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Expanding the IL-17 Therapeutic Landscape
IL-17 inhibitors are an effective therapeutic for a broad spectrum of inflammatory and autoimmune diseases and its blockade has revolutionized management of diseases such as psoriasis, psoriatic arthritis and SpA. Is there a need for more medications within the same therapeutic class?
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Psoriatic Arthritis: Hit hard and Early
EurekAlert!
Two recent studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate2,3, but these did not select for poor prognosis.
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PsO + recent arthralgia—but no PsA. Treat or wait?
🧠 18% developed PsA in 3 yrs, most in year 1
🔍 Predictors: tender joints, disability, enthesis erosion
Consider early rheum input for these patients
Abstract POS0299 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Can RZB deliver in real-world early PsA?
💥 9-month results say yes:
✅ Dactylitis gone in 79%
✅ Enthesitis in 90%
✅ 97% MDs & 88% pts satisfied
Early intervention may pay off.
Abstract POS0304 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
#Psoriatic_Arthritis
#Preclinical #Early
❓️ Does joint swelling occur in the same anatomical locations affected in the subclinical phase?
🅰️ Yes, in 68%
🅰️ Especially if positive ultrasound
#EULAR2025
@RheumNow
OP0179 by Ivan Giivannini et al. https://t.co/rKfreQyJeG
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Acute Dactylitis in #Psoriatic_Arthritis
🔹️1216 patients Canada 🇨🇦
🔹️52% had at least one episode of acute dactylitis in a median 12 years
🔹️Positive association with HLA-B27 and HLA-B27/C02
🔹️No association with HLA-B51
#EULAR2025
@RheumNow
OP0180 by Kharouf et al. https://t.co/oNNMBcvVb4
Nelly ZIADE 🍀 Nellziade ( View Tweet)
In PsA, can we better pick IL-17A inhibitor responders (after TNFi failure)?
Transcriptomic profiling is going to get better at telling us which pathways are truly important for response to specific treatments
POS0232 #EULAR2025 @RheumNow https://t.co/uycuXB0TFK
David Liew drdavidliew ( View Tweet)
Diagnostic delay in #SpA
🔹️Data from the @Official_ASAS
Study
🔹️4339 patients
🔹️Delay was 6.6 years
🔹️Longer in axSpA and IBD-SpA, shorter in PsA and pSpA
🔹️Associated with type of initial symptoms (shorter in peripheral)
POS0909 #EULAR2025
@rheumnow https://t.co/3BMYFxbKiq
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Prédiction of PsA from PsO. Stockholm cohort, n=672):
•PsA incidence 21.1/1000 PY.
•AUC 0.80 for both referral and prognostic models.
•Predictors: HLA-B27, uveitis, enthesial pain, TJC, hsCRP, BMI, SAA, GlycA.
•Early identification feasible.
Abstract OP0178 @RheumNow https://t.co/dxdChN6VZy
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Do the sites of clinical onset of PsA (i.e., swelling) correspond to those that, at the time of enrollment in the study, showed evidence of joint tenderness and/or ultrasound-detected alterations compatible with inflammation? Of 28 incident PsA cases, 68% had prior subclinical https://t.co/rAZJU6Va5x
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Study on the HLAs associated with the occurrence and course of acute/tender dactylitis in PsA patients.
Acute dactylitis genetics:
•HLA-B27 (OR 1.71), HLA-C12 (OR 1.43), B38/C12 & B27/C02 haplotypes.
•Resolution faster on b/tsDMARDs (HR 1.67); unaffected by HLA.
Abstract
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
GRAPPA defines :
- D2T-PsA (failed ≥3 therapies incl. ≥2 b/tsDMARDs)
- CM(complex to manage)-PsA (adds pain, comorbidity, complexity).
A needed framework to improve trial design & real-world care.
Do these definitions fit your clinic?
#OP0175 @RheumNow #EULAR2025 https://t.co/ot1bVLIYLA
Jiha Lee JihaRheum ( View Tweet)
29% of new-onset psoriasis pts in Stockholm cohort developed PsA over 9,255 person-years.
Two prediction models (AUC 0.804) identify:
➡ who to refer
➡ who will progress
Key predictors: HLA-B27, CRP, enthesitis, arthralgia.
@RheumNow #EULAR2025 #OP0178:
Jiha Lee JihaRheum ( View Tweet)
OP0176: Among D2T PsA pts, 43% lacked inflammation on imaging—despite symptoms.
Clinical + US split them into PIPsA vs NIPsA, helping distinguish who needs escalation vs who doesn’t.
A step toward smarter care in D2T PsA.
@RheumNow #EULAR2025 https://t.co/E9igwvDPPN
Jiha Lee JihaRheum ( View Tweet)
FAPI-PET/CT - detecting synovial and enthesial fibroblast activation- predicts the development of #psoriatic_arthritis in patients with psoriasis and arthralgia
✨️ A promising tool for early diagnosis of PsA
Giulia Corte et al.
OP#0174
#EULAR2025
@RheumNow https://t.co/QVmoECIhBI
Nelly ZIADE 🍀 Nellziade ( View Tweet)
✨️ New Definition Alert
The GRAPPA definition of
C2M (Complex to Manage)
&
D2T (Difficult to Treat)
#Psoriatic_arthritis
A hope for having a homogeneous and widely accepted definition for future clinical research
Presented at #EULAR2025
Proft et al.
OP#0175
@RheumNow https://t.co/et9cuMROkb
Nelly ZIADE 🍀 Nellziade ( View Tweet)
OP0179: In a psoriasis cohort, 68% of PsA onset sites showed prior subclinical inflammation (26% tender, 32% US+, 42% both).
Should we redefine when PsA truly begins?
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
In D2T-PsA (10%), 57% had persistent inflammation (PIPsA), 43% non-inflammatory (NIPsA). Ultrasound distinguished phenotypes: median US activity score 3.22 vs 0.88.,swollen joints 2.5 vs 0, tender points higher in NIPsA.
Abstract OP0176 @RheumNow #EULAR2025 https://t.co/k7m8gAzbAZ
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Nordic registries (n=13,872): D2T-PsA varied 37% (≥2 b/tsDMARDs failed) to 0.6% (strictest). Female predominance increased with therapy failures (≥4 failures: 67% female). Median time to failure: 5–7 years.
Abstract OP0177 @RheumNow #EULAR2025 https://t.co/lchPnTCEx7
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Difficult-to-treat & early PsA at #EULAR2025
GRAPPA definitions: D2T-PsA (≥3 therapies incl ≥2 b/tsDMARDs with persistent inflammation); C2M-PsA (broader: comorbidities, pain, intolerance). 95% GRAPPA consensus.
Abstact OP0175 @RheumNow #EULAR2025 https://t.co/eqKmMPh80x
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
