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Do Probiotics Improve Psoriatic Arthritis?
Psoriatic arthritis and the gut microbiome have become more intertwined, especially in the past few years. It was to my amazement that one of the first abstracts I came across was the effect of probiotic modulation on gut dysbiosis and disease activity in psoriatic arthritis patients.
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SpA Sleuths: The Case of Undiagnosed IBD
Abstract #0494 provides context to our continual search for better understanding of inflammatory bowel disease in patients with AS, nr-AxSpA, and PsA.
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Late-Breaking Ph 2b RCT of TAK-279, oral TYK2 Inhib, in Active PsA. ACR20 in 53-54% (30 mg qd) vs 29.2% PBO at wk 12 (p = 0.002). Abst #L12 presented on Tuesday. #ACR23
Dr. John Cush RheumNow ( View Tweet)
DRESS-PS study LTE. 12 month observational extension. 114 patients PsA/AxSpA. Essentially patients TNFi tapered or not in T2T fashion. TNFi dose remained lower in tapering group but it is consistently creeping back up. Abstr#0775 @RheumNow #ACR23 https://t.co/aYoOl6Ccin https://t.co/BtMR95lIfs
Richard Conway ( View Tweet)
MEDIPSA: probiotic vs PBO RCT in PsA
12 weeks
Using strains Bifidobacterium and Lactobacillus
No effect on DA or PROMs in PsA
No effect on gut parameters either
Good safety profile
Wrong strains or not an generally efficient intervention?
ABST0778 @RheumNow #ACR23 https://t.co/RPgT7LoRgC
Aurelie Najm ( View Tweet)
Do probiotics improve psoriatic arthritis?
Unfortunately no difference in disease activity compared to placebo.
Limited effects on gut dysbiosis
Minor effects on T cell composition
@RheumNow #ACR23 Abs#0778 https://t.co/JuBesyfnV2
Robert B Chao, MD ( View Tweet)
#ACR23
Lower persistance of TNFi in women than men in Psa👍🇫🇷🇫🇷🇫🇷 CHU Mondor
@RheumNow https://t.co/27OVLz4aZN
Dellal ( View Tweet)
Biologic persistance rates consistently lower in women vs men with PsA. 52% vs 62% @ 1 year. Some statistically significant, but really it is a consistent message across drugs. We urgently need research on the reasons. Abstr#0779 #ACR23 @RheumNow https://t.co/Kfk3k3LJ44 https://t.co/SmiOnt7D4d
Richard Conway ( View Tweet)
🆕 Imaging modality: MSOT multispectral optoacoustic tomography
Findings PsA enthesis
-Hyperemia ↗️ oxygenation So2 and Hboxy
-Reduction Collagen concentration
-Lipids substitution
But surprise PSO pts display similar signs despite abs of symptoms!
@RheumNow ABST0750 #ACR23 https://t.co/qWMvmIRd7j
Aurelie Najm ( View Tweet)
2 yrs extension of DRESS-PS study
100+ pts w/ PsA and AxSPA
-70% LDA state in both Ctrl & Intervention gps
-strong recovery after relapse
No difference efficacy protocolized & routine care tapering but inferior TNFi use (52 vs. 77%) in Intervention gp
@RheumNow #ACR23 ABST0775 https://t.co/V2DqCjT0w3
Aurelie Najm ( View Tweet)
#ACR23
IV secukinumab vs placebo at 52 Weeks
@RheumNow https://t.co/4zQa37tN4l
Dellal ( View Tweet)
Phase 3 Study of IV Secukinumab for treatment of PsA - efficacious and safety profile similar to Subq version
~60% ACR 50 response maintained at week 52
2nd responses of MDA, PASI90, enthesitis, dactylitis resolution met
@RheumNow #ACR23 Abs#0776 https://t.co/jikWd4fnGm
Robert B Chao, MD ( View Tweet)
Is exercise safe in PsO/PsA? Ab0497 #ACR23
US of entheses before & after 60 min of badminton 🏸
7 PsA pts, 9 PsO pts, 196 US scans acquired.
No signif change in VAS pain/tender entheses
4 pts w grade 1 doppler at 6 entheses, butnon-tender
1 pt w active PsA had worsening
@RheumNow https://t.co/nsi9b6px0X
Eric Dein ( View Tweet)
Ab#498 Does DMARD for PsO and PsA decrease MACE?
#ACR23 @RheumNow
Retrospective database Israeli study.
PsO, PsA on MTX or bDMARD: lower MACE compared to health matched controled (HR 0.45-0.68, p<0.001)
Pts on topical Rx had marginally Increased MACE (HR 1.14, p <0.001) https://t.co/0uRgjzYbFp
Eric Dein ( View Tweet)
BKZ tx resulted in sustained improvements in pt‑reported pain and fatigue from Wk 16 - 52 in bDMARD-naïve and TNFi-IR pts w/ active PsA, w/ clinically meaningful improvements observed in >50% of pts in BE-OPTIMAL & BE-COMPLETE #ACR23 Abs 0527 https://t.co/AQKYUubKLl @rheumnow https://t.co/WsXlhENzL1
Dr. Rachel Tate ( View Tweet)
EISER study: Undiagnosed IBD in SpA
Abs#0495 #ACR23 @RheumNow
559 pts, 47% PsA/53% SpA (80% r-AxSpA)
Higher mean fecal calprotectin in r-AxSpA (395 vs 305 nrAxSpA/PsA)
14.6% IBD symptoms, 23 patients (4.4% were dx w IBD)
Fecal calprotectin & history can uncover IBD
#ACRBest
Eric Dein ( View Tweet)
High hs-CRP predicts PsO -> PsA?
Abs#0484 #ACR23 @RheumNow
589 PsO pts wo PsA, followed mean 7.5 years
57 pts developed PsA (1.2 events/yr)
Higher levels of b/l hs-CRP seen w: arthrlalgia, obesity, females
Higher hs-CRP ass. w/ PsA - p=0.002, but HR only 1.03 (CI 1.01-1.05)
Eric Dein ( View Tweet)
Systemic anti-inflammatory treatments for PsO and PsA including methotrexate and biologics provided cardioprotective effects
Potential cardiovascular benefits of IL-17i and IL-12/23i compared to TNFi
@RheumNow #ACR23 Abs#0498 https://t.co/Np7PSNvFd6
Robert B Chao, MD ( View Tweet)
Long term safety data for bimekizumab (IL17i) in Psa & axSpA
Overall as expected; increased infections (esp fungal/candida) & hepatic events
No new signals... uveitis flares is interesting
Need H2H of IL17's! IXE vs SEC vs BIM
@RheumNow #ACR23 Abstr 0511 https://t.co/pBqly2JylA
Mike Putman EBRheum ( View Tweet)
Deucravacitinib (TYK2) data has been surprisngly good in SLE
Strong rationale in PsA as well; I liked this poster & the focus on pain scores / patient QOL
Probably my #1 draft pick for "drugs I'm buying right now"
@RheumNow #ACR23 Abstr0508 https://t.co/FHNvgUrYxp
Mike Putman EBRheum ( View Tweet)
