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The Need for Comparative Treatment Trials in Psoriatic Arthritis
Psoriatic arthritis is currently experiencing a burgeoning selection of treatment options. While this is a very welcome development in a disease which has had less treatment options compared to RA, it leaves us with a difficult conundrum: which agent to choose for an individual patient.
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Post hoc analysis of pooled data from 19 clin trials on SEC & CV risk & systemic #inflammation in PsO, PsA, AS
📌Traditional CV parameters remained stable on all SEC treated grps
📌SEC sig. ⬇hsCRP & NLR
@RheumNow #ACR21 abs1835 https://t.co/iCaGFbXNXn
sheila RHEUMarampa ( View Tweet)
2 year study shows low rates of radiographic progression in PsA pts on guselkumab
#ACR21 @RheumNow Abs#1805
https://t.co/dobg3cEXXG https://t.co/m1P24qPAhy
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
SERENA interim analysis on interruption of secukinumab in AS and PsA
🔹>=16 wks of Rx before interruption of >= 3 mo.
🔹75-80% of pts reinitiated w/o loading phase
🔹AS: BASDAI, PGA stable
🔹PsA: SJC, TJC returned to Rx baseline
https://t.co/3G6rVW8TPv
#ACR21 Abst#1361 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Have you heard of pSpA? (Peripheral) pSpA: distinct clinical phenotype w/ intermediate features between pure PsA & pure axSpA but w/ a higher disease burden compared to both diseases, & lower use of b-DMARDs. Abs 1787 #ACR21 #ACRbest #RheumNow @RheumNow https://t.co/Wsysm7A0Y3 https://t.co/rwQ8ukBEDq
Dr. Rachel Tate uptoTate ( View Tweet)
Pregnant pts w/ PsA, but not AxSpA, at increased risk of pre-eclampsia. In RA pregnancies, pre-eclampsia risk increases w/ dz severity prior/during pregnancy. We need to discuss potential risks w/ pts and OB team. Abs 1722 #ACR21 #RheumNow @RheumNow https://t.co/yeQmNAZ1jV https://t.co/cBfeVKQHfr
Dr. Rachel Tate uptoTate ( View Tweet)
The wave of the future? Study details immune profile which discriminates PsA from PsO using phenotyping of serum immune cell subsets & machine learning. Abs 1774 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/huNTY3IdRf https://t.co/3aW64pb9UW
Dr. Rachel Tate uptoTate ( View Tweet)
Abst1783 #ACR21 #ACRBest @RheumNow Canadian study reports promising trends on hospitalizations for serious infections in PsA: 2012 – 2017 statist signif ⬇️ in discharges for sepsis, skin & soft tissue infect & UTI (p < 0.001 for all). no statistical difference in the trend of PNA https://t.co/lqtCzUFPAW
Olga Petryna DrPetryna ( View Tweet)
Upadacitinib showed similar efficacy in AS pts compared to PsA pts with axial involvement
⭐️PsA pt w/ axial involvement and AS pts with differences in baseline characteristics
#ACR21 @RheumNow
Abs#1802
https://t.co/QvyayelBYU https://t.co/50dNQm30vf
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Excellent overview on assessment of patients with #PsA by @AlexisOgdie!
Really clear and easy-to-follow slides to add structure to clinical assessment.
#ACR21 @RheumNow https://t.co/XGZrCxOukm
Mrinalini Dey DrMiniDey ( View Tweet)
Fr AQUILA study: #Uveitis status in AS or PsA pts given SEC
👁🗨3 pts w/o uveitis at BL developed new onset uveitis during study
👁🗨Most pts w/uveitis at BL - status remained unchanged or improved
👁🗨SEC did not ⬆ risk of uveitis
@RheumNow #ACR21 abs1738 https://t.co/IGUpgXBLvt
sheila RHEUMarampa ( View Tweet)
No benefit to using MTX in combination with ustekinumab in PsA. No difference in efficacy for arthritis, enthesitis, dactylitis, skin, QoL or function. Abstr#L12 #ACR21 @RheumNow https://t.co/iojKLqRb06
Richard Conway RichardPAConway ( View Tweet)
Clinical and research pearl: SPACC vs LEEDs enthesitis scoring for your PsA patients by Dr. Ogdie. #ACR21 @RheumNow #RheumNow https://t.co/dDznwSicRQ
Dr. Rachel Tate uptoTate ( View Tweet)
Isolated axial involvement exists in 2-5% of PsA patients. In 576 patients 495 (31.4%) had axial disease, of which 32 (2.0%) had isolated axial disease. HLA-B*27+ and lower HAQ scores were associated with isolated axial disease @RheumNow #ACR21 Abst#1775 https://t.co/Y1EAJlA0mT https://t.co/8oZhN3mT30
Dr. Antoni Chan synovialjoints ( View Tweet)
Dr Deike on prevalence and incidence of PsA in Germany. Prevalence 5-6/1000. Incidence 30-40/100000. Marked age variations that don't really make sense for prevalence. Abstr#1785 #ACR21 @RheumNow https://t.co/uW0ruW2Jda
Richard Conway RichardPAConway ( View Tweet)
Can we predict which PsO pts will develop PsA?
Machine learning and phenotyping of blood immune cell subsets identified an immune profile to discriminate PsO from PsA.
Abs#1774
#ACR21
@RheumNow
https://t.co/PERx86jjkJ https://t.co/oEpbMZ0nnK
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Individual patient data analysis from RCTs (indirect comparison) of guselkumab vs ustekinumab in PsA. Guselkumab appears superior for joint and skin. Abstr#1773 #ACR21 @RheumNow https://t.co/MTRjXyHoh6
Richard Conway RichardPAConway ( View Tweet)
No significant difference in enthesitis activity in PsA pts taking csDMARD vs. TNFi vs. IL-17i
⭐️Age, duration of disease, physician global were main differences in TNFi and IL-17i vs. cDMARD
⭐️no specific clustering noted
Abs#1782
#ACR21 @RheumNow
https://t.co/AH33ZjHUa1 https://t.co/Gb2zKMBUqo
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Dr Kwok on isolated axial disease in PsA. Seen in 2% of cohort. Significantly more likely to be HLA-B27 positive. Lower HAQ score. No obvious predictors of future development of peripheral disease. Abstr#1775 #ACR21 @RheumNow https://t.co/SqpaLjCrmm
Richard Conway RichardPAConway ( View Tweet)
Watch my video of #ACR21 Abstract 1456, a double blind RCT of CBD for hand OA and PsA @RheumNow https://t.co/p0IiYzYe2m
Richard Conway RichardPAConway ( View Tweet)
