Clinical Edge Journal Scan

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Apremilast reduced inflammation in the joints and entheses of patients with psoriatic arthritis (PsA), as assessed by magnetic resonance imaging.

Major finding: Apremilast improved the composite inflammation score of bone marrow edema, synovitis, and tenosynovitis in the hand, as assessed by the Psoriatic Arthritis Magnetic Resonance Imaging Scoring System at week 24 (least squares mean change [Δ], −2.32; 95% CI, −4.73 to 0.09) and week 48 (Δ, −2.91; 95% CI, −5.45 to −0.37). No new safety concerns were reported.

Study details: This phase 4 MOSAIC study included 122 adults with PsA treated with apremilast, each having at least three swollen and three tender joints involving the hands, along with at least 1 active enthesitis site.

Disclosures: This study was funded by Amgen. Six authors reported being employees of and owning stock in Amgen. Other authors declared having ties with various sources, including Amgen.

Source: Østergaard M, Boesen M, Maksymowych WP, et al. Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): A phase 4, multicentre, single-arm, open-label study. Lancet Rheumatol. Published online October 30, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source

Key clinical point: Guselkumab led to sustained minimal or low disease activity (MDA/LDA) and remission across multiple disease domains over 1 year in patients with psoriatic arthritis (PsA) who had an inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).

Major finding: At week 24, a greater proportion of patients receiving guselkumab vs placebo achieved MDA/LDA (14.8%-52.4% vs 3.1%-28.1%) and remission (3.7%-5.3% vs 0.0%-2.1%), according to composite indices. Most of the patients who achieved LDA/MDA or remission at week 24 (≥70%) maintained the response at week 48.

Study details: This post hoc analysis of the phase 3b COSMOS trial included 285 patients with PsA who had TNFi-IR and were randomly assigned to receive 100 mg guselkumab (n = 189) or placebo (n = 96) with 51 patients switching to guselkumab at week 24.

Disclosures: This study was supported by Johnson & Johnson Innovative Medicine. Several authors declared having ties with various sources, including being employees and having stock options or bond ownership in Johnson & Johnson or its subsidiaries.

Source: Gossec L, Baraliakos X, Aletaha D, et al. Multi-domain effectiveness of guselkumab evaluated via composite indices through 1 year in patients with PsA and inadequate response to TNFi: Post hoc analysis of COSMOS. Rheumatology (Oxford). Published online October 22, 2024. Source