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Functional MRI studies have been out there for a while, but mechanisms and significance underlying fMRI findings are unclear
fMRI study in 38 active PsA pts w/ significant fatigue
Altered functional connectivity between posterior insula to cerebellum & superior frontal gyrus https://t.co/3s9CJUg2uN
Aurelie Najm AurelieRheumo ( View Tweet)
Abstract 1421: PsA and 'Brain Fog'
Pts w/ #PsA who did not achieve Minimal Disease Activity (MDA) had higher odds of subjective cognitive decline vs those with MDA
🔹 Fatigue, and to a lesser extent depression/anxiety, ↓ this associated risk
@RheumNow #ACR25 https://t.co/RohwKJZDzp
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In the SERENA study (n=292), secukinumab reduced PsA incidence to 0.49/100 PY over 5 years in PsO patients with nail involvement, an ~82% drop vs historic non-biologic rates (2.7/100 PY). 98.3% remained PsA-free; PASI 90 achieved in 63%. Abstract#1463 @RheumNow #ACR25 https://t.co/ySOuFJiwge
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
This study evaluated effectiveness of SEC in PsA prevention of a subgroup of pts from SELENA: PsO pts w/o PsA & nail dse (n=292)
At 5 yrs:
🎯98.3% didn't develop PsA (yEAIR 0.49)
🎯 Sustained PASI, PGA 0/1
💡Longterm SEC effective for PsA prevention?
#ACR25 @RheumNow Abs1463 https://t.co/t7P1Oerbrw
sheila RHEUMarampa ( View Tweet)
In pooled analysis of 9 PsA trials, 6.9% of secukinumab-treated patients had fungal infections, mostly mild/moderate. Candida rates were low (1.86–2.18/100 PY) and didn’t increase over time. 89.7% resolved fully; only 0.8% led to discontinuation. Abstract 1459 @RheumNow #ACR25 https://t.co/kltMZVEDf9
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Mease et al. What agent to use after failure of first TNFi in PsA. Real world study, 320 patients. Switching to upadacitinib led to better joint responses than second TNFi or IL17i @RheumNow #ACR25 Abstr#1453 https://t.co/SQnN0skw7r
Richard Conway RichardPAConway ( View Tweet)
Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ
Richard Conway RichardPAConway ( View Tweet)
Kharouf et al. Effect of handedness on radiographic damage in PsA. Left-handedness associated increased peripheral damage, especially in left hand. Hypothesis that having to use tools designed for right-handedness increases mechanical stress @RheumNow #ACR25 Abstr#1415 https://t.co/gfGQkrYyc8
Richard Conway RichardPAConway ( View Tweet)
I wouldn't sleep on this. 😴💤
Abstract 1413: In a PsA cohort, restless leg syndrome was linked to:
🔹 ↑ disease activity (polyarthritis, swollen joints, DAPSA)
🔹 Worse physical function (↑ HAQ)
🔹 Fatigue, anxiety, depression, & poorer sleep quality
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
After At-risk RA, time to discuss At-risk PsA patients
ARP-PsA
Prospective cohort 1400+ pts
8.4% met ARP-PsA criteria (arthralgia + Fam Hx +Pso, not referred via Dermatology)
Risk factors:
Pso >15 years
Pso + Family Hx
US synovitis/enthesitis
At 1 yr follow-up 30% progressed https://t.co/ZY2ezh8nZN
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Abstract 1431: Radiographic sacroiliitis in #PsA: insights from an Indian cohort
- Cervical and lumbosacral spine syndesmophytes were common
- Levels C5, C6, and L4 vertebrae frequently involved including syndesmophyte damage w/ non-marginal bridging
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Picture this 👉radiographic joint damage tied to worse physical function in #PsA:
🔹 ↑ mSS → ↑ HAQ (β=0.003 [0.002–0.004])
🔹 ↑ mSS → ↓ SF-36 PF (β=−0.10 [−0.15 to −0.05])
🔹 ↑ # of damaged joints → worse physical function
@RheumNow #ACR25 Abstract 1425
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstrat 1414 Compared to #PsO, early #PsA showed:
🔹 ↑ Dactylitis (66%), Enthesitis (78%), CRP/ESR
🔹 Longer morning stiffness & ↑TJC/SJC
🔹 MRI/US: frequent tenosynovitis & bone changes
🔹 Predictive model combining these features showed Sens 89%, Spec 84%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 0878: In PsA pts w/ lateral epicondyle enthesitis on secukinumab (n=11):
🔹 Improved DAPSA & SPARCC scores
🔹 entheseal tissue biopsy showing shift toward pro-resolving fibroblasts (↑DKK3/CD200⁺)
🔹 ↓ osteoblast-related pathways
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
X-sectional study by Dr Toledano et al showed that 20% (46/230) PsA pts had restless leg syndrome (RDS).
Pts w/ RDS:
- Polyarthritis
⬆️ Swollen jts
⬆️ Fatigue, anxiety, depression
⬆️ Dse activity
Poor sleep quality
Polyarthritis & Pso: assocd w/ RDS
#ACR25 @RheumNow Abs1413 https://t.co/8Ds3TgLjs1
sheila RHEUMarampa ( View Tweet)
In ICONIC-LEAD, adolescents (12 to <18 years) with moderate-to-severe psoriasis treated with icotrokinra (ICO) achieved Investigator Global Assessment (IGA) 0/1 in 84.1% vs 27.3% (placebo) and PASI 90 in 70.5% vs 13.6% at Week 16. Week 24 responses reached 88.6%. Safety profile https://t.co/L7h8BlnWaO
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A post-hoc analysis from the ReFlaP study showed that there was a significant correlation between PsAID12 & HAQ scores
MDA-PsAIDrem (SN 82.6% SP97.1%) and MDA-PsAIDlow (SN 90.7% SP 91.2%)
Potential alternative for HAQ in MDA criteria?
#ACR25 @RheumNow Abs1411 https://t.co/QAxKsuhtDq
Links:
sheila RHEUMarampa ( View Tweet)
In high-risk psoriasis patients with nail disease, Secukinumab reduced PsA onset over 5 years with a total exposure of 1022 patient-years. Annual incidence dropped from 2.7 to 0.49 per 100 patient-years. Data from the real world SERENA study. Abstract 1463 @RheumNow #ACR25
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
POETYK-PsA 1 & 2 Phase 3 RCT TYK2i Deucravacitinib
Pooled analysis 640+pts PBO vs. 640+pts DEUCRA 6mg QD
MDA 12% vs 22%
All elements of MDA response sig different except for Leeds enthesitis index
DAPSA Remission 2% vs. 9%
PsARC 42% vs. 61%
PASDAS -1 vs. -1.7
mCPDAI -1.2 vs. -1.9 https://t.co/OTOFxTOrRp
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
GLP-1 receptor agonists reduce mortality in PsA
Tsibadze et al retrospectively compared ~4k PsA on GLP-1 to ~86k PsA not
After propensity matching, those treated with GLP-1:
- lower risk MACE
- lower risk overall death
@RheumNow #ACR25 Abst 0849 https://t.co/EuojrDq0Fj
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
