receive tofacitinib 5 mg twice daily, placebo switching to tofacitinib 5 mg twice daily at month 3 (placebo-to-tofacitinib), or adalimumab.

Disclosures: This study was funded by Pfizer Inc. Some of the authors declared serving as consultant and/or receiving grant/research support and consultancy fees from various sources including Pfizer Inc. Three authors reported being employees and stockholders of Pfizer Inc.

Source: de Vlam K et al. RMD Open. 2021 Jul 5. doi: 10.1136/rmdopen-2021-001609.

Key clinical point: Among patients with psoriatic arthritis (PsA), those receiving tofacitinib experienced more rapid pain improvement compared with placebo.

Major finding: Median days to 30% or higher and 50% or higher initial pain improvement in patients receiving tofacitinib vs those switching from placebo to tofacitinib was 55.0 (95% confidence interval [CI], 29.0-57.0) vs 106.0 (95% CI, 64.0-115.0) and 85.0 (95% CI, 57.0-92.0) vs 169.0 (95% CI, 120.0-189.0), respectively.

Study details: This was a post hoc analysis of 2 phase 3 OPAL Broaden and OPAL Beyond trials involving 238 patients with active PsA randomly assigned to receive tofacitinib 5 mg twice daily, placebo switching to tofacitinib 5 mg twice daily at month 3 (placebo-to-tofacitinib), or adalimumab.

Disclosures: This study was funded by Pfizer Inc. Some of the authors declared serving as consultant and/or receiving grant/research support and consultancy fees from various sources including Pfizer Inc. Three authors reported being employees and stockholders of Pfizer Inc.

Source: de Vlam K et al. RMD Open. 2021 Jul 5. doi: 10.1136/rmdopen-2021-001609.

Key clinical point: Among patients with psoriatic arthritis (PsA), those receiving tofacitinib experienced more rapid pain improvement compared with placebo.

Major finding: Median days to 30% or higher and 50% or higher initial pain improvement in patients receiving tofacitinib vs those switching from placebo to tofacitinib was 55.0 (95% confidence interval [CI], 29.0-57.0) vs 106.0 (95% CI, 64.0-115.0) and 85.0 (95% CI, 57.0-92.0) vs 169.0 (95% CI, 120.0-189.0), respectively.

Study details: This was a post hoc analysis of 2 phase 3 OPAL Broaden and OPAL Beyond trials involving 238 patients with active PsA randomly assigned to receive tofacitinib 5 mg twice daily, placebo switching to tofacitinib 5 mg twice daily at month 3 (placebo-to-tofacitinib), or adalimumab.

Disclosures: This study was funded by Pfizer Inc. Some of the authors declared serving as consultant and/or receiving grant/research support and consultancy fees from various sources including Pfizer Inc. Three authors reported being employees and stockholders of Pfizer Inc.

Source: de Vlam K et al. RMD Open. 2021 Jul 5. doi: 10.1136/rmdopen-2021-001609.

Key clinical point: Secukinumab improved disease burden in patients with psoriatic arthritis (PsA), regardless of previous tumor necrosis factor inhibitor (TNFi) exposure.

Major finding: Higher proportion of TNFi-naive patients receiving secukinumab 300 and 150 mg vs placebo showed resolution in 66 swollen joint count (SJC66; 41.5% and 27.7% vs 16.8%, respectively) and 68 tender joint counts (24.4% and 13.4% vs 5.7%, respectively; all P less than .05). Among patients with inadequate response to TNFi (TNFi-IR), those who received secukinumab 150 mg vs placebo experienced significant SJC66 resolution (20.8% vs 12.3%; P less than .05).

Study details: Findings are from a pooled analysis of 4 phase 3 randomized controlled trials (FUTURE 2, FUTURE 3, FUTURE 4, and FUTURE 5) involving 2049 patients with PsA who were either TNFi naive (n=1436) or TNFi-IR (n=613). Patients received either secukinumab 300 mg (n=461), secukinumab 150 mg (n=907), or placebo (n=681).

Disclosures: This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. The authors including the lead author reported receiving grant support, speaker fees, and/or consulting fees from various sources. O Chambenoit and X Meng reported being employees and stockholders of Novartis.

Source: Orbai AM et al. Rheumatol Ther. 2021 Jul 3. doi: 10.1007/s40744-021-00337-5.

Key clinical point: Secukinumab improved disease burden in patients with psoriatic arthritis (PsA), regardless of previous tumor necrosis factor inhibitor (TNFi) exposure.

Major finding: Higher proportion of TNFi-naive patients receiving secukinumab 300 and 150 mg vs placebo showed resolution in 66 swollen joint count (SJC66; 41.5% and 27.7% vs 16.8%, respectively) and 68 tender joint counts (24.4% and 13.4% vs 5.7%, respectively; all P less than .05). Among patients with inadequate response to TNFi (TNFi-IR), those who received secukinumab 150 mg vs placebo experienced significant SJC66 resolution (20.8% vs 12.3%; P less than .05).

Study details: Findings are from a pooled analysis of 4 phase 3 randomized controlled trials (FUTURE 2, FUTURE 3, FUTURE 4, and FUTURE 5) involving 2049 patients with PsA who were either TNFi naive (n=1436) or TNFi-IR (n=613). Patients received either secukinumab 300 mg (n=461), secukinumab 150 mg (n=907), or placebo (n=681).

Disclosures: This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. The authors including the lead author reported receiving grant support, speaker fees, and/or consulting fees from various sources. O Chambenoit and X Meng reported being employees and stockholders of Novartis.

Source: Orbai AM et al. Rheumatol Ther. 2021 Jul 3. doi: 10.1007/s40744-021-00337-5.

Key clinical point: Secukinumab improved disease burden in patients with psoriatic arthritis (PsA), regardless of previous tumor necrosis factor inhibitor (TNFi) exposure.

Major finding: Higher proportion of TNFi-naive patients receiving secukinumab 300 and 150 mg vs placebo showed resolution in 66 swollen joint count (SJC66; 41.5% and 27.7% vs 16.8%, respectively) and 68 tender joint counts (24.4% and 13.4% vs 5.7%, respectively; all P less than .05). Among patients with inadequate response to TNFi (TNFi-IR), those who received secukinumab 150 mg vs placebo experienced significant SJC66 resolution (20.8% vs 12.3%; P less than .05).

Study details: Findings are from a pooled analysis of 4 phase 3 randomized controlled trials (FUTURE 2, FUTURE 3, FUTURE 4, and FUTURE 5) involving 2049 patients with PsA who were either TNFi naive (n=1436) or TNFi-IR (n=613). Patients received either secukinumab 300 mg (n=461), secukinumab 150 mg (n=907), or placebo (n=681).

Disclosures: This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. The authors including the lead author reported receiving grant support, speaker fees, and/or consulting fees from various sources. O Chambenoit and X Meng reported being employees and stockholders of Novartis.

Source: Orbai AM et al. Rheumatol Ther. 2021 Jul 3. doi: 10.1007/s40744-021-00337-5.

Key clinical point: In a real-world cohort of patients with psoriatic arthritis (PsA), achievement of treatment targets was similar after 6 months of treatment with ustekinumab or tumor necrosis factor (TNF) inhibitors.

Major finding: After 6 months of treatment, the proportion of patients achieving clinical Disease Activity Index for PsA (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.46-1.15), low disease activity (LDA; OR, 0.74; 95% CI, 0.53-1.04), minimal disease activity (OR, 0.87; 95% CI, 0.61-1.25), and very LDA (OR, 0.74; 95% CI, 0.42-1.30) was not significantly different in ustekinumab vs TNF inhibitor groups. Both the groups reported similar adverse and serious adverse events.

Study details: Findings are from an analysis of 868 patients with PsA from the observational PsABio study, who were treated with first-line to third-line ustekinumab or TNF inhibitors.

Disclosures: PsABio study was sponsored by Janssen. The authors including the lead author reported receiving grants/research support and/or personal fees from various sources including Janssen. W Noël, P Bergmans, and E Theander reported being full-time employees of Janssen.

Source: Smolen JS et al. Ann Rheum Dis. 2021 Jun 23. doi: 10.1136/annrheumdis-2021-220263.

Key clinical point: In a real-world cohort of patients with psoriatic arthritis (PsA), achievement of treatment targets was similar after 6 months of treatment with ustekinumab or tumor necrosis factor (TNF) inhibitors.

Major finding: After 6 months of treatment, the proportion of patients achieving clinical Disease Activity Index for PsA (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.46-1.15), low disease activity (LDA; OR, 0.74; 95% CI, 0.53-1.04), minimal disease activity (OR, 0.87; 95% CI, 0.61-1.25), and very LDA (OR, 0.74; 95% CI, 0.42-1.30) was not significantly different in ustekinumab vs TNF inhibitor groups. Both the groups reported similar adverse and serious adverse events.

Study details: Findings are from an analysis of 868 patients with PsA from the observational PsABio study, who were treated with first-line to third-line ustekinumab or TNF inhibitors.

Disclosures: PsABio study was sponsored by Janssen. The authors including the lead author reported receiving grants/research support and/or personal fees from various sources including Janssen. W Noël, P Bergmans, and E Theander reported being full-time employees of Janssen.

Source: Smolen JS et al. Ann Rheum Dis. 2021 Jun 23. doi: 10.1136/annrheumdis-2021-220263.

Key clinical point: In a real-world cohort of patients with psoriatic arthritis (PsA), achievement of treatment targets was similar after 6 months of treatment with ustekinumab or tumor necrosis factor (TNF) inhibitors.

Major finding: After 6 months of treatment, the proportion of patients achieving clinical Disease Activity Index for PsA (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.46-1.15), low disease activity (LDA; OR, 0.74; 95% CI, 0.53-1.04), minimal disease activity (OR, 0.87; 95% CI, 0.61-1.25), and very LDA (OR, 0.74; 95% CI, 0.42-1.30) was not significantly different in ustekinumab vs TNF inhibitor groups. Both the groups reported similar adverse and serious adverse events.

Study details: Findings are from an analysis of 868 patients with PsA from the observational PsABio study, who were treated with first-line to third-line ustekinumab or TNF inhibitors.

Disclosures: PsABio study was sponsored by Janssen. The authors including the lead author reported receiving grants/research support and/or personal fees from various sources including Janssen. W Noël, P Bergmans, and E Theander reported being full-time employees of Janssen.

Source: Smolen JS et al. Ann Rheum Dis. 2021 Jun 23. doi: 10.1136/annrheumdis-2021-220263.

Key clinical point: The composite ultrasonography scores showed a significantly greater value for assessment of disease activity than clinical scores in patients with psoriatic arthritis (PsA) with coexisting fibromyalgia syndrome (FMS).

Major finding: Patients with coexisting PsA and FMS vs those without FMS had higher scores for several disease activity indices, including Composite Psoriatic Disease Activity Index, Disease Activity for PsA, and PsA Disease Activity Score (P less than .001). However, both groups had similar total ultrasonographic scores regardless of FMS (P = .68). A significant association was observed between FMS and higher scores on clinical activity indices (P less than .001) but not with the ultrasonography score.

Study details: The data come from a prospective study of 156 patients with PsA who were categorized into those with (n=42) and without (n=114) FMS.

Disclosures: No specific funding or conflicts of interest were reported.

Source: Polachek A et al. Ann Rheum Dis. 2021 Jul 2. doi: 10.1136/annrheumdis-2021-220562.

Key clinical point: The composite ultrasonography scores showed a significantly greater value for assessment of disease activity than clinical scores in patients with psoriatic arthritis (PsA) with coexisting fibromyalgia syndrome (FMS).

Major finding: Patients with coexisting PsA and FMS vs those without FMS had higher scores for several disease activity indices, including Composite Psoriatic Disease Activity Index, Disease Activity for PsA, and PsA Disease Activity Score (P less than .001). However, both groups had similar total ultrasonographic scores regardless of FMS (P = .68). A significant association was observed between FMS and higher scores on clinical activity indices (P less than .001) but not with the ultrasonography score.

Study details: The data come from a prospective study of 156 patients with PsA who were categorized into those with (n=42) and without (n=114) FMS.

Disclosures: No specific funding or conflicts of interest were reported.

Source: Polachek A et al. Ann Rheum Dis. 2021 Jul 2. doi: 10.1136/annrheumdis-2021-220562.

Key clinical point: The composite ultrasonography scores showed a significantly greater value for assessment of disease activity than clinical scores in patients with psoriatic arthritis (PsA) with coexisting fibromyalgia syndrome (FMS).

Major finding: Patients with coexisting PsA and FMS vs those without FMS had higher scores for several disease activity indices, including Composite Psoriatic Disease Activity Index, Disease Activity for PsA, and PsA Disease Activity Score (P less than .001). However, both groups had similar total ultrasonographic scores regardless of FMS (P = .68). A significant association was observed between FMS and higher scores on clinical activity indices (P less than .001) but not with the ultrasonography score.

Study details: The data come from a prospective study of 156 patients with PsA who were categorized into those with (n=42) and without (n=114) FMS.

Disclosures: No specific funding or conflicts of interest were reported.

Source: Polachek A et al. Ann Rheum Dis. 2021 Jul 2. doi: 10.1136/annrheumdis-2021-220562.

Key clinical point: Findings from this real-life cohort of patients with early psoriatic arthritis (PsA) confirm the safety and efficacy of guselkumab on peripheral and axial manifestations.

Major finding: After 12 months of guselkumab treatment, the mean Patient Global Assessment (P less than .0001), Visual Analogue Scale of Pain (P less than .001), and Disease Activity Score of PsA (P less than .0001) decreased significantly. Inflammatory low back pain disappeared as early as 24 weeks in all patients with concomitant axial disease. Low disease activity and remission were achieved by 65% and 35% of patients, respectively. No adverse events were reported.

Study details: The data come from an observational study involving 24 patients with early PsA who initiated therapy with guselkumab for severe skin involvement.

Disclosures: No specific funding was received for this study. The authors declared no conflicts of interest.

 Source: Pantano I et al. Rheumatology (Oxford). 2021 Jun 21. doi: 10.1093/rheumatology/keab509.

Key clinical point: Findings from this real-life cohort of patients with early psoriatic arthritis (PsA) confirm the safety and efficacy of guselkumab on peripheral and axial manifestations.

Major finding: After 12 months of guselkumab treatment, the mean Patient Global Assessment (P less than .0001), Visual Analogue Scale of Pain (P less than .001), and Disease Activity Score of PsA (P less than .0001) decreased significantly. Inflammatory low back pain disappeared as early as 24 weeks in all patients with concomitant axial disease. Low disease activity and remission were achieved by 65% and 35% of patients, respectively. No adverse events were reported.

Study details: The data come from an observational study involving 24 patients with early PsA who initiated therapy with guselkumab for severe skin involvement.

Disclosures: No specific funding was received for this study. The authors declared no conflicts of interest.

 Source: Pantano I et al. Rheumatology (Oxford). 2021 Jun 21. doi: 10.1093/rheumatology/keab509.

Key clinical point: Findings from this real-life cohort of patients with early psoriatic arthritis (PsA) confirm the safety and efficacy of guselkumab on peripheral and axial manifestations.

Major finding: After 12 months of guselkumab treatment, the mean Patient Global Assessment (P less than .0001), Visual Analogue Scale of Pain (P less than .001), and Disease Activity Score of PsA (P less than .0001) decreased significantly. Inflammatory low back pain disappeared as early as 24 weeks in all patients with concomitant axial disease. Low disease activity and remission were achieved by 65% and 35% of patients, respectively. No adverse events were reported.

Study details: The data come from an observational study involving 24 patients with early PsA who initiated therapy with guselkumab for severe skin involvement.

Disclosures: No specific funding was received for this study. The authors declared no conflicts of interest.

 Source: Pantano I et al. Rheumatology (Oxford). 2021 Jun 21. doi: 10.1093/rheumatology/keab509.

Key clinical point: Patients with psoriatic arthritis (PsA) with vs without nail involvement had higher rates of carotid plaque (CP) and carotid intima-media thickness (cIMT). Additionally, nail involvement in PsA was independently associated with CP risk.

Major finding: Patients with vs without nail involvement showed a higher prevalence of CP (53.1% vs 25.0%; P = .021) and cIMT (0.85 vs 0.59 mm; P = .026). The nail involvement was an independent risk factor for the presence of CP (odds ratio, 6.64; P = .006).

Study details: Findings are from a cross-sectional, observational study involving 64 patients with PsA. Patients with nail involvement were matched by age, gender, and type 2 diabetes mellitus diagnosis to those without nail involvement.

Disclosures: No specific funding or conflicts of interest were declared.

Source: Colunga-Pedraza IJ et al. Ann Rheum Dis. 2021 Jun 24. doi: 10.1136/annrheumdis-2021-220782.

Key clinical point: Patients with psoriatic arthritis (PsA) with vs without nail involvement had higher rates of carotid plaque (CP) and carotid intima-media thickness (cIMT). Additionally, nail involvement in PsA was independently associated with CP risk.

Major finding: Patients with vs without nail involvement showed a higher prevalence of CP (53.1% vs 25.0%; P = .021) and cIMT (0.85 vs 0.59 mm; P = .026). The nail involvement was an independent risk factor for the presence of CP (odds ratio, 6.64; P = .006).

Study details: Findings are from a cross-sectional, observational study involving 64 patients with PsA. Patients with nail involvement were matched by age, gender, and type 2 diabetes mellitus diagnosis to those without nail involvement.

Disclosures: No specific funding or conflicts of interest were declared.

Source: Colunga-Pedraza IJ et al. Ann Rheum Dis. 2021 Jun 24. doi: 10.1136/annrheumdis-2021-220782.

Key clinical point: Patients with psoriatic arthritis (PsA) with vs without nail involvement had higher rates of carotid plaque (CP) and carotid intima-media thickness (cIMT). Additionally, nail involvement in PsA was independently associated with CP risk.

Major finding: Patients with vs without nail involvement showed a higher prevalence of CP (53.1% vs 25.0%; P = .021) and cIMT (0.85 vs 0.59 mm; P = .026). The nail involvement was an independent risk factor for the presence of CP (odds ratio, 6.64; P = .006).

Study details: Findings are from a cross-sectional, observational study involving 64 patients with PsA. Patients with nail involvement were matched by age, gender, and type 2 diabetes mellitus diagnosis to those without nail involvement.

Disclosures: No specific funding or conflicts of interest were declared.

Source: Colunga-Pedraza IJ et al. Ann Rheum Dis. 2021 Jun 24. doi: 10.1136/annrheumdis-2021-220782.