Psoriatic arthritis may be associated with excess mortality risk but the current evidence to support excess mortality in psoriatic arthritis is inconclusive. Nevertheless, identifying risk factors for mortality in patients with psoriatic arthritis is important so that modifiable factors could be addressed. Vela et al investigated whether the cumulative pain experienced by psoriatic arthritis patients was associated with increased mortality. Using data from the Danish nationwide registry of biological therapies (DANBIO), the authors showed that although there was a significant association between pain intensity and mortality (odds ratio 1.06 (95%CI 1.02 to 1.10) per 5 VAS unit increase), no association was found when the analyses was adjusted for confounders including age, CRP, joint counts, HAQ score, treatment, and comorbidities. As expected, recent glucocorticoid use, chronic obstructive pulmonary disease, diabetes mellitus, cancer and cardiovascular disease were associated with excess mortality. The results indicate that mortality in psoriatic arthritis is primarily driven by associated comorbidities; holistic management of psoriatic disease should include management of associated comorbidities.

Comorbidities have a major impact on patients with psoriatic arthritis and influence a patient’s quality of life and function as well as treatment response. Neuropsychiatric comorbidities have been less studied in psoriatic arthritis. An intriguing study by Garcia et al indicate that cognitive impairment may be associated with psoriatic arthritis. In a small cross-sectional study, they demonstrated that patients with psoriatic arthritis score worse on the Montreal Cognitive Assessment (MoCA) tool compared to controls, with executive skills, naming, language, and abstraction being most affected. Further research is required to explore whether other comorbidities such as cerebrovascular disease, depression or sleep disturbances explain the cognitive impairment. Depression and anxiety are also associated with reduced likelihood of achieving remission or low disease activity state in psoriatic arthritis. In a study of 743 patients, Wong et al demonstrated that patients with depression or anxiety are less likely to achieve a state of sustained minimal disease activity. These studies once again highlight the management of comorbidities to achieve improved outcomes in patients with psoriatic arthritis.

New data also indicate efficacy of targeted therapy in psoriatic arthritis. In two phase 3 trials funded by LEO pharma, Mease et al report that brodalumab, an interleukin 17 receptor inhibitor that is already available for the treatment for psoriasis, is efficacious in the treatment of psoriatic arthritis. Although the trial was terminated early, pooled data from the two trials showed that higher proportions of patients on 140 mg and 210 mg of brodalumab achieved American College of Rheumatology (ACR)20 response at week 16 compared to placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001).

There are limited data on treatment withdrawal in patients with psoriatic arthritis. Coates et al investigated whether continued treatment with ixekizumab, an interleukin 17A inhibitor was superior to withdrawing ixekizumab in maintaining minimal disease activity state in patents with psoriatic arthritis. They showed that more patients relapsed rapidly after ixekizumab was withdrawn compared to those continuing ixekizumab treatment. Importantly, >95% of patients who relapsed with treatment withdrawal re-achieved MDA on retreatment with ixekizumab within a median duration of 4.1 weeks. Thus, ixekizumab treatment is best maintained after a patient achieves a state of minimal disease activity. If the treatment needs to be interrupted (e.g., infection, surgery), most patients will re-achieve the state of minimal disease activity on retreatment.

Finally, research continues to demonstrate delayed diagnosis of psoriatic arthritis. Karmacharya et al showed that only 45% of patients receive a diagnosis of psoriatic arthritis by 2 years after symptom onset. This study from the population-based Rochester Epidemiology Project indicates that earlier age of onset of symptoms, the presence of higher body mass index and enthesitis are associated with diagnostic delay. Further education of health care providers and patients with psoriasis about psoriatic arthritis may help reduce diagnostic delay; delayed diagnosis leads to poorer long-term outcomes.

Psoriatic arthritis may be associated with excess mortality risk but the current evidence to support excess mortality in psoriatic arthritis is inconclusive. Nevertheless, identifying risk factors for mortality in patients with psoriatic arthritis is important so that modifiable factors could be addressed. Vela et al investigated whether the cumulative pain experienced by psoriatic arthritis patients was associated with increased mortality. Using data from the Danish nationwide registry of biological therapies (DANBIO), the authors showed that although there was a significant association between pain intensity and mortality (odds ratio 1.06 (95%CI 1.02 to 1.10) per 5 VAS unit increase), no association was found when the analyses was adjusted for confounders including age, CRP, joint counts, HAQ score, treatment, and comorbidities. As expected, recent glucocorticoid use, chronic obstructive pulmonary disease, diabetes mellitus, cancer and cardiovascular disease were associated with excess mortality. The results indicate that mortality in psoriatic arthritis is primarily driven by associated comorbidities; holistic management of psoriatic disease should include management of associated comorbidities.

Comorbidities have a major impact on patients with psoriatic arthritis and influence a patient’s quality of life and function as well as treatment response. Neuropsychiatric comorbidities have been less studied in psoriatic arthritis. An intriguing study by Garcia et al indicate that cognitive impairment may be associated with psoriatic arthritis. In a small cross-sectional study, they demonstrated that patients with psoriatic arthritis score worse on the Montreal Cognitive Assessment (MoCA) tool compared to controls, with executive skills, naming, language, and abstraction being most affected. Further research is required to explore whether other comorbidities such as cerebrovascular disease, depression or sleep disturbances explain the cognitive impairment. Depression and anxiety are also associated with reduced likelihood of achieving remission or low disease activity state in psoriatic arthritis. In a study of 743 patients, Wong et al demonstrated that patients with depression or anxiety are less likely to achieve a state of sustained minimal disease activity. These studies once again highlight the management of comorbidities to achieve improved outcomes in patients with psoriatic arthritis.

New data also indicate efficacy of targeted therapy in psoriatic arthritis. In two phase 3 trials funded by LEO pharma, Mease et al report that brodalumab, an interleukin 17 receptor inhibitor that is already available for the treatment for psoriasis, is efficacious in the treatment of psoriatic arthritis. Although the trial was terminated early, pooled data from the two trials showed that higher proportions of patients on 140 mg and 210 mg of brodalumab achieved American College of Rheumatology (ACR)20 response at week 16 compared to placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001).

There are limited data on treatment withdrawal in patients with psoriatic arthritis. Coates et al investigated whether continued treatment with ixekizumab, an interleukin 17A inhibitor was superior to withdrawing ixekizumab in maintaining minimal disease activity state in patents with psoriatic arthritis. They showed that more patients relapsed rapidly after ixekizumab was withdrawn compared to those continuing ixekizumab treatment. Importantly, >95% of patients who relapsed with treatment withdrawal re-achieved MDA on retreatment with ixekizumab within a median duration of 4.1 weeks. Thus, ixekizumab treatment is best maintained after a patient achieves a state of minimal disease activity. If the treatment needs to be interrupted (e.g., infection, surgery), most patients will re-achieve the state of minimal disease activity on retreatment.

Finally, research continues to demonstrate delayed diagnosis of psoriatic arthritis. Karmacharya et al showed that only 45% of patients receive a diagnosis of psoriatic arthritis by 2 years after symptom onset. This study from the population-based Rochester Epidemiology Project indicates that earlier age of onset of symptoms, the presence of higher body mass index and enthesitis are associated with diagnostic delay. Further education of health care providers and patients with psoriasis about psoriatic arthritis may help reduce diagnostic delay; delayed diagnosis leads to poorer long-term outcomes.

Psoriatic arthritis may be associated with excess mortality risk but the current evidence to support excess mortality in psoriatic arthritis is inconclusive. Nevertheless, identifying risk factors for mortality in patients with psoriatic arthritis is important so that modifiable factors could be addressed. Vela et al investigated whether the cumulative pain experienced by psoriatic arthritis patients was associated with increased mortality. Using data from the Danish nationwide registry of biological therapies (DANBIO), the authors showed that although there was a significant association between pain intensity and mortality (odds ratio 1.06 (95%CI 1.02 to 1.10) per 5 VAS unit increase), no association was found when the analyses was adjusted for confounders including age, CRP, joint counts, HAQ score, treatment, and comorbidities. As expected, recent glucocorticoid use, chronic obstructive pulmonary disease, diabetes mellitus, cancer and cardiovascular disease were associated with excess mortality. The results indicate that mortality in psoriatic arthritis is primarily driven by associated comorbidities; holistic management of psoriatic disease should include management of associated comorbidities.

Comorbidities have a major impact on patients with psoriatic arthritis and influence a patient’s quality of life and function as well as treatment response. Neuropsychiatric comorbidities have been less studied in psoriatic arthritis. An intriguing study by Garcia et al indicate that cognitive impairment may be associated with psoriatic arthritis. In a small cross-sectional study, they demonstrated that patients with psoriatic arthritis score worse on the Montreal Cognitive Assessment (MoCA) tool compared to controls, with executive skills, naming, language, and abstraction being most affected. Further research is required to explore whether other comorbidities such as cerebrovascular disease, depression or sleep disturbances explain the cognitive impairment. Depression and anxiety are also associated with reduced likelihood of achieving remission or low disease activity state in psoriatic arthritis. In a study of 743 patients, Wong et al demonstrated that patients with depression or anxiety are less likely to achieve a state of sustained minimal disease activity. These studies once again highlight the management of comorbidities to achieve improved outcomes in patients with psoriatic arthritis.

New data also indicate efficacy of targeted therapy in psoriatic arthritis. In two phase 3 trials funded by LEO pharma, Mease et al report that brodalumab, an interleukin 17 receptor inhibitor that is already available for the treatment for psoriasis, is efficacious in the treatment of psoriatic arthritis. Although the trial was terminated early, pooled data from the two trials showed that higher proportions of patients on 140 mg and 210 mg of brodalumab achieved American College of Rheumatology (ACR)20 response at week 16 compared to placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001).

There are limited data on treatment withdrawal in patients with psoriatic arthritis. Coates et al investigated whether continued treatment with ixekizumab, an interleukin 17A inhibitor was superior to withdrawing ixekizumab in maintaining minimal disease activity state in patents with psoriatic arthritis. They showed that more patients relapsed rapidly after ixekizumab was withdrawn compared to those continuing ixekizumab treatment. Importantly, >95% of patients who relapsed with treatment withdrawal re-achieved MDA on retreatment with ixekizumab within a median duration of 4.1 weeks. Thus, ixekizumab treatment is best maintained after a patient achieves a state of minimal disease activity. If the treatment needs to be interrupted (e.g., infection, surgery), most patients will re-achieve the state of minimal disease activity on retreatment.

Finally, research continues to demonstrate delayed diagnosis of psoriatic arthritis. Karmacharya et al showed that only 45% of patients receive a diagnosis of psoriatic arthritis by 2 years after symptom onset. This study from the population-based Rochester Epidemiology Project indicates that earlier age of onset of symptoms, the presence of higher body mass index and enthesitis are associated with diagnostic delay. Further education of health care providers and patients with psoriasis about psoriatic arthritis may help reduce diagnostic delay; delayed diagnosis leads to poorer long-term outcomes.

Key clinical point: More than half of patients with PsA had a diagnostic delay of >2 years.

Major finding: The percentage of patients receiving a diagnosis of PsA by 2 years after symptom onset was 45%. Factors associated with a diagnostic delay of >2 years included earlier age at onset of symptoms, higher body mass index, and enthesitis.

Study details: The data come from a retrospective, population-based cohort of 164 incident adult PsA patients.

Disclosures: The study used resources of the Rochester Epidemiology Project, which is supported by various National Institutes of Health grants. P Karmacharya and A Duarte-García reported receiving individual research grants. A Ogdie and JM Davis reported ties with various pharmaceutical companies. The remaining authors declared no conflicts of interest.

Source: Karmacharya P et al. J Rheumatol. 2021 Feb 15. doi: 10.3899/jrheum.201199.

Key clinical point: More than half of patients with PsA had a diagnostic delay of >2 years.

Major finding: The percentage of patients receiving a diagnosis of PsA by 2 years after symptom onset was 45%. Factors associated with a diagnostic delay of >2 years included earlier age at onset of symptoms, higher body mass index, and enthesitis.

Study details: The data come from a retrospective, population-based cohort of 164 incident adult PsA patients.

Disclosures: The study used resources of the Rochester Epidemiology Project, which is supported by various National Institutes of Health grants. P Karmacharya and A Duarte-García reported receiving individual research grants. A Ogdie and JM Davis reported ties with various pharmaceutical companies. The remaining authors declared no conflicts of interest.

Source: Karmacharya P et al. J Rheumatol. 2021 Feb 15. doi: 10.3899/jrheum.201199.

Key clinical point: More than half of patients with PsA had a diagnostic delay of >2 years.

Major finding: The percentage of patients receiving a diagnosis of PsA by 2 years after symptom onset was 45%. Factors associated with a diagnostic delay of >2 years included earlier age at onset of symptoms, higher body mass index, and enthesitis.

Study details: The data come from a retrospective, population-based cohort of 164 incident adult PsA patients.

Disclosures: The study used resources of the Rochester Epidemiology Project, which is supported by various National Institutes of Health grants. P Karmacharya and A Duarte-García reported receiving individual research grants. A Ogdie and JM Davis reported ties with various pharmaceutical companies. The remaining authors declared no conflicts of interest.

Source: Karmacharya P et al. J Rheumatol. 2021 Feb 15. doi: 10.3899/jrheum.201199.

Key clinical point: There is favorable agreement between ultrasound (US) and magnetic resonance imaging (MRI) for detecting inflammatory changes in finger joints of patients with psoriatic arthritis (PsA). Additionally, there is a favorable agreement between US, radiography and MRI for detecting destructive changes.

Major finding: The absolute agreement between US and MRI was in the range of good-to-very good for detecting synovitis (85%-96%), flexor tenosynovitis (93%-98%), and extensor paratenonitis (95%-98%). Agreement between US, MRI and radiography was also good-to-very good for detecting erosions (96%-98%) and bone proliferations (71%-93%).

Study details: The data come from a study of 100 consecutive PsA patients who underwent clinical assessment and concomitant radiographic, US and MRI evaluations of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of one hand.

Disclosures: The study was supported by an investigator-initiated research grant sponsored by Johnson and Johnson. The authors declared no conflicts of interest.

Source: Polachek A et al. Rheumatology (Oxford). 2021 Mar 17. doi: 10.1093/rheumatology/keab272.

Key clinical point: There is favorable agreement between ultrasound (US) and magnetic resonance imaging (MRI) for detecting inflammatory changes in finger joints of patients with psoriatic arthritis (PsA). Additionally, there is a favorable agreement between US, radiography and MRI for detecting destructive changes.

Major finding: The absolute agreement between US and MRI was in the range of good-to-very good for detecting synovitis (85%-96%), flexor tenosynovitis (93%-98%), and extensor paratenonitis (95%-98%). Agreement between US, MRI and radiography was also good-to-very good for detecting erosions (96%-98%) and bone proliferations (71%-93%).

Study details: The data come from a study of 100 consecutive PsA patients who underwent clinical assessment and concomitant radiographic, US and MRI evaluations of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of one hand.

Disclosures: The study was supported by an investigator-initiated research grant sponsored by Johnson and Johnson. The authors declared no conflicts of interest.

Source: Polachek A et al. Rheumatology (Oxford). 2021 Mar 17. doi: 10.1093/rheumatology/keab272.

Key clinical point: There is favorable agreement between ultrasound (US) and magnetic resonance imaging (MRI) for detecting inflammatory changes in finger joints of patients with psoriatic arthritis (PsA). Additionally, there is a favorable agreement between US, radiography and MRI for detecting destructive changes.

Major finding: The absolute agreement between US and MRI was in the range of good-to-very good for detecting synovitis (85%-96%), flexor tenosynovitis (93%-98%), and extensor paratenonitis (95%-98%). Agreement between US, MRI and radiography was also good-to-very good for detecting erosions (96%-98%) and bone proliferations (71%-93%).

Study details: The data come from a study of 100 consecutive PsA patients who underwent clinical assessment and concomitant radiographic, US and MRI evaluations of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of one hand.

Disclosures: The study was supported by an investigator-initiated research grant sponsored by Johnson and Johnson. The authors declared no conflicts of interest.

Source: Polachek A et al. Rheumatology (Oxford). 2021 Mar 17. doi: 10.1093/rheumatology/keab272.

Key clinical point: Cognitive impairment may be one of the neurological manifestations of psoriatic arthritis (PsA).

Major finding: Patients with PsA scored worse on the Montreal Cognitive Assessment (MoCA) vs. controls (P = .01). Additionally, the proportion of patients with cognitive impairment according to MoCA was significantly higher among cases vs. controls (91.9% vs. 58.3%, P = .002).

Study details: The data come from a cross-sectional case-control study involving 37 patients with PsA and 36 healthy controls.

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

Source: Garcia LOKL et al. Acta Neurol Belg. 2021 Mar 13. doi: 10.1007/s13760-021-01644-y.

Key clinical point: Cognitive impairment may be one of the neurological manifestations of psoriatic arthritis (PsA).

Major finding: Patients with PsA scored worse on the Montreal Cognitive Assessment (MoCA) vs. controls (P = .01). Additionally, the proportion of patients with cognitive impairment according to MoCA was significantly higher among cases vs. controls (91.9% vs. 58.3%, P = .002).

Study details: The data come from a cross-sectional case-control study involving 37 patients with PsA and 36 healthy controls.

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

Source: Garcia LOKL et al. Acta Neurol Belg. 2021 Mar 13. doi: 10.1007/s13760-021-01644-y.

Key clinical point: Cognitive impairment may be one of the neurological manifestations of psoriatic arthritis (PsA).

Major finding: Patients with PsA scored worse on the Montreal Cognitive Assessment (MoCA) vs. controls (P = .01). Additionally, the proportion of patients with cognitive impairment according to MoCA was significantly higher among cases vs. controls (91.9% vs. 58.3%, P = .002).

Study details: The data come from a cross-sectional case-control study involving 37 patients with PsA and 36 healthy controls.

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

Source: Garcia LOKL et al. Acta Neurol Belg. 2021 Mar 13. doi: 10.1007/s13760-021-01644-y.

Key clinical point: In patients with active psoriatic arthritis (PsA), intravenous (IV) golimumab improved health-related quality of life (HRQoL) and productivity as early as 8 weeks and maintained improvement through 1 year; and these improvements were associated with improvements in disease activity and patient functional capability outcomes.

Major finding: At week 8, patients receiving IV golimumab vs. placebo had greater improvements in EuroQol-5 dimension-5 level index (0.14 vs. 0.04) and visual analog scale (VAS; 17.16 vs. 3.69), daily productivity VAS (−2.91 vs. −0.71), and Work Limitations Questionnaire productivity loss score (−2.92 vs. −0.78). At week 52, improvements were similar in the golimumab and placebo-crossover groups. HRQoL and productivity correlated with disease activity and functional capability, with continued association from week 8 through week 52.

Study details: In this phase 3 GO-VIBRANT trial, 480 patients with PsA were randomly assigned to receive IV golimumab 2 mg/kg (n=241) at weeks 0, 4, and then every 8 weeks (q8w) through week 52 or placebo (n=239) at weeks 0, 4, and then q8w, with crossover to IV golimumab 2 mg/kg at weeks 24, 28, and then q8w through week 52.

Disclosures: This study was supported by Janssen Research & Development, LLC, Spring House, PA. Some study investigators are employees of Janssen Global Services, LLC and own stock in Johnson & Johnson, of which Janssen Global Services, LLC is a wholly owned subsidiary. Some study authors reported receiving support from and consulting for Janssen.

Source: Ogdie A et al. Clin Rheumatol. 2021 Mar 2. doi: 10.1007/s10067-021-05639-1.

Key clinical point: In patients with active psoriatic arthritis (PsA), intravenous (IV) golimumab improved health-related quality of life (HRQoL) and productivity as early as 8 weeks and maintained improvement through 1 year; and these improvements were associated with improvements in disease activity and patient functional capability outcomes.

Major finding: At week 8, patients receiving IV golimumab vs. placebo had greater improvements in EuroQol-5 dimension-5 level index (0.14 vs. 0.04) and visual analog scale (VAS; 17.16 vs. 3.69), daily productivity VAS (−2.91 vs. −0.71), and Work Limitations Questionnaire productivity loss score (−2.92 vs. −0.78). At week 52, improvements were similar in the golimumab and placebo-crossover groups. HRQoL and productivity correlated with disease activity and functional capability, with continued association from week 8 through week 52.

Study details: In this phase 3 GO-VIBRANT trial, 480 patients with PsA were randomly assigned to receive IV golimumab 2 mg/kg (n=241) at weeks 0, 4, and then every 8 weeks (q8w) through week 52 or placebo (n=239) at weeks 0, 4, and then q8w, with crossover to IV golimumab 2 mg/kg at weeks 24, 28, and then q8w through week 52.

Disclosures: This study was supported by Janssen Research & Development, LLC, Spring House, PA. Some study investigators are employees of Janssen Global Services, LLC and own stock in Johnson & Johnson, of which Janssen Global Services, LLC is a wholly owned subsidiary. Some study authors reported receiving support from and consulting for Janssen.

Source: Ogdie A et al. Clin Rheumatol. 2021 Mar 2. doi: 10.1007/s10067-021-05639-1.

Key clinical point: In patients with active psoriatic arthritis (PsA), intravenous (IV) golimumab improved health-related quality of life (HRQoL) and productivity as early as 8 weeks and maintained improvement through 1 year; and these improvements were associated with improvements in disease activity and patient functional capability outcomes.

Major finding: At week 8, patients receiving IV golimumab vs. placebo had greater improvements in EuroQol-5 dimension-5 level index (0.14 vs. 0.04) and visual analog scale (VAS; 17.16 vs. 3.69), daily productivity VAS (−2.91 vs. −0.71), and Work Limitations Questionnaire productivity loss score (−2.92 vs. −0.78). At week 52, improvements were similar in the golimumab and placebo-crossover groups. HRQoL and productivity correlated with disease activity and functional capability, with continued association from week 8 through week 52.

Study details: In this phase 3 GO-VIBRANT trial, 480 patients with PsA were randomly assigned to receive IV golimumab 2 mg/kg (n=241) at weeks 0, 4, and then every 8 weeks (q8w) through week 52 or placebo (n=239) at weeks 0, 4, and then q8w, with crossover to IV golimumab 2 mg/kg at weeks 24, 28, and then q8w through week 52.

Disclosures: This study was supported by Janssen Research & Development, LLC, Spring House, PA. Some study investigators are employees of Janssen Global Services, LLC and own stock in Johnson & Johnson, of which Janssen Global Services, LLC is a wholly owned subsidiary. Some study authors reported receiving support from and consulting for Janssen.

Source: Ogdie A et al. Clin Rheumatol. 2021 Mar 2. doi: 10.1007/s10067-021-05639-1.

Key clinical point: The presence of depression/anxiety symptoms reduces the probability of achieving sustained minimal disease activity (MDA) in patients with psoriatic arthritis (PsA), regardless of the method used to define depression/anxiety.

Major finding: When depression/anxiety was defined as a score of 38 or lower on the Mental Component Summary of the Short Form-36 questionnaire (definition 1), the odds ratio (OR) for reaching sustained MDA was 0.30 (P less than .0001). The OR values were 0.34 (P less than .0001) and 0.47 (P less than .0001) for a score of 56 or lower on the Mental Health sub-scale (definition 2) and for rheumatologist’s report of a diagnosis or treatment for depression/anxiety (definition 3), respectively.

Study details: The data come from a study of 743 patients with PsA.

Disclosures: No study sponsor was identified. Several of the authors are affiliated with the Psoriatic Disease Program of the Krembil Research Institute of University Health Network in Toronto, which is supported by the Krembil Foundation. Dr. A Wong was supported by a Krembil Psoriatic Arthritis Fellowship and Dr. V Chandran was supported by a Pfizer Chair Rheumatology Research Award from the Department of Medicine, University of Toronto.

Source: Wong A et al. Arthritis Care Res (Hoboken). 2021 Mar 4. doi: 10.1002/acr.24593.

Key clinical point: The presence of depression/anxiety symptoms reduces the probability of achieving sustained minimal disease activity (MDA) in patients with psoriatic arthritis (PsA), regardless of the method used to define depression/anxiety.

Major finding: When depression/anxiety was defined as a score of 38 or lower on the Mental Component Summary of the Short Form-36 questionnaire (definition 1), the odds ratio (OR) for reaching sustained MDA was 0.30 (P less than .0001). The OR values were 0.34 (P less than .0001) and 0.47 (P less than .0001) for a score of 56 or lower on the Mental Health sub-scale (definition 2) and for rheumatologist’s report of a diagnosis or treatment for depression/anxiety (definition 3), respectively.

Study details: The data come from a study of 743 patients with PsA.

Disclosures: No study sponsor was identified. Several of the authors are affiliated with the Psoriatic Disease Program of the Krembil Research Institute of University Health Network in Toronto, which is supported by the Krembil Foundation. Dr. A Wong was supported by a Krembil Psoriatic Arthritis Fellowship and Dr. V Chandran was supported by a Pfizer Chair Rheumatology Research Award from the Department of Medicine, University of Toronto.

Source: Wong A et al. Arthritis Care Res (Hoboken). 2021 Mar 4. doi: 10.1002/acr.24593.

Key clinical point: The presence of depression/anxiety symptoms reduces the probability of achieving sustained minimal disease activity (MDA) in patients with psoriatic arthritis (PsA), regardless of the method used to define depression/anxiety.

Major finding: When depression/anxiety was defined as a score of 38 or lower on the Mental Component Summary of the Short Form-36 questionnaire (definition 1), the odds ratio (OR) for reaching sustained MDA was 0.30 (P less than .0001). The OR values were 0.34 (P less than .0001) and 0.47 (P less than .0001) for a score of 56 or lower on the Mental Health sub-scale (definition 2) and for rheumatologist’s report of a diagnosis or treatment for depression/anxiety (definition 3), respectively.

Study details: The data come from a study of 743 patients with PsA.

Disclosures: No study sponsor was identified. Several of the authors are affiliated with the Psoriatic Disease Program of the Krembil Research Institute of University Health Network in Toronto, which is supported by the Krembil Foundation. Dr. A Wong was supported by a Krembil Psoriatic Arthritis Fellowship and Dr. V Chandran was supported by a Pfizer Chair Rheumatology Research Award from the Department of Medicine, University of Toronto.

Source: Wong A et al. Arthritis Care Res (Hoboken). 2021 Mar 4. doi: 10.1002/acr.24593.

Key clinical point: Alcohol consumption, older age, suffering from fatty liver when less than 45 years old, and elevated high-sensitivity C-reactive protein (hs-CRP) level appear to increase the risk of transition from subclinical to clinical psoriatic arthritis (PsA).

Major finding: Older age (greater than 45 years; odds ratio [OR], 10.15; P = 0.00), alcohol consumption (OR, 3.43; P = .03), and elevated hs-CRP (OR, 1.05; P = 0.03) were associated with an increased risk of progression from subclinical PsA to clinical PsA. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant.

Study details: The data come from a retrospective case-control study of 25 patients with clinically confirmed PsA (cases) and 137 controls without confirmed PsA.

Disclosures: This study was funded by the 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, Chengdu, Sichuan, China and West China Precision Medicine Industrial Technology Institutes. The authors declared no conflicts of interest.

Source: Wang Y et al. Rheumatol Ther. 2021 Mar 5. doi: 10.1007/s40744-021-00295-y.

Key clinical point: Alcohol consumption, older age, suffering from fatty liver when less than 45 years old, and elevated high-sensitivity C-reactive protein (hs-CRP) level appear to increase the risk of transition from subclinical to clinical psoriatic arthritis (PsA).

Major finding: Older age (greater than 45 years; odds ratio [OR], 10.15; P = 0.00), alcohol consumption (OR, 3.43; P = .03), and elevated hs-CRP (OR, 1.05; P = 0.03) were associated with an increased risk of progression from subclinical PsA to clinical PsA. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant.

Study details: The data come from a retrospective case-control study of 25 patients with clinically confirmed PsA (cases) and 137 controls without confirmed PsA.

Disclosures: This study was funded by the 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, Chengdu, Sichuan, China and West China Precision Medicine Industrial Technology Institutes. The authors declared no conflicts of interest.

Source: Wang Y et al. Rheumatol Ther. 2021 Mar 5. doi: 10.1007/s40744-021-00295-y.

Key clinical point: Alcohol consumption, older age, suffering from fatty liver when less than 45 years old, and elevated high-sensitivity C-reactive protein (hs-CRP) level appear to increase the risk of transition from subclinical to clinical psoriatic arthritis (PsA).

Major finding: Older age (greater than 45 years; odds ratio [OR], 10.15; P = 0.00), alcohol consumption (OR, 3.43; P = .03), and elevated hs-CRP (OR, 1.05; P = 0.03) were associated with an increased risk of progression from subclinical PsA to clinical PsA. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant.

Study details: The data come from a retrospective case-control study of 25 patients with clinically confirmed PsA (cases) and 137 controls without confirmed PsA.

Disclosures: This study was funded by the 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, Chengdu, Sichuan, China and West China Precision Medicine Industrial Technology Institutes. The authors declared no conflicts of interest.

Source: Wang Y et al. Rheumatol Ther. 2021 Mar 5. doi: 10.1007/s40744-021-00295-y.

Key clinical point: Continued ixekizumab (IXE) therapy was superior to IXE withdrawal in maintaining minimal disease activity (MDA) in biologic-naive patients with psoriatic arthritis (PsA). In case of treatment interruption, re-treatment with IXE following relapse may restore disease control.

Major finding: Patients relapsed more rapidly with IXE withdrawal (median, 22.3 weeks) vs. continued IXE treatment (median was not estimable because less than 50% of patients had relapsed by the end of study period; P less than .0001). The cumulative relapse rate from week 24 to week 104 was higher for the withdrawal vs. continued treatment group (85% vs. 38%; P less than .0001). Median time to re-achieving MDA on retreatment was 4.1 weeks; 64 (95.5%) of 67 patients who relapsed with treatment withdrawal re-achieved MDA on retreatment.

Study details: SPIRIT-P3 was a multicenter, randomized, double-blind withdrawal study of 394 biologic-naive patients with PsA who received open-label IXE (160 mg at week 0, 80 mg every 2 weeks) for 36 weeks. Between weeks 36 and 64, 158 patients who achieved sustained MDA (greater than 3 months) were randomized (1:1) to continue on 80 mg IXE every 2 weeks or placebo until week 104.

Disclosures: This study was funded by Eli Lilly and Company. Some study investigators reported owning stock in, being an employee of, receiving support from, and/or consulting for Eli Lilly and Company.

Source: Coates LC et al. Arthritis Rheumatol. 2021 Mar 7. doi: 10.1002/art.41716.

Key clinical point: Continued ixekizumab (IXE) therapy was superior to IXE withdrawal in maintaining minimal disease activity (MDA) in biologic-naive patients with psoriatic arthritis (PsA). In case of treatment interruption, re-treatment with IXE following relapse may restore disease control.

Major finding: Patients relapsed more rapidly with IXE withdrawal (median, 22.3 weeks) vs. continued IXE treatment (median was not estimable because less than 50% of patients had relapsed by the end of study period; P less than .0001). The cumulative relapse rate from week 24 to week 104 was higher for the withdrawal vs. continued treatment group (85% vs. 38%; P less than .0001). Median time to re-achieving MDA on retreatment was 4.1 weeks; 64 (95.5%) of 67 patients who relapsed with treatment withdrawal re-achieved MDA on retreatment.

Study details: SPIRIT-P3 was a multicenter, randomized, double-blind withdrawal study of 394 biologic-naive patients with PsA who received open-label IXE (160 mg at week 0, 80 mg every 2 weeks) for 36 weeks. Between weeks 36 and 64, 158 patients who achieved sustained MDA (greater than 3 months) were randomized (1:1) to continue on 80 mg IXE every 2 weeks or placebo until week 104.

Disclosures: This study was funded by Eli Lilly and Company. Some study investigators reported owning stock in, being an employee of, receiving support from, and/or consulting for Eli Lilly and Company.

Source: Coates LC et al. Arthritis Rheumatol. 2021 Mar 7. doi: 10.1002/art.41716.

Key clinical point: Continued ixekizumab (IXE) therapy was superior to IXE withdrawal in maintaining minimal disease activity (MDA) in biologic-naive patients with psoriatic arthritis (PsA). In case of treatment interruption, re-treatment with IXE following relapse may restore disease control.

Major finding: Patients relapsed more rapidly with IXE withdrawal (median, 22.3 weeks) vs. continued IXE treatment (median was not estimable because less than 50% of patients had relapsed by the end of study period; P less than .0001). The cumulative relapse rate from week 24 to week 104 was higher for the withdrawal vs. continued treatment group (85% vs. 38%; P less than .0001). Median time to re-achieving MDA on retreatment was 4.1 weeks; 64 (95.5%) of 67 patients who relapsed with treatment withdrawal re-achieved MDA on retreatment.

Study details: SPIRIT-P3 was a multicenter, randomized, double-blind withdrawal study of 394 biologic-naive patients with PsA who received open-label IXE (160 mg at week 0, 80 mg every 2 weeks) for 36 weeks. Between weeks 36 and 64, 158 patients who achieved sustained MDA (greater than 3 months) were randomized (1:1) to continue on 80 mg IXE every 2 weeks or placebo until week 104.

Disclosures: This study was funded by Eli Lilly and Company. Some study investigators reported owning stock in, being an employee of, receiving support from, and/or consulting for Eli Lilly and Company.

Source: Coates LC et al. Arthritis Rheumatol. 2021 Mar 7. doi: 10.1002/art.41716.

Key clinical point: Brodalumab demonstrated significant and rapid improvements in signs and symptoms of psoriatic arthritis (PsA) vs. placebo in 2 phase 3 trials.

Major finding: The percentage of patients achieving American College of Rheumatology (ACR)20 response at week 16 was significantly higher in the 140 mg and 210 mg brodalumab treatment groups than in the placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001). Results were similar at week 24. The proportion of brodalumab-treated patients achieving ACR50/70, Psoriasis Area and Severity Index 75/90/100 and resolution of dactylitis and enthesitis was significantly higher than placebo-treated patients (P less than .01). Brodalumab was well tolerated.

Study details: In the AMVISION-1 and AMVISION-2 trials, a total of 962 adult patients with active PsA refractory to conventional treatment were randomly assigned (1:1:1) to either subcutaneous brodalumab 140 mg or 210 mg or placebo at weeks 0, 1 and every 2 weeks up to 24 weeks.

Disclosures: The trials were funded by LEO Pharma. K Raymond is an employee of LEO Pharma. KF Hjuler was an employee of LEO Pharma at the time the study was conducted. PJ Mease, PS Helliwell, KF Hjuler and IB McInnes reported ties with various pharmaceutical companies.

Source: Mease PJ et al. Ann Rheum Dis. 2021 Feb. doi: 10.1136/annrheumdis-2019-216835.

Key clinical point: Brodalumab demonstrated significant and rapid improvements in signs and symptoms of psoriatic arthritis (PsA) vs. placebo in 2 phase 3 trials.

Major finding: The percentage of patients achieving American College of Rheumatology (ACR)20 response at week 16 was significantly higher in the 140 mg and 210 mg brodalumab treatment groups than in the placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001). Results were similar at week 24. The proportion of brodalumab-treated patients achieving ACR50/70, Psoriasis Area and Severity Index 75/90/100 and resolution of dactylitis and enthesitis was significantly higher than placebo-treated patients (P less than .01). Brodalumab was well tolerated.

Study details: In the AMVISION-1 and AMVISION-2 trials, a total of 962 adult patients with active PsA refractory to conventional treatment were randomly assigned (1:1:1) to either subcutaneous brodalumab 140 mg or 210 mg or placebo at weeks 0, 1 and every 2 weeks up to 24 weeks.

Disclosures: The trials were funded by LEO Pharma. K Raymond is an employee of LEO Pharma. KF Hjuler was an employee of LEO Pharma at the time the study was conducted. PJ Mease, PS Helliwell, KF Hjuler and IB McInnes reported ties with various pharmaceutical companies.

Source: Mease PJ et al. Ann Rheum Dis. 2021 Feb. doi: 10.1136/annrheumdis-2019-216835.

Key clinical point: Brodalumab demonstrated significant and rapid improvements in signs and symptoms of psoriatic arthritis (PsA) vs. placebo in 2 phase 3 trials.

Major finding: The percentage of patients achieving American College of Rheumatology (ACR)20 response at week 16 was significantly higher in the 140 mg and 210 mg brodalumab treatment groups than in the placebo group (45.8% and 47.9%, respectively vs. 20.9%; P less than .0001). Results were similar at week 24. The proportion of brodalumab-treated patients achieving ACR50/70, Psoriasis Area and Severity Index 75/90/100 and resolution of dactylitis and enthesitis was significantly higher than placebo-treated patients (P less than .01). Brodalumab was well tolerated.

Study details: In the AMVISION-1 and AMVISION-2 trials, a total of 962 adult patients with active PsA refractory to conventional treatment were randomly assigned (1:1:1) to either subcutaneous brodalumab 140 mg or 210 mg or placebo at weeks 0, 1 and every 2 weeks up to 24 weeks.

Disclosures: The trials were funded by LEO Pharma. K Raymond is an employee of LEO Pharma. KF Hjuler was an employee of LEO Pharma at the time the study was conducted. PJ Mease, PS Helliwell, KF Hjuler and IB McInnes reported ties with various pharmaceutical companies.

Source: Mease PJ et al. Ann Rheum Dis. 2021 Feb. doi: 10.1136/annrheumdis-2019-216835.

Key clinical point: Pain intensity has limited predictive value for preterm or excess mortality, whereas recent glucocorticoid use and comorbidities were associated with an increased risk of early mortality in patients with psoriatic arthritis.

Major finding: Higher mean pain intensity was associated with an increased risk of mortality (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02-1.10). However, this association attenuated after adjusting for additional confounders. Recent glucocorticoid use (OR, 5.60; 95% CI, 3.71-8.45), concurrent chronic obstructive pulmonary disease (OR, 1.72; 95% CI, 1.06-2.80), diabetes mellitus (OR, 1.86; 95% CI, 1.19-2.90), cancer (OR, 7.17; 95% CI, 4.70-10.93), and cardiovascular disease (OR, 3.04; 95% CI, 2.06-4.49) were all associated with early mortality.

Study details: This nested case-control study included 276 patients with psoriatic arthritis who died (cases) and 1,187 matched controls using data from the nationwide DANBIO register and Danish healthcare registers.

Disclosures: This study was supported by the Danish Psoriasis Foundation Grant, the Danish Rheumatism Foundation Grant, and a grant from Aalborg University and Aalborg University hospital. The authors declared no conflicts of interest.

Source: Vela J et al. Rheumatology (Oxford). 2021 Mar 1. doi: 10.1093/rheumatology/keab192.

Key clinical point: Pain intensity has limited predictive value for preterm or excess mortality, whereas recent glucocorticoid use and comorbidities were associated with an increased risk of early mortality in patients with psoriatic arthritis.

Major finding: Higher mean pain intensity was associated with an increased risk of mortality (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02-1.10). However, this association attenuated after adjusting for additional confounders. Recent glucocorticoid use (OR, 5.60; 95% CI, 3.71-8.45), concurrent chronic obstructive pulmonary disease (OR, 1.72; 95% CI, 1.06-2.80), diabetes mellitus (OR, 1.86; 95% CI, 1.19-2.90), cancer (OR, 7.17; 95% CI, 4.70-10.93), and cardiovascular disease (OR, 3.04; 95% CI, 2.06-4.49) were all associated with early mortality.

Study details: This nested case-control study included 276 patients with psoriatic arthritis who died (cases) and 1,187 matched controls using data from the nationwide DANBIO register and Danish healthcare registers.

Disclosures: This study was supported by the Danish Psoriasis Foundation Grant, the Danish Rheumatism Foundation Grant, and a grant from Aalborg University and Aalborg University hospital. The authors declared no conflicts of interest.

Source: Vela J et al. Rheumatology (Oxford). 2021 Mar 1. doi: 10.1093/rheumatology/keab192.

Key clinical point: Pain intensity has limited predictive value for preterm or excess mortality, whereas recent glucocorticoid use and comorbidities were associated with an increased risk of early mortality in patients with psoriatic arthritis.

Major finding: Higher mean pain intensity was associated with an increased risk of mortality (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02-1.10). However, this association attenuated after adjusting for additional confounders. Recent glucocorticoid use (OR, 5.60; 95% CI, 3.71-8.45), concurrent chronic obstructive pulmonary disease (OR, 1.72; 95% CI, 1.06-2.80), diabetes mellitus (OR, 1.86; 95% CI, 1.19-2.90), cancer (OR, 7.17; 95% CI, 4.70-10.93), and cardiovascular disease (OR, 3.04; 95% CI, 2.06-4.49) were all associated with early mortality.

Study details: This nested case-control study included 276 patients with psoriatic arthritis who died (cases) and 1,187 matched controls using data from the nationwide DANBIO register and Danish healthcare registers.

Disclosures: This study was supported by the Danish Psoriasis Foundation Grant, the Danish Rheumatism Foundation Grant, and a grant from Aalborg University and Aalborg University hospital. The authors declared no conflicts of interest.

Source: Vela J et al. Rheumatology (Oxford). 2021 Mar 1. doi: 10.1093/rheumatology/keab192.