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High prevalence of sleep related symptoms in PsA pts!
-Snoring 53%
-Morning fatigue 68%
-Obstructive Sleep Apnea in 50%
14% mild 19% moderate 17% severe
Estimated prevalence 36%
No correlation between OSA and PsA disease activity or comorbidities
But small cohort! https://t.co/VKe7qcHIRm
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Ogdie on emerging PsA tx:
“It’s not just about the pharmacotherapy but also about making the patient feel better”
Also, weight loss is incredibly important but also incredibly hard. Losing weight is more impt than the type of diet a patient should be on.
#ACR25 @RheumNow https://t.co/FN3EEowkDP
Links:
sheila RHEUMarampa ( View Tweet)
Why do we need to identify early PsA?
🔅Improve symptoms
🔅Prevent radiographic progression
🔅Preserve function
☝️Recent data show that erosions are prevalent in early PsA but lower if symptom duration is <6 mos.
#ACR25 @RheumNow https://t.co/sEGXzd8RiD
Links:
sheila RHEUMarampa ( View Tweet)
What are the RFs for progression of Pso to PsA?
🔸PsO disease severity - 3.2x risk —>PsA
🔸Phenotype - nail involvement
🔸Obesity - 6x higher risk of developing PsA
🔸MSK symptoms - arthralgia & heel pain
#ACR25 @RheumNow https://t.co/UPXuxBPyKI
Links:
sheila RHEUMarampa ( View Tweet)
The severity of skin psoriasis increases the risk of psoriatic arthritis. Scher J @RheumNow #ACR25 https://t.co/EI0ACWACHy
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Trying to reach RA, PsA patients on social media, to participate in studies?
Simple, informational messages work for recruitment
Message framing affects engagement but not recruitment
The more we understand, the better we can reach the right people
#ACR25 ABST0187 @RheumNow https://t.co/JoAthXhXvi
David Liew drdavidliew ( View Tweet)
A simple flow cytometry analysis of peripheral blood monocytes to predicts progression to clinical RA or PsA in at-risk patients?
Too good to be true!
284 RA 56 PsA 57 HC
-HLA-DR higher in PsA
-CD11c lower in RA
But no clear difference between Converters and non Converters https://t.co/f3Sett4eXd
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
PD-1+ effector memory T cells in PsA synovium are functionally active and regulate Th17 cytokines via STAT3/RORγt. Recombinant PD-L1 agonist significantly reduced T cell proliferation and IL-17A/F/IL-22 production highlighting checkpoint agonists as a novel therapeutic strategy https://t.co/I6eNa0j7aa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts
IL-23i and IL-17Ai associated w/
-lower risks of diabetes
-Diabetic nephropathy
-Stage 3–5 CKD
and reduced risk compared to TNFi treated and bionaive pts
Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Retrospective study by Dr. Goudot et al. - pts w/D2T PsA had dactylitis, fibromylagia & ischemic cardiomyopathy
In multivariate analysis, FM & ischemic CM found to be RFs for D2T PsA
☝️Consider other dx if D2T PsA
#ACR25 @RheumNow ABS0566 https://t.co/FOXv6LbysZ
sheila RHEUMarampa ( View Tweet)
Icotrokinra, a first-in-class targeted oral peptide IL-23R inhibitor, cleared scalp (66%), genital (77%), and overall skin (57%) PsO vs placebo at Week 16. Basket trial design enabled targeted evaluation. Safety profile favorable. Abstract 0555 @RheumNow #ACR25
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A systematic review by Dr. SRamiro et al evaluated efficacy of b/tsDMARDs on peripheral axSpA
Majority on bDMARDs (TNFi, n=24; IL-17, n=13)
Most of the SMDs were small --> b/tsDMARDs showed small to moderate effects on peripheral arthritis & enthesitis.
#ACR25 @RheumNow Abs0588 https://t.co/yGXcqhZ1Uv
sheila RHEUMarampa ( View Tweet)
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0
Richard Conway RichardPAConway ( View Tweet)
Ogdie et al. Week 24 results of SOLSTICE study. Guselkumab in TNF-IR in PsA. Good efficacy on skin and joint disease. No difference seen in Q4 vs Q8 weekly doses. @RheumNow #ACR25 Abstr#563 https://t.co/ztK0O9iKb8
Richard Conway RichardPAConway ( View Tweet)
From the FOREMOST study factors predicting progression from oligo to polyarticular PsA: Female sex, enthesitis and dactylitis found to increase the risk of progression. Among patients in FOREMOST receiving PBO, prior csDMARD use was protective. Abstract#0576 @RheumNow #ACR25 https://t.co/CFMhAFgFBa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Real-world T2T strategy from MONITOR-PsA cohort:
🎯 At 48 weeks - 33.6% (49/146) of pts achieved PASDAS 'moderate' response & 37% (54/146) achieved a 'good' response
This was close to the T2T outcomes of the TICOPA trial
Adapt a T2T approach in PsA tx
#ACR25 @RheumNow Abs0572 https://t.co/FPiFIiO8Oe
Links:
sheila RHEUMarampa ( View Tweet)
Ribeiro et al. Case series of combination bDMARD/tsDMARD in PsA from Toronto. 24 patients, median just over a year follow-up. Appear effective, especially for objective skin and joint measures. No major safety concerns but short follow-up to date. @RheumNow #ACR25 Abstr#565 https://t.co/Zk3odT2EX2
Richard Conway RichardPAConway ( View Tweet)
Damen et al. 10-year follow-up of CRESPA study. Treatment withdrawl trial in early peripheral SpA. 38% in drug free remission. 82% in remission. @RheumNow #ACR25 Abstr#568 https://t.co/KOVW5pSbJg
Richard Conway RichardPAConway ( View Tweet)
This retrospective cohort analysis by Dr. Lihi Eder et al showed that among patients with PsA, those w/ high dse activity & high 3VAS scores were assoc w/⬆️ risk of atrial tachyarrythmias.
Main message: PsA conveys ⬆️CV risk; inflamm control is key!
#ACR25 @RheumNow Abs0522 https://t.co/7sRM7K4V1c
sheila RHEUMarampa ( View Tweet)
High-resolution ultrasound detected subclinical enthesitis in 44% of psoriasis patients without arthritis and 12% had PD positivity. Supports a preclinical PsA phase and use of MSUS to detect entheseal inflammation in both symptomatic and asymptomatic PsO patients for timely
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
