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*️⃣Abst#1800 observed that a changing pattern of purine, lipid, & amino acid metabolites occurred during transition from PsO to PsA.
*️⃣Compared to pts w/ Pso that didn't progress to PsA, those that progressed had elevated levels of guanine!
Potential biomarkers?
#ACR21 @RheumNow https://t.co/iQh1ZapDMB
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
⭐️Immune phenotyping of 45 patients with Pso and 41 PsA pts showed a number of cell subsets significantly different in Pso vs PsA
⭐️Future possibility of using a combination of selected immune cell subsets as a method for detecting PsA in Pso pts
Abst#1774 #ACR21 @Rheumnow https://t.co/ER1MPOvMa6
swethaann23 swethaann23 ( View Tweet)
Abst#1774 identified a blood-based immune profile with a machine-learning approach that discriminates PsA from Pso.
➡️↑ proportions of differentiated CD4+CD196+CD183–CD194+ and CD4+CD196–CD183–CD194+ T-cells in PsA
#ACR21 @RheumNow https://t.co/64uhJCd2qo
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#Guselkimab Better than #ustekinumab for skin& MSK. #Ixekizumab beat ustekinumab for skin. #ustekinumab loses throne in #psoriasis and #psoriatic arthritis except maybe if concomitant inflammatory bowel disease post TNFi? Rapidly evolving PsA Rx. Abst#1773 #ACR21 @RheumNow https://t.co/Dkf2DFFsSK
Janet Pope Janetbirdope ( View Tweet)
All for one or one for all? Lumper or splitter? Highlight from #ACR21 was session 6S403 looking at axial involvement in AxSpa vs PsA. I share my thoughts here at https://t.co/i2nDvMklee @RheumNow https://t.co/62tRRiAcUJ
Dr. Antoni Chan synovialjoints ( View Tweet)
Dr. Atul Deodhar with an excellent presentation on treatment in axSpA and axPsA. Note ustekinumab and risankizumab did not show improvement in axSpA. However, these studies did not include axPsA.
@ACR21 6S403 @RheumNow https://t.co/F73lvpF2at
Pedro Castillo _Castillo_Pedro ( View Tweet)
OK is this a swan or a swan song? Graph looks like a swan 🦢 but message is NO #MACE differences in PsA on csDMARDs v #biologics #ACR21 abst#1833 @RheumNow https://t.co/TM91z5wiFY
Janet Pope Janetbirdope ( View Tweet)
So are we in an era of #monotherapy with bDMARDs in #PsA? Ustekinumab & Secukinumab not different w or without #MTX. Abst#L12 @RheumNow #ACR21 https://t.co/Zp5owTpLvm
Janet Pope Janetbirdope ( View Tweet)
Cycling bDMARDs in #PsA. Law of diminishing returns. The more you fail, the more you cycle BUT can we break cycle by ⬆️adherence & health literacy, d/c smoking, use drug levels, biomarkers. Oh that in in future #ACR meetings! #ACR21 abst#1830 @RheumNow https://t.co/GyhgUGHWe8
Janet Pope Janetbirdope ( View Tweet)
Increased age at PSO diagnosis was significantly associated with shorter transition time between PSO and PsA diagnoses. No other variables, including BSA, were associated with time to transition @RheumNow #ACR21 Abst#1798 https://t.co/fLPBHKAMAc
Dr. Antoni Chan synovialjoints ( View Tweet)
Composite MACE outcomes no different among PsA pts treated w/ biologics and DMARDs. Abs 1833 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/TxyE4Uqttq https://t.co/Eykxwmcc44
Dr. Rachel Tate uptoTate ( View Tweet)
Abst1830 #ACR21 @RheumNow d/c of TNFi in PsA/PSO: probability of d/c TNFi ⬆️ by 9.6% for each additional biologic trial. Former smoker &PsA duration correlated w/ discontinuation. most commonly reason for d/c TNFi was secondary failure (33%). infliximab had lower d/c rate https://t.co/BXd2ALX2qo
Olga Petryna DrPetryna ( View Tweet)
Deucravacitinib is a novel, oral, selective TYK2 inhibitor in PsA and selectively mediates specific inflammatory pathways (IL-23, IL-12, Type I IFN). Listen to my interview with Prof. Oliver Fitzgerald on this and his highlights https://t.co/3UJCwbHsLC
@RheumNow #ACR21 Abst#490 https://t.co/OWZDHhcQ9q
Dr. Antoni Chan synovialjoints ( View Tweet)
Racial disparities & Co-morbidities in PsA findings. Amongst important others, increased biologic use in Caucasians w/ PsA vs DMARDs in black PsA pts. View Abs 1780 for other relevant findings. #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/0uKsa8i0bG https://t.co/R9YkxYqXws
Dr. Rachel Tate uptoTate ( View Tweet)
Methotrexate did not improve Ustekinumab efficacy in tx of PsA
⭐️Addition of MTX did not improve dactylitis, enthesitis, skin, QoL or function
#ACR21 #ACRBest @RheumNow
Abs#L12
https://t.co/6dxWPNskou https://t.co/BnzH8PfaMV
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Prevalent drug utilization unrelated to enthesitis in PsA. Pts on cDMARDs had higher physician globals vs those treated w/TNFi & IL-17i. In aggregate, no pattern of dz activity scores correlation w/drugs. Abs 1782 #ACR21 #RheumNow @RheumNow @doctorRBC https://t.co/x57BkBjpjo https://t.co/QmdXqOxLki
Dr. Rachel Tate uptoTate ( View Tweet)
Phase 2 trial of tildrakizumab (IL-23i) for the treatment of PsA showed lower efficacy in pts with metabolic syndrome compared to those without
#ACR21 @RheumNow
Abs#1819
https://t.co/GYHbiH9NSW https://t.co/YGcZcITjzj
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Abst1810 #acr21 @RheumNow survey of pt preferred meds for PsA points out ⬆️ interest in IL17 & PDE4 since 2018 guideline update: anti-IL17 compared to 2018 or earlier (30% vs 3.5% p< 0.001);anti-PDE4 (40% vs 11.5% p< 0.012). Meds SEs& prevention of joint damage important for pts
Olga Petryna DrPetryna ( View Tweet)
After 2018 ACR Guidelines, significant increase in IL-17i and PDE4i use in PsA pts
⭐️TNFi most common tx
⭐️28% pts not on any tx⭐️
#ACR21 @RheumNow Abs#1810
https://t.co/7Rmirfm3nK https://t.co/0Ui9pq5uyo
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
In Phase 2 trial of Tildrakizumab in active PsA efficacy tended to be lower among patients with comorbid MetS, with improvements from baseline across efficacy measures generally larger in patients without MetS vs those with MetS @RheumNow #ACR21 Abst#1819 https://t.co/ATxaFz9X2O https://t.co/2iJMNmfUzg
Dr. Antoni Chan synovialjoints ( View Tweet)
