Psoriatic Arthritis

BOSTON – Treatment with apremilast (Otezla) did not significantly affect vascular inflammation in patients with psoriasis but was associated with a generally beneficial effect on biomarkers associated with heart disease, lipid metabolism, and glucose metabolism, in a study presented at the 2022 American Academy of Dermatology annual meeting.

In the phase 4, open-label, single arm trial, participants also lost subcutaneous and visceral fat after 16 weeks on the oral medication, a phosphodiesterase 4 (PDE4) inhibitor, and maintained that loss at 52 weeks.

People with psoriasis have an increased risk of obesity, type 2 diabetes, and cardiovascular events. Patients with more significant psoriasis “tend to die about 5 years younger than they should, based on their risk factors for mortality,” Joel Gelfand, MD, MSCE, professor of dermatology and epidemiology and vice chair of clinical research in dermatology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, told this news organization.

He led the research and presented the findings at the AAD meeting March 26. “As a result, there has been a keen interest in understanding how psoriasis therapies impact cardiovascular risk, the idea being that by controlling inflammation, you may lower the risk of these patients developing cardiovascular disease over time,” he said.

Previous trials looking at the effect of psoriasis therapies on vascular inflammation “have been, for the most part, inconclusive,” Michael Garshick, MD, a cardiologist at NYU Langone Health, told this news organization. Dr. Garshick was not involved with the research. A 2021 systematic review of psoriasis clinicals trials reported that the tumor necrosis factor (TNF) blocker adalimumab (Humira) and phototherapy had the greatest effect on cardiometabolic markers, while ustekinumab (Stelara), an interleukin (IL)-12 and IL-23 antagonist, was the only treatment that improved vascular inflammation. These variable findings make this area “ripe for study,” noted Dr. Garshick.

To observe how apremilast, which is approved by the FDA for treating psoriasis and psoriatic arthritis, affected vascular inflammation, adiposity, and blood-based cardiometabolic markers, Dr. Gelfand organized an open-label study in adults with moderate-to-severe psoriasis. All participants were 18 years or older, had psoriasis for at least 6 months, and were candidates for systemic therapy. All patients underwent FDG PET/CT scans to assess aortic vascular inflammation and had blood work at baseline. Of the 70 patients originally enrolled in the study, 60 remained in the study at week 16, including 57 who underwent imaging for the second time. Thirty-nine participants remained in the study until week 52, and all except one had another scan.

The average age of participants was 47 years, and their mean BMI was 30. More than 80% of participants were White (83%) and 77% were male. The study population had lived with psoriasis for an average of 16 years and 8 patients also had psoriatic arthritis. At baseline, on average, participants had a Psoriasis Area and Severity Index (PASI) score of 18.62, a dermatology life quality index (DLQI) score of 11.60, and 22% of participants’ BSA (body surface area) were affected. The mean TBRmax, the marker for vascular inflammation, was 1.61.

Treatment responses were as expected for apremilast, with 35% of patients achieving PASI 75 and 65% of participants reporting DLQI scores of 5 or less by 16 weeks. At 52 weeks, 31% of the cohort had achieved PASI 75, and 67% reported DLQI score of 5 or higher. All psoriasis endpoints had improved since baseline (P = .001).

Throughout the study period, there was no significant change in TBRmax. However, in a sensitivity analysis, the 16 patients with a baseline TBRmax  of 1.6 or higher had an absolute reduction of 0.21 in TBR by week 52. “That suggests that maybe a subset of people who have higher levels of aortic inflammation at baseline may experience some reduction that portend, potentially, some health benefits over time,” Dr. Gelfand said. “Ultimately, I wouldn’t hang my hat on the finding,” he said, noting that additional research comparing the treatment to placebo is necessary.

Both visceral and subcutaneous adipose tissue (VAT and SAT) decreased by week 16, and this reduction was maintained through week 52. In the first 16 weeks of the study, VAT decreased by 5.32% (P = .0009), and SAT decreased by 5.53% (P = .0005). From baseline to 52 weeks, VAT decreased by 5.52% (P = .0148), and SAT decreased by 5.50% (P = .0096). There were no significant differences between week 16 and week 52 in VAT or SAT.

Of the 68 blood biomarkers analyzed, there were significant decreases in the inflammatory markers ferritin (P = .015) and IL-beta (P = .006), the lipid metabolism biomarker HDL-cholesterol efflux (P = .008), and ketone bodies (P = .006). There were also increases in the inflammatory marker IL-8 (P = .003), the lipid metabolism marker ApoA (P = .05), and insulin (P = .05). Ferritin was the only biomarker that was reduced on both week 16 and week 52.

“If you want to be a purist, this was a negative trial,” said Dr. Garshick, because apremilast was not found to decrease vascular inflammation; however, he noted that the biomarker changes “were hopeful secondary endpoints.” It could be, he said, that another outcome measure may be better able to show changes in vascular inflammation compared with FDG. “It’s always hard to figure out what a good surrogate endpoint is in cardiovascular trials,” he noted, “so it may be that FDG/PET is too noisy or not reliable enough to see the outcome that we want to see.”

Dr. Gelfand reports consulting fees/grants from Amgen, AbbVie, BMS, Boehringer Ingelheim, Janssen Biologics, Novartis Corp, Pfizer, and UCB (DSMB). He serves as the Deputy Editor for the Journal of Investigative Dermatology and the Chief Medical Editor at Healio Psoriatic Disease and receives honoraria for both roles. Dr. Garshick has received consulting fees from AbbVie.

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

BOSTON – Treatment with apremilast (Otezla) did not significantly affect vascular inflammation in patients with psoriasis but was associated with a generally beneficial effect on biomarkers associated with heart disease, lipid metabolism, and glucose metabolism, in a study presented at the 2022 American Academy of Dermatology annual meeting.

In the phase 4, open-label, single arm trial, participants also lost subcutaneous and visceral fat after 16 weeks on the oral medication, a phosphodiesterase 4 (PDE4) inhibitor, and maintained that loss at 52 weeks.

People with psoriasis have an increased risk of obesity, type 2 diabetes, and cardiovascular events. Patients with more significant psoriasis “tend to die about 5 years younger than they should, based on their risk factors for mortality,” Joel Gelfand, MD, MSCE, professor of dermatology and epidemiology and vice chair of clinical research in dermatology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, told this news organization.

He led the research and presented the findings at the AAD meeting March 26. “As a result, there has been a keen interest in understanding how psoriasis therapies impact cardiovascular risk, the idea being that by controlling inflammation, you may lower the risk of these patients developing cardiovascular disease over time,” he said.

Previous trials looking at the effect of psoriasis therapies on vascular inflammation “have been, for the most part, inconclusive,” Michael Garshick, MD, a cardiologist at NYU Langone Health, told this news organization. Dr. Garshick was not involved with the research. A 2021 systematic review of psoriasis clinicals trials reported that the tumor necrosis factor (TNF) blocker adalimumab (Humira) and phototherapy had the greatest effect on cardiometabolic markers, while ustekinumab (Stelara), an interleukin (IL)-12 and IL-23 antagonist, was the only treatment that improved vascular inflammation. These variable findings make this area “ripe for study,” noted Dr. Garshick.

To observe how apremilast, which is approved by the FDA for treating psoriasis and psoriatic arthritis, affected vascular inflammation, adiposity, and blood-based cardiometabolic markers, Dr. Gelfand organized an open-label study in adults with moderate-to-severe psoriasis. All participants were 18 years or older, had psoriasis for at least 6 months, and were candidates for systemic therapy. All patients underwent FDG PET/CT scans to assess aortic vascular inflammation and had blood work at baseline. Of the 70 patients originally enrolled in the study, 60 remained in the study at week 16, including 57 who underwent imaging for the second time. Thirty-nine participants remained in the study until week 52, and all except one had another scan.

The average age of participants was 47 years, and their mean BMI was 30. More than 80% of participants were White (83%) and 77% were male. The study population had lived with psoriasis for an average of 16 years and 8 patients also had psoriatic arthritis. At baseline, on average, participants had a Psoriasis Area and Severity Index (PASI) score of 18.62, a dermatology life quality index (DLQI) score of 11.60, and 22% of participants’ BSA (body surface area) were affected. The mean TBRmax, the marker for vascular inflammation, was 1.61.

Treatment responses were as expected for apremilast, with 35% of patients achieving PASI 75 and 65% of participants reporting DLQI scores of 5 or less by 16 weeks. At 52 weeks, 31% of the cohort had achieved PASI 75, and 67% reported DLQI score of 5 or higher. All psoriasis endpoints had improved since baseline (P = .001).

Throughout the study period, there was no significant change in TBRmax. However, in a sensitivity analysis, the 16 patients with a baseline TBRmax  of 1.6 or higher had an absolute reduction of 0.21 in TBR by week 52. “That suggests that maybe a subset of people who have higher levels of aortic inflammation at baseline may experience some reduction that portend, potentially, some health benefits over time,” Dr. Gelfand said. “Ultimately, I wouldn’t hang my hat on the finding,” he said, noting that additional research comparing the treatment to placebo is necessary.

Both visceral and subcutaneous adipose tissue (VAT and SAT) decreased by week 16, and this reduction was maintained through week 52. In the first 16 weeks of the study, VAT decreased by 5.32% (P = .0009), and SAT decreased by 5.53% (P = .0005). From baseline to 52 weeks, VAT decreased by 5.52% (P = .0148), and SAT decreased by 5.50% (P = .0096). There were no significant differences between week 16 and week 52 in VAT or SAT.

Of the 68 blood biomarkers analyzed, there were significant decreases in the inflammatory markers ferritin (P = .015) and IL-beta (P = .006), the lipid metabolism biomarker HDL-cholesterol efflux (P = .008), and ketone bodies (P = .006). There were also increases in the inflammatory marker IL-8 (P = .003), the lipid metabolism marker ApoA (P = .05), and insulin (P = .05). Ferritin was the only biomarker that was reduced on both week 16 and week 52.

“If you want to be a purist, this was a negative trial,” said Dr. Garshick, because apremilast was not found to decrease vascular inflammation; however, he noted that the biomarker changes “were hopeful secondary endpoints.” It could be, he said, that another outcome measure may be better able to show changes in vascular inflammation compared with FDG. “It’s always hard to figure out what a good surrogate endpoint is in cardiovascular trials,” he noted, “so it may be that FDG/PET is too noisy or not reliable enough to see the outcome that we want to see.”

Dr. Gelfand reports consulting fees/grants from Amgen, AbbVie, BMS, Boehringer Ingelheim, Janssen Biologics, Novartis Corp, Pfizer, and UCB (DSMB). He serves as the Deputy Editor for the Journal of Investigative Dermatology and the Chief Medical Editor at Healio Psoriatic Disease and receives honoraria for both roles. Dr. Garshick has received consulting fees from AbbVie.

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

BOSTON – Treatment with apremilast (Otezla) did not significantly affect vascular inflammation in patients with psoriasis but was associated with a generally beneficial effect on biomarkers associated with heart disease, lipid metabolism, and glucose metabolism, in a study presented at the 2022 American Academy of Dermatology annual meeting.

In the phase 4, open-label, single arm trial, participants also lost subcutaneous and visceral fat after 16 weeks on the oral medication, a phosphodiesterase 4 (PDE4) inhibitor, and maintained that loss at 52 weeks.

People with psoriasis have an increased risk of obesity, type 2 diabetes, and cardiovascular events. Patients with more significant psoriasis “tend to die about 5 years younger than they should, based on their risk factors for mortality,” Joel Gelfand, MD, MSCE, professor of dermatology and epidemiology and vice chair of clinical research in dermatology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, told this news organization.

He led the research and presented the findings at the AAD meeting March 26. “As a result, there has been a keen interest in understanding how psoriasis therapies impact cardiovascular risk, the idea being that by controlling inflammation, you may lower the risk of these patients developing cardiovascular disease over time,” he said.

Previous trials looking at the effect of psoriasis therapies on vascular inflammation “have been, for the most part, inconclusive,” Michael Garshick, MD, a cardiologist at NYU Langone Health, told this news organization. Dr. Garshick was not involved with the research. A 2021 systematic review of psoriasis clinicals trials reported that the tumor necrosis factor (TNF) blocker adalimumab (Humira) and phototherapy had the greatest effect on cardiometabolic markers, while ustekinumab (Stelara), an interleukin (IL)-12 and IL-23 antagonist, was the only treatment that improved vascular inflammation. These variable findings make this area “ripe for study,” noted Dr. Garshick.

To observe how apremilast, which is approved by the FDA for treating psoriasis and psoriatic arthritis, affected vascular inflammation, adiposity, and blood-based cardiometabolic markers, Dr. Gelfand organized an open-label study in adults with moderate-to-severe psoriasis. All participants were 18 years or older, had psoriasis for at least 6 months, and were candidates for systemic therapy. All patients underwent FDG PET/CT scans to assess aortic vascular inflammation and had blood work at baseline. Of the 70 patients originally enrolled in the study, 60 remained in the study at week 16, including 57 who underwent imaging for the second time. Thirty-nine participants remained in the study until week 52, and all except one had another scan.

The average age of participants was 47 years, and their mean BMI was 30. More than 80% of participants were White (83%) and 77% were male. The study population had lived with psoriasis for an average of 16 years and 8 patients also had psoriatic arthritis. At baseline, on average, participants had a Psoriasis Area and Severity Index (PASI) score of 18.62, a dermatology life quality index (DLQI) score of 11.60, and 22% of participants’ BSA (body surface area) were affected. The mean TBRmax, the marker for vascular inflammation, was 1.61.

Treatment responses were as expected for apremilast, with 35% of patients achieving PASI 75 and 65% of participants reporting DLQI scores of 5 or less by 16 weeks. At 52 weeks, 31% of the cohort had achieved PASI 75, and 67% reported DLQI score of 5 or higher. All psoriasis endpoints had improved since baseline (P = .001).

Throughout the study period, there was no significant change in TBRmax. However, in a sensitivity analysis, the 16 patients with a baseline TBRmax  of 1.6 or higher had an absolute reduction of 0.21 in TBR by week 52. “That suggests that maybe a subset of people who have higher levels of aortic inflammation at baseline may experience some reduction that portend, potentially, some health benefits over time,” Dr. Gelfand said. “Ultimately, I wouldn’t hang my hat on the finding,” he said, noting that additional research comparing the treatment to placebo is necessary.

Both visceral and subcutaneous adipose tissue (VAT and SAT) decreased by week 16, and this reduction was maintained through week 52. In the first 16 weeks of the study, VAT decreased by 5.32% (P = .0009), and SAT decreased by 5.53% (P = .0005). From baseline to 52 weeks, VAT decreased by 5.52% (P = .0148), and SAT decreased by 5.50% (P = .0096). There were no significant differences between week 16 and week 52 in VAT or SAT.

Of the 68 blood biomarkers analyzed, there were significant decreases in the inflammatory markers ferritin (P = .015) and IL-beta (P = .006), the lipid metabolism biomarker HDL-cholesterol efflux (P = .008), and ketone bodies (P = .006). There were also increases in the inflammatory marker IL-8 (P = .003), the lipid metabolism marker ApoA (P = .05), and insulin (P = .05). Ferritin was the only biomarker that was reduced on both week 16 and week 52.

“If you want to be a purist, this was a negative trial,” said Dr. Garshick, because apremilast was not found to decrease vascular inflammation; however, he noted that the biomarker changes “were hopeful secondary endpoints.” It could be, he said, that another outcome measure may be better able to show changes in vascular inflammation compared with FDG. “It’s always hard to figure out what a good surrogate endpoint is in cardiovascular trials,” he noted, “so it may be that FDG/PET is too noisy or not reliable enough to see the outcome that we want to see.”

Dr. Gelfand reports consulting fees/grants from Amgen, AbbVie, BMS, Boehringer Ingelheim, Janssen Biologics, Novartis Corp, Pfizer, and UCB (DSMB). He serves as the Deputy Editor for the Journal of Investigative Dermatology and the Chief Medical Editor at Healio Psoriatic Disease and receives honoraria for both roles. Dr. Garshick has received consulting fees from AbbVie.

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

Treatment of psoriatic arthritis (PsA) was the focus of clinical research papers published this month. Despite the advances made in treating PsA with targeted therapies, in most parts of the world, conventional disease-modifying antirheumatic drugs (DMARDs) are the first line of treatment. Methotrexate (MTX) and leflunomide (LEF) are commonly used, but there are limited data on the effectiveness of combination therapy. To address this issue, Mulder and colleagues enrolled 78 patients with active PsA who have two or more swollen joints and randomly allocated them to either 25 mg oral MTX weekly after 4 weeks of 15 mg weekly plus 20 mg LEF daily (n = 39) or MTX plus placebo (monotherapy; n = 39). At week 16, PsA disease activity score was improved significantly in the MTX + LEF vs. MTX monotherapy group (3.1 vs. 3.7; P = .025). Incidence of mild adverse events, such as nausea/vomiting (44% vs. 28%) and altered bowel habits (26% vs. 8%), was higher with MTX + LEF vs. MTX + placebo. So although less well tolerated, MTX + LEF therapy was superior to MTX monotherapy at improving disease activity in patients with PsA.

Biologics targeting tumor necrosis factor (TNF), interleukin (IL) -12/23, -23, and -17A are efficacious for the management of PsA, but questions remain about comparative effectiveness. Gossec and colleagues reported the results from their prospective observational PsABio study that evaluated real-world treatment persistence and effectiveness at 1 year after initiation of first-line to third-line IL-12/23 inhibitor ustekinumab or a TNF inhibitor (TNFi). Their study followed 893 patients. After 1 year of treatment, ustekinumab and the TNFi showed similar persistence (hazard ratio [HR] for stopping/switching treatment 0.82; 95% CI 0.60-1.13) and a similar proportion of patients achieving (on the Disease Activity Index for PsA) clinical low disease activity (odds ratio [OR] 0.80; 95% CI 0.57-1.10) and remission (OR 0.73; 95% CI 0.49-1.07), along with similar safety profiles. Thus in real-world studies, TNFi and ustekinumab seem to have similar effectiveness and safety.

Drug persistence between patients with psoriasis alone vs. those with PsA is also of interest. In a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation, Ortolan and colleagues demonstrated that the retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with PsA in the overall cohort (HR 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021). Thus, the presence of PsA and obesity lower the secukinumab retention rate.

1. Despite the advent of many targeted therapies for PsA, there remain many unmet needs. Deucravacitinib is a novel oral selective inhibitor of tyrosine kinase 2 (TYK2) acting via binding to the TYK2 regulatory domain. In a phase 2 study including 203 patients with active PsA that was intolerant to at least one therapy who were randomly assigned to receive 6 mg deucravacitinib once daily, 12 mg deucravacitinib once daily, or placebo for 16 weeks, Mease and colleagues demonstrated that at week 16, American College of Rheumatology 20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (52.9%, adjusted OR [aOR] 2.4; P = .0134) and 12 mg (62.7%, aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported. Thus, TYK2 inhibition shows promise in the treatment of PsA and the results from phase 3 trials are awaited.

Treatment of psoriatic arthritis (PsA) was the focus of clinical research papers published this month. Despite the advances made in treating PsA with targeted therapies, in most parts of the world, conventional disease-modifying antirheumatic drugs (DMARDs) are the first line of treatment. Methotrexate (MTX) and leflunomide (LEF) are commonly used, but there are limited data on the effectiveness of combination therapy. To address this issue, Mulder and colleagues enrolled 78 patients with active PsA who have two or more swollen joints and randomly allocated them to either 25 mg oral MTX weekly after 4 weeks of 15 mg weekly plus 20 mg LEF daily (n = 39) or MTX plus placebo (monotherapy; n = 39). At week 16, PsA disease activity score was improved significantly in the MTX + LEF vs. MTX monotherapy group (3.1 vs. 3.7; P = .025). Incidence of mild adverse events, such as nausea/vomiting (44% vs. 28%) and altered bowel habits (26% vs. 8%), was higher with MTX + LEF vs. MTX + placebo. So although less well tolerated, MTX + LEF therapy was superior to MTX monotherapy at improving disease activity in patients with PsA.

Biologics targeting tumor necrosis factor (TNF), interleukin (IL) -12/23, -23, and -17A are efficacious for the management of PsA, but questions remain about comparative effectiveness. Gossec and colleagues reported the results from their prospective observational PsABio study that evaluated real-world treatment persistence and effectiveness at 1 year after initiation of first-line to third-line IL-12/23 inhibitor ustekinumab or a TNF inhibitor (TNFi). Their study followed 893 patients. After 1 year of treatment, ustekinumab and the TNFi showed similar persistence (hazard ratio [HR] for stopping/switching treatment 0.82; 95% CI 0.60-1.13) and a similar proportion of patients achieving (on the Disease Activity Index for PsA) clinical low disease activity (odds ratio [OR] 0.80; 95% CI 0.57-1.10) and remission (OR 0.73; 95% CI 0.49-1.07), along with similar safety profiles. Thus in real-world studies, TNFi and ustekinumab seem to have similar effectiveness and safety.

Drug persistence between patients with psoriasis alone vs. those with PsA is also of interest. In a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation, Ortolan and colleagues demonstrated that the retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with PsA in the overall cohort (HR 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021). Thus, the presence of PsA and obesity lower the secukinumab retention rate.

1. Despite the advent of many targeted therapies for PsA, there remain many unmet needs. Deucravacitinib is a novel oral selective inhibitor of tyrosine kinase 2 (TYK2) acting via binding to the TYK2 regulatory domain. In a phase 2 study including 203 patients with active PsA that was intolerant to at least one therapy who were randomly assigned to receive 6 mg deucravacitinib once daily, 12 mg deucravacitinib once daily, or placebo for 16 weeks, Mease and colleagues demonstrated that at week 16, American College of Rheumatology 20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (52.9%, adjusted OR [aOR] 2.4; P = .0134) and 12 mg (62.7%, aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported. Thus, TYK2 inhibition shows promise in the treatment of PsA and the results from phase 3 trials are awaited.

Treatment of psoriatic arthritis (PsA) was the focus of clinical research papers published this month. Despite the advances made in treating PsA with targeted therapies, in most parts of the world, conventional disease-modifying antirheumatic drugs (DMARDs) are the first line of treatment. Methotrexate (MTX) and leflunomide (LEF) are commonly used, but there are limited data on the effectiveness of combination therapy. To address this issue, Mulder and colleagues enrolled 78 patients with active PsA who have two or more swollen joints and randomly allocated them to either 25 mg oral MTX weekly after 4 weeks of 15 mg weekly plus 20 mg LEF daily (n = 39) or MTX plus placebo (monotherapy; n = 39). At week 16, PsA disease activity score was improved significantly in the MTX + LEF vs. MTX monotherapy group (3.1 vs. 3.7; P = .025). Incidence of mild adverse events, such as nausea/vomiting (44% vs. 28%) and altered bowel habits (26% vs. 8%), was higher with MTX + LEF vs. MTX + placebo. So although less well tolerated, MTX + LEF therapy was superior to MTX monotherapy at improving disease activity in patients with PsA.

Biologics targeting tumor necrosis factor (TNF), interleukin (IL) -12/23, -23, and -17A are efficacious for the management of PsA, but questions remain about comparative effectiveness. Gossec and colleagues reported the results from their prospective observational PsABio study that evaluated real-world treatment persistence and effectiveness at 1 year after initiation of first-line to third-line IL-12/23 inhibitor ustekinumab or a TNF inhibitor (TNFi). Their study followed 893 patients. After 1 year of treatment, ustekinumab and the TNFi showed similar persistence (hazard ratio [HR] for stopping/switching treatment 0.82; 95% CI 0.60-1.13) and a similar proportion of patients achieving (on the Disease Activity Index for PsA) clinical low disease activity (odds ratio [OR] 0.80; 95% CI 0.57-1.10) and remission (OR 0.73; 95% CI 0.49-1.07), along with similar safety profiles. Thus in real-world studies, TNFi and ustekinumab seem to have similar effectiveness and safety.

Drug persistence between patients with psoriasis alone vs. those with PsA is also of interest. In a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation, Ortolan and colleagues demonstrated that the retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with PsA in the overall cohort (HR 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021). Thus, the presence of PsA and obesity lower the secukinumab retention rate.

1. Despite the advent of many targeted therapies for PsA, there remain many unmet needs. Deucravacitinib is a novel oral selective inhibitor of tyrosine kinase 2 (TYK2) acting via binding to the TYK2 regulatory domain. In a phase 2 study including 203 patients with active PsA that was intolerant to at least one therapy who were randomly assigned to receive 6 mg deucravacitinib once daily, 12 mg deucravacitinib once daily, or placebo for 16 weeks, Mease and colleagues demonstrated that at week 16, American College of Rheumatology 20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (52.9%, adjusted OR [aOR] 2.4; P = .0134) and 12 mg (62.7%, aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported. Thus, TYK2 inhibition shows promise in the treatment of PsA and the results from phase 3 trials are awaited.

Key clinical point: Irrespective of human leukocyte antigen-B27 (HLA-B27) status, patients with axial psoriatic arthritis (PsA) experienced mild improvement in disease outcomes after 6 months of initiating targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) or biologic DMARDs (bDMARD).

Major finding: After 6 months, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score remained >4, indicating moderate-to-severe disease activity irrespective of HLA-B27 status, with a mean reduction in BASDAI score of 0.80 and 0.84 (both not clinically meaningful) in the HLA-B27-positive and HLA-B27-negative groups, respectively.

Study details: This prospective, observational study included 135 patients with moderate-to-severe axial PsA who initiated bDMARDs or tsDMARDs and were followed up for 6 months, of which 39 and 96 patients had HLA-B27-positive and HLA-B27-negative status, respectively.

Disclosures: This study was sponsored by CorEvitas, LLC. The authors declared receiving research support, consulting fees, or speaker bureau support from several sources. Two authors declared being employees and shareholders of Johnson and Johnson; three authors declared being present or former employees of CorEvitas, LLC.

Source: Mease PJ et al. treatment responses in patients with psoriatic arthritis axial disease according to human leukocyte antigen-B27 Status: An analysis from the CorEvitas Psoriatic Arthritis/Spondyloarthritis registry. ACR Open Rheumatol. 2022 (Feb 26). Doi: 10.1002/acr2.11416

Key clinical point: Irrespective of human leukocyte antigen-B27 (HLA-B27) status, patients with axial psoriatic arthritis (PsA) experienced mild improvement in disease outcomes after 6 months of initiating targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) or biologic DMARDs (bDMARD).

Major finding: After 6 months, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score remained >4, indicating moderate-to-severe disease activity irrespective of HLA-B27 status, with a mean reduction in BASDAI score of 0.80 and 0.84 (both not clinically meaningful) in the HLA-B27-positive and HLA-B27-negative groups, respectively.

Study details: This prospective, observational study included 135 patients with moderate-to-severe axial PsA who initiated bDMARDs or tsDMARDs and were followed up for 6 months, of which 39 and 96 patients had HLA-B27-positive and HLA-B27-negative status, respectively.

Disclosures: This study was sponsored by CorEvitas, LLC. The authors declared receiving research support, consulting fees, or speaker bureau support from several sources. Two authors declared being employees and shareholders of Johnson and Johnson; three authors declared being present or former employees of CorEvitas, LLC.

Source: Mease PJ et al. treatment responses in patients with psoriatic arthritis axial disease according to human leukocyte antigen-B27 Status: An analysis from the CorEvitas Psoriatic Arthritis/Spondyloarthritis registry. ACR Open Rheumatol. 2022 (Feb 26). Doi: 10.1002/acr2.11416

Key clinical point: Irrespective of human leukocyte antigen-B27 (HLA-B27) status, patients with axial psoriatic arthritis (PsA) experienced mild improvement in disease outcomes after 6 months of initiating targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) or biologic DMARDs (bDMARD).

Major finding: After 6 months, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score remained >4, indicating moderate-to-severe disease activity irrespective of HLA-B27 status, with a mean reduction in BASDAI score of 0.80 and 0.84 (both not clinically meaningful) in the HLA-B27-positive and HLA-B27-negative groups, respectively.

Study details: This prospective, observational study included 135 patients with moderate-to-severe axial PsA who initiated bDMARDs or tsDMARDs and were followed up for 6 months, of which 39 and 96 patients had HLA-B27-positive and HLA-B27-negative status, respectively.

Disclosures: This study was sponsored by CorEvitas, LLC. The authors declared receiving research support, consulting fees, or speaker bureau support from several sources. Two authors declared being employees and shareholders of Johnson and Johnson; three authors declared being present or former employees of CorEvitas, LLC.

Source: Mease PJ et al. treatment responses in patients with psoriatic arthritis axial disease according to human leukocyte antigen-B27 Status: An analysis from the CorEvitas Psoriatic Arthritis/Spondyloarthritis registry. ACR Open Rheumatol. 2022 (Feb 26). Doi: 10.1002/acr2.11416

Key clinical point: Patients with psoriatic arthritis (PsA) reported musculoskeletal pain as the most burdensome symptom and preferred a treatment regimen that improved their joint symptoms and did not include a methotrexate coprescription.

Major finding: Joint pain (98%), fatigue (94%), and morning stiffness (94%) were the most common symptoms of PsA; therefore, 74% of patients preferred therapies that improved joint-related vs. psoriasis-related symptoms, with once-daily oral medication being preferred by 38% of patients and 47% of patients with experience receiving methotrexate preferring a treatment regimen without methotrexate.

Study details: This cross-sectional, web-based survey included 332 adults from ArthritisPower who had a self-reported physician diagnosis of PsA.

Disclosures: This study was funded by AbbVie and RTI Health Solutions. Three authors declared being employees of RTI Health Solutions, two authors declared being employees or share/stockowners of AbbVie, and other authors declared financial/nonfinancial ties with various sources.

Source: Ogdie A et al. Experiences and treatment preferences in patients with psoriatic arthritis: A cross-sectional study in the ArthritisPower registry. Rheumatol Ther. 2022 (Mar 13). Doi: 10.1007/s40744-022-00436-x

Key clinical point: Patients with psoriatic arthritis (PsA) reported musculoskeletal pain as the most burdensome symptom and preferred a treatment regimen that improved their joint symptoms and did not include a methotrexate coprescription.

Major finding: Joint pain (98%), fatigue (94%), and morning stiffness (94%) were the most common symptoms of PsA; therefore, 74% of patients preferred therapies that improved joint-related vs. psoriasis-related symptoms, with once-daily oral medication being preferred by 38% of patients and 47% of patients with experience receiving methotrexate preferring a treatment regimen without methotrexate.

Study details: This cross-sectional, web-based survey included 332 adults from ArthritisPower who had a self-reported physician diagnosis of PsA.

Disclosures: This study was funded by AbbVie and RTI Health Solutions. Three authors declared being employees of RTI Health Solutions, two authors declared being employees or share/stockowners of AbbVie, and other authors declared financial/nonfinancial ties with various sources.

Source: Ogdie A et al. Experiences and treatment preferences in patients with psoriatic arthritis: A cross-sectional study in the ArthritisPower registry. Rheumatol Ther. 2022 (Mar 13). Doi: 10.1007/s40744-022-00436-x

Key clinical point: Patients with psoriatic arthritis (PsA) reported musculoskeletal pain as the most burdensome symptom and preferred a treatment regimen that improved their joint symptoms and did not include a methotrexate coprescription.

Major finding: Joint pain (98%), fatigue (94%), and morning stiffness (94%) were the most common symptoms of PsA; therefore, 74% of patients preferred therapies that improved joint-related vs. psoriasis-related symptoms, with once-daily oral medication being preferred by 38% of patients and 47% of patients with experience receiving methotrexate preferring a treatment regimen without methotrexate.

Study details: This cross-sectional, web-based survey included 332 adults from ArthritisPower who had a self-reported physician diagnosis of PsA.

Disclosures: This study was funded by AbbVie and RTI Health Solutions. Three authors declared being employees of RTI Health Solutions, two authors declared being employees or share/stockowners of AbbVie, and other authors declared financial/nonfinancial ties with various sources.

Source: Ogdie A et al. Experiences and treatment preferences in patients with psoriatic arthritis: A cross-sectional study in the ArthritisPower registry. Rheumatol Ther. 2022 (Mar 13). Doi: 10.1007/s40744-022-00436-x

Key clinical point: In the real-world setting, secukinumab has a satisfactory retention rate in psoriatic arthritis (PsA). However, retention rates are lower in PsA than in psoriasis, with arthritis and obesity being significant predictors of shorter drug survival.

Major finding: Retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with arthritis in the overall cohort (hazard ratio 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021).

Study details: Findings are from a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation.

Disclosures: This study did not receive any funding. R Ramonda and S Piaserico declared receiving honoraria and speaker fees form Novartis, Abbvie, Pfizer, MSD, and Janssen.

Source: Ortolan A et al. Secukinumab drug survival in psoriasis and psoriatic arthritis patients: A 24-month real-life study. Dermatology. 2022 (Mar 9). Doi: 10.1159/000522008

Key clinical point: In the real-world setting, secukinumab has a satisfactory retention rate in psoriatic arthritis (PsA). However, retention rates are lower in PsA than in psoriasis, with arthritis and obesity being significant predictors of shorter drug survival.

Major finding: Retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with arthritis in the overall cohort (hazard ratio 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021).

Study details: Findings are from a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation.

Disclosures: This study did not receive any funding. R Ramonda and S Piaserico declared receiving honoraria and speaker fees form Novartis, Abbvie, Pfizer, MSD, and Janssen.

Source: Ortolan A et al. Secukinumab drug survival in psoriasis and psoriatic arthritis patients: A 24-month real-life study. Dermatology. 2022 (Mar 9). Doi: 10.1159/000522008

Key clinical point: In the real-world setting, secukinumab has a satisfactory retention rate in psoriatic arthritis (PsA). However, retention rates are lower in PsA than in psoriasis, with arthritis and obesity being significant predictors of shorter drug survival.

Major finding: Retention rate of secukinumab was higher in psoriasis vs. PsA at 12 (85% vs. 68%) and 24 (61% vs. 57%) months, with the risk for secukinumab discontinuation being higher among patients with arthritis in the overall cohort (hazard ratio 2.43; P = .035) and in patients with obesity in the PsA cohort (P = .021).

Study details: Findings are from a real-life study including 62 patients with psoriasis and 90 patients with PsA who initiated treatment with secukinumab and were followed up for 24 months or until discontinuation.

Disclosures: This study did not receive any funding. R Ramonda and S Piaserico declared receiving honoraria and speaker fees form Novartis, Abbvie, Pfizer, MSD, and Janssen.

Source: Ortolan A et al. Secukinumab drug survival in psoriasis and psoriatic arthritis patients: A 24-month real-life study. Dermatology. 2022 (Mar 9). Doi: 10.1159/000522008

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: The association between abnormalities in renal function parameters and disease activity may be guided by the degree of disease control in psoriatic arthritis (PsA), with disease relapse having a significant effect on renal function in patients with PsA.

Major finding: Renal dysfunction was experienced by 38.5%-58.3% of patients with PsA within 12 months of treatment initiation. Patients with vs. without disease relapse had significantly higher mean serum creatinine levels (P = .031) at treatment initiation; however, clinical remission or treatment type did not seem to affect renal function parameters.

Study details: This single-center retrospective study included 45 patients with PsA (n = 23) or rheumatoid arthritis (n = 22) who received appropriate medication and underwent renal function evaluation every 3-6 months.

Disclosures: This study was supported by Novartis. The authors declared no conflict of interests.

Source: Atzeni F et al. Frequency of renal function parameter abnormalities in patients with psoriatic arthritis and rheumatoid arthritis: Real-world evidence from clinical practice. J Clin Med. 2022;11(4):1029 (Feb 16). Doi: 10.3390/jcm11041029

Key clinical point: In the initial 16 weeks of this phase 2 trial, patients with psoriatic arthritis (PsA) achieved higher response with deucravacitinib vs. placebo along with a consistent safety profile.

Major finding: At week 16, American College of Rheumatology-20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (adjusted odds ratio [aOR] 2.4; P = .0134) and 12 mg (aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported in patients treated with deucravacitinib.

Study details: Findings are from a phase 2 study including 203 patients with active PsA intolerant to ≥1 therapy who were randomly assigned to receive 6 mg deucravacitinib once a day, 12 mg deucravacitinib once daily, or placebo for 16 weeks.

Disclosures: This study was sponsored by Bristol Myers Squibb. Eight authors declared being employees or shareholders of Bristol Myers Squibb or of receiving payments or speaker/consultant fees from Bristol Myers Squibb.

Source: Mease PJ et al. Efficacy and safety of selective TYK2 inhibitor, deucravacitinib, in a phase II trial in psoriatic arthritis. Ann Rheum Dis. 2022 (Mar 3). Doi: 10.1136/annrheumdis-2021-221664

Key clinical point: In the initial 16 weeks of this phase 2 trial, patients with psoriatic arthritis (PsA) achieved higher response with deucravacitinib vs. placebo along with a consistent safety profile.

Major finding: At week 16, American College of Rheumatology-20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (adjusted odds ratio [aOR] 2.4; P = .0134) and 12 mg (aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported in patients treated with deucravacitinib.

Study details: Findings are from a phase 2 study including 203 patients with active PsA intolerant to ≥1 therapy who were randomly assigned to receive 6 mg deucravacitinib once a day, 12 mg deucravacitinib once daily, or placebo for 16 weeks.

Disclosures: This study was sponsored by Bristol Myers Squibb. Eight authors declared being employees or shareholders of Bristol Myers Squibb or of receiving payments or speaker/consultant fees from Bristol Myers Squibb.

Source: Mease PJ et al. Efficacy and safety of selective TYK2 inhibitor, deucravacitinib, in a phase II trial in psoriatic arthritis. Ann Rheum Dis. 2022 (Mar 3). Doi: 10.1136/annrheumdis-2021-221664

Key clinical point: In the initial 16 weeks of this phase 2 trial, patients with psoriatic arthritis (PsA) achieved higher response with deucravacitinib vs. placebo along with a consistent safety profile.

Major finding: At week 16, American College of Rheumatology-20 (ACR20) response was significantly higher with 6 mg once-daily deucravacitinib (adjusted odds ratio [aOR] 2.4; P = .0134) and 12 mg (aOR 3.6; P = .0004) vs. placebo (31.8%), with 12 mg deucravacitinib improving ACR20 response as early as at 8 weeks (P < .05). No serious adverse events were reported in patients treated with deucravacitinib.

Study details: Findings are from a phase 2 study including 203 patients with active PsA intolerant to ≥1 therapy who were randomly assigned to receive 6 mg deucravacitinib once a day, 12 mg deucravacitinib once daily, or placebo for 16 weeks.

Disclosures: This study was sponsored by Bristol Myers Squibb. Eight authors declared being employees or shareholders of Bristol Myers Squibb or of receiving payments or speaker/consultant fees from Bristol Myers Squibb.

Source: Mease PJ et al. Efficacy and safety of selective TYK2 inhibitor, deucravacitinib, in a phase II trial in psoriatic arthritis. Ann Rheum Dis. 2022 (Mar 3). Doi: 10.1136/annrheumdis-2021-221664

Key clinical point: A magnetic resonance imaging (MRI)-based scoring method was sensitive to changes in clinical outcomes of psoriatic arthritis (PsA) caused by abatacept, validating the responsiveness of the OMERACT PsA MRI Scoring System.

Major finding: Until day 169, patients receiving 30 mg/kg abatacept with a switch over to 10 mg/kg and those receiving 10 mg/kg abatacept reported significant reduction in MRI-detected synovitis (−0.97; P = .04) and tenosynovitis (−1.65; P = .01) vs. placebo, with patients switching from placebo to 10 mg/kg abatacept at day 169 showing significant improvements in total inflammation, synovitis, and tenosynovitis (P < .05) up to day 365.

Study details: This was a post hoc analysis of a phase 2b study including 123 patients with active PsA and an inadequate response to disease-modifying antirheumatic drugs randomly assigned to receive abatacept or placebo.

Disclosures: This study was funded by Bristol Myers Squibb. The authors declared serving on speakers’ bureaus and as consultants or receiving grants/research support from several sources. Six authors declared being employees or shareholders of Bristol Myers Squibb.

Source: Østergaard M et al. Implementation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Scoring System in a randomized phase IIb study of abatacept in psoriatic arthritis. Rheumatology (Oxford). 2022 (Feb 8). Doi: 10.1093/rheumatology/keac073

Key clinical point: A magnetic resonance imaging (MRI)-based scoring method was sensitive to changes in clinical outcomes of psoriatic arthritis (PsA) caused by abatacept, validating the responsiveness of the OMERACT PsA MRI Scoring System.

Major finding: Until day 169, patients receiving 30 mg/kg abatacept with a switch over to 10 mg/kg and those receiving 10 mg/kg abatacept reported significant reduction in MRI-detected synovitis (−0.97; P = .04) and tenosynovitis (−1.65; P = .01) vs. placebo, with patients switching from placebo to 10 mg/kg abatacept at day 169 showing significant improvements in total inflammation, synovitis, and tenosynovitis (P < .05) up to day 365.

Study details: This was a post hoc analysis of a phase 2b study including 123 patients with active PsA and an inadequate response to disease-modifying antirheumatic drugs randomly assigned to receive abatacept or placebo.

Disclosures: This study was funded by Bristol Myers Squibb. The authors declared serving on speakers’ bureaus and as consultants or receiving grants/research support from several sources. Six authors declared being employees or shareholders of Bristol Myers Squibb.

Source: Østergaard M et al. Implementation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Scoring System in a randomized phase IIb study of abatacept in psoriatic arthritis. Rheumatology (Oxford). 2022 (Feb 8). Doi: 10.1093/rheumatology/keac073

Key clinical point: A magnetic resonance imaging (MRI)-based scoring method was sensitive to changes in clinical outcomes of psoriatic arthritis (PsA) caused by abatacept, validating the responsiveness of the OMERACT PsA MRI Scoring System.

Major finding: Until day 169, patients receiving 30 mg/kg abatacept with a switch over to 10 mg/kg and those receiving 10 mg/kg abatacept reported significant reduction in MRI-detected synovitis (−0.97; P = .04) and tenosynovitis (−1.65; P = .01) vs. placebo, with patients switching from placebo to 10 mg/kg abatacept at day 169 showing significant improvements in total inflammation, synovitis, and tenosynovitis (P < .05) up to day 365.

Study details: This was a post hoc analysis of a phase 2b study including 123 patients with active PsA and an inadequate response to disease-modifying antirheumatic drugs randomly assigned to receive abatacept or placebo.

Disclosures: This study was funded by Bristol Myers Squibb. The authors declared serving on speakers’ bureaus and as consultants or receiving grants/research support from several sources. Six authors declared being employees or shareholders of Bristol Myers Squibb.

Source: Østergaard M et al. Implementation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Scoring System in a randomized phase IIb study of abatacept in psoriatic arthritis. Rheumatology (Oxford). 2022 (Feb 8). Doi: 10.1093/rheumatology/keac073

Key clinical point: Humoral response to BNT162b2 mRNA SARS-CoV-2 vaccine was reduced in patients with psoriatic arthritis (PsA) who received immunomodulatory treatment with antitumor necrosis factor (TNF) therapy, methotrexate, or interleukin 17 inhibitor compared with those without PsA.

Major finding: The median anti-SARS-CoV-2 spike receptor-binding domain immunoglobulin G (IgG) antibody level after 3 weeks of receiving the second dose of BNT162b2 mRNA SARS-CoV-2 vaccine was significantly higher in individuals without vs. with PsA (1,562.00 vs. 928.00 binding antibody units (BAU)/mL; P ≤ .001). The levels were, however, similar across anti-TNF therapy, secukinumab, or methotrexate treatment groups (P = .73).

Study details: Findings are from a prospective study including 110 patients with PsA in clinical remission who received immunomodulatory treatment and were matched with 96 healthy healthcare workers, all of whom had previously received two shots of the BNT162b2 mRNA SARS-CoV-2 vaccine.

Disclosures: The study did not report any source of funding. The authors declared no conflict of interests.

Source: Benucci M et al. Vaccination for SARS-CoV-2 in Patients With Psoriatic Arthritis: Can Therapy Affect the Immunological Response? Front Med. 2022;9:811829 (Feb 28). Doi: 10.3389/fmed.2022.811829

Key clinical point: Humoral response to BNT162b2 mRNA SARS-CoV-2 vaccine was reduced in patients with psoriatic arthritis (PsA) who received immunomodulatory treatment with antitumor necrosis factor (TNF) therapy, methotrexate, or interleukin 17 inhibitor compared with those without PsA.

Major finding: The median anti-SARS-CoV-2 spike receptor-binding domain immunoglobulin G (IgG) antibody level after 3 weeks of receiving the second dose of BNT162b2 mRNA SARS-CoV-2 vaccine was significantly higher in individuals without vs. with PsA (1,562.00 vs. 928.00 binding antibody units (BAU)/mL; P ≤ .001). The levels were, however, similar across anti-TNF therapy, secukinumab, or methotrexate treatment groups (P = .73).

Study details: Findings are from a prospective study including 110 patients with PsA in clinical remission who received immunomodulatory treatment and were matched with 96 healthy healthcare workers, all of whom had previously received two shots of the BNT162b2 mRNA SARS-CoV-2 vaccine.

Disclosures: The study did not report any source of funding. The authors declared no conflict of interests.

Source: Benucci M et al. Vaccination for SARS-CoV-2 in Patients With Psoriatic Arthritis: Can Therapy Affect the Immunological Response? Front Med. 2022;9:811829 (Feb 28). Doi: 10.3389/fmed.2022.811829

Key clinical point: Humoral response to BNT162b2 mRNA SARS-CoV-2 vaccine was reduced in patients with psoriatic arthritis (PsA) who received immunomodulatory treatment with antitumor necrosis factor (TNF) therapy, methotrexate, or interleukin 17 inhibitor compared with those without PsA.

Major finding: The median anti-SARS-CoV-2 spike receptor-binding domain immunoglobulin G (IgG) antibody level after 3 weeks of receiving the second dose of BNT162b2 mRNA SARS-CoV-2 vaccine was significantly higher in individuals without vs. with PsA (1,562.00 vs. 928.00 binding antibody units (BAU)/mL; P ≤ .001). The levels were, however, similar across anti-TNF therapy, secukinumab, or methotrexate treatment groups (P = .73).

Study details: Findings are from a prospective study including 110 patients with PsA in clinical remission who received immunomodulatory treatment and were matched with 96 healthy healthcare workers, all of whom had previously received two shots of the BNT162b2 mRNA SARS-CoV-2 vaccine.

Disclosures: The study did not report any source of funding. The authors declared no conflict of interests.

Source: Benucci M et al. Vaccination for SARS-CoV-2 in Patients With Psoriatic Arthritis: Can Therapy Affect the Immunological Response? Front Med. 2022;9:811829 (Feb 28). Doi: 10.3389/fmed.2022.811829