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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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Depression and anxiety in PsA is higher and has more consequences than in general population
Swedish and Danish clinical registers 23000+ PsA pts
HR 1.4 specialised psychiatric out/ inpatient care vs. general pop
HR for psychiatric in patient care numerically higher but ns.
No https://t.co/qduMcwGK0S
Aurelie Najm AurelieRheumo ( View Tweet)
Prediction of PsA in PSO pts: does it work?
First predictive model using mainly clinical data and labs extracted from primary care
Performs well in the cohort it was trained w/ but not in validation cohort.
Often an issue with prediction models!
Needs more granularity than https://t.co/5cVgqfd4fX
Aurelie Najm AurelieRheumo ( View Tweet)
PsA asso w/ higher risk of preterm births in women
Scandinavian registries
688 PsA pregnancies
8% preterm births vs. 4.5% general population OR 1.8
16.4% if bDMARD combination OR 4
3.1% if bDMARD monotherapy OR 0.7
bDMARDs combo probably a surrogate of high disease activity
Aurelie Najm AurelieRheumo ( View Tweet)
What's the difference between PIPsA & NIPsA?
(Persistent Inflammatory confirmed by IMAGING
vs. Non inflammatory PsA)
🔹️Cross-sectional study
🔹️517 pts under b/tsDMARDs
🔹️10.3% D2T
🔹️57% PIPsA / 43% NIPsA
👇 Distinct phenotypes 👇
OP0176
#EULAR2025
@rheumnow https://t.co/YGHpbeE6ws
Nelly ZIADE 🍀 Nellziade ( View Tweet)
What happens to the prevalence of D2T PsA if we use different parameters in its definition?
Data from 5 Nordic registries including 13,872 patients showed a variation from 37% (less stringent) to 0.6% (more stringent)!
OP0177
#EULAR2025
@rheumnow https://t.co/QbF15t3Zrz
Nelly ZIADE 🍀 Nellziade ( View Tweet)
🚨Diagnostic delays are real in axSpA:
-Can lead to more extra-msk manfieststions (EMMs) in PsA and axSpA.
-Increases disease burden and productivity losses.
-EMMs can present before articular sx
-Uveitis and IBD associated with longer dx delays.
-Diagnosis has improved since https://t.co/rWMwG7Ewwe
Links:
Adela Castro AdelaCastro222 ( View Tweet)
A machine learning (ML) model using electronic medical record (EMR) data from 396,000 Mayo Clinic primary care patients identified undiagnosed psoriatic arthritis (PsA) with area under the curve (AUC) 79.6%. Key predictors: psoriasis, joint pain, tenosynovitis, https://t.co/VsYevnJEjK
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
In 1314 PsA patients, cumulative methotrexate dose was not associated with liver fibrosis (OR 0.99). Instead, higher BMI (OR 1.03) & diabetes (OR 5.03) were key drivers. MASLD, not MTX, may underlie fibrosis risk in PsA. APRI >0.7 used for fibrosis detection. Abstract#POS0111 https://t.co/zsX7NUOT9m
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Tofacitinib vs biologics in PsA:
📍MI/stroke ✅ similar
📍Serious infection ✅ similar
📍Malignancy ✅ similar
📍VTE ❌ higher vs TNFi (aHR 0.26)
Large US claims study (n=48k)
Abstract POS0296 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
📊 SIJ findings in PsA (n=581):
🧠 31% = MRI-confirmed axSpA
🦴 Only 29% met r-mNY criteria
MRI-axPsA group: younger, more male, HLA-B27+
Clinical + radiographic definitely underperform vs MRI
#POS0297 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
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)
