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Are MDA criteria created equal in PsA?
Minimal Disease Activity criteria are used to evaluate PsA disease activity and response to treatment. Given that a patient only has to meet 5 of the 7 criteria, should the individual components be weighted equally?
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Are we really treating Psoriatic disease if we only address active disease domains and T2T?
It’s widely accepted that Psoriatic disease has multi-system, multi-domain potential that can lead to life altering complications if left untreated or undertreated. Rheumatologists have shifted the way we discuss treatment options and disease state expectations with patients. Two #ACR22 abstracts stood out to me regarding the Psoriatic disease patient experience and will, ultimately, add to what I do in clinic.
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Window of opportunity in PsA
CorEvitas registry:
Early initiators had more severe disease & worse PROs
but if DMARD therapy initiated within 1 yr: RR=2 MDA achievement & higher reduction of CDAI
https://t.co/Xm9i7aiq85
Abs#1493 #ACR22 @Rheumnow https://t.co/RAGoHeuSIg
Aurelie Najm AurelieRheumo ( View Tweet)
Performance BASDAI & ASDAS in evaluating PsA axial symptoms?
400+ pts DISCOVER 1&2
Weak correlations w/ peripheral arthritis
Moderate/strong correlations w/ fatigue & pain
Both perform similarly but do they perform well enough?
https://t.co/alnrEXtydp
Abs#1037 #ACR22 @Rheumnow https://t.co/Zuf1FruneK
Aurelie Najm AurelieRheumo ( View Tweet)
Low likelihood of syndesmophyte formation in PsA but is more likely assoc'd w/ axial involvement radiographically + high CRP. Abs 1014 #ACR22 @RheumNow https://t.co/M5Tc0fd64s https://t.co/e25gwVQKeo
Dr. Rachel Tate uptoTate ( View Tweet)
DISCOVER 1 & 2: Subanalysis of GUS in 181 pts w/ Axial PsA and imaging confirmed SI
GUS improves BASDAI, mBASDAI, spinal pain, morning stiffness, and ASDAS from W8 to W24
W24 Response rates BASDAI50 38% BASDAI70 20%
https://t.co/MrS8atrIOI
Abs#1035 #ACR22 @Rheumnow https://t.co/wMDkO1Qak9
Aurelie Najm AurelieRheumo ( View Tweet)
Abstr #1037 evaluated BASDAI vs ASDAS in PsA w/ axial dx
Both ASDAS & BASDAI showed
- strong correlation w/ pt pain & Global Assessment
- weak correlation in tender and swollen joint counts and enthesitis
#ACR22 @RheumNow #axSpA #PsA https://t.co/EunXIwzn3M
Akhil Sood MD AkhilSoodMD ( View Tweet)
Valero et al. Combined biologics in PsA. @RheumNow #ACR22 Abstr1044 https://t.co/7nNf0Ktf0M https://t.co/CIE9BnBFvx
Richard Conway RichardPAConway ( View Tweet)
Can we predict PsA incidence and prevalence trends?
Germany long-term projection 2040
3 scenarios:
1. increase 5%/yr
2. stable
3. decrease 5%/yr.
Best scenario (3) = peak diagnoses in 2028. Are medical resources ready for it?
https://t.co/ws87zDukuM
Abs#1019 #ACR22 @Rheumnow https://t.co/dqkfrag0w2
Aurelie Najm AurelieRheumo ( View Tweet)
Phase 1 data shows Ebdarokimab (IL12/23i) safe and well tolerated in moderate to severe plaque psoriasis patients. Abs 0752 #ACR22 @RheumNow https://t.co/QqTE4WJtDa https://t.co/eMaEurZAr0
Dr. Rachel Tate uptoTate ( View Tweet)
#abst1012 #acr22 @rheumnow CASIPSA Study of SI CT in 48 PsA pts vs 48 controls. Disease duration 22.87 ± 14.95 y, 43.48 %HLA-B27+. higher prevalences of erosion in PsA (18%) preferentially located on the anterior and middle regions of the SIJs https://t.co/4dtJNCKf4I
Olga Petryna DrPetryna ( View Tweet)
axPsA and AS adult pts exhibit different genetic risk factors & serum IL-17 levels. GUS demonstrated significant pharmacodynamic effects and clinical improvement in axPsA and non-axPsA pts. Abs 1038 #ACR22 @RheumNow https://t.co/9Rjw7usO8J
Dr. Rachel Tate uptoTate ( View Tweet)
JAK and TYK-2 inhibitors and indications in SpA:
● Tofacitinib ➣ Pan JAKi (AS, PsA)
● Baricitinib ➣ JAK1,2
● Upadacitinib ➣ JAK1 (AxSpA, PsA)
● Deucravacitinib ➣ TYK2 (PsA)
Carol Langford, Year in Review #ACR22 @RheumNow https://t.co/EMLEvptySS
Dr. Antoni Chan synovialjoints ( View Tweet)
Differences between #uveitis pattern in AS vs. PsA and IBD 👇
This is always asked to our rheum fellows during Kelley's hour 🤓
#ACR22 @RheumNow @rheumarhyme @trishiemd @RheumaRamblings @RheumaRambolMD https://t.co/gWxQ9xdb06
sheila RHEUMarampa ( View Tweet)
Across 9 trials of Upadacitinib in RA, PsA and AS, 40%–50% of patients had ≥ 2 CV risk factors, ≥ 65 years 6%–23%. Rates of adjudicated MACE and VTE with UPA were infrequent, consistent with background rates in RA, PsA, and AS Abst 0510 https://t.co/HDkQ6ELnAy #ACR22 @RheumNow https://t.co/SRJYdFFNIQ
Dr. Antoni Chan synovialjoints ( View Tweet)
In this study, Dr. Niti Goel shows the under-reporting of race & ethnicity in publications of #psoriaticarthritis clinical trials
🧐Participant diversity is important to consider since different races & ethnicities may respond differently to therapies
#ACR22 @RheumNow ABST0090 https://t.co/BzHpuHYVI5
sheila RHEUMarampa ( View Tweet)
Post hoc analysis from the SELECT-PsA 1 trial by Dr. @DrLauraCoates and team:
💊Pts on UPA showed greater improvement from BL in RAPID3 vs. ADA in all visits
💊Pts on UPA had better responses in all assessments vs. PBO
Reassuring data. #ACR22 @RheumNow ABST0192 https://t.co/NgeUU5bPPf
sheila RHEUMarampa ( View Tweet)
🤕 Late onset PsA associated with
⬆️ structural damage
💪🏻UL > LL arthritis
⬆️ BASFI
🙋♂️ males
⬇️ enthesitis/ sacroilitis
Abst# 0377
#ACR22 @RheumNow
Patricia Harkins DrTrishHarkins ( View Tweet)
What’s new to treat PsA? Let’s discuss anti-IL-17A, Izokibep #ACR22 @RheumNow
Abstract #0199
💪 Izokibep 40 v. 80 mg q2 weeks SQ v. placebo
💪 135 patients, 28 sites
💪 At 12 weeks, all patient reported outcomes and PsAID subdomains significantly improved (dose dependent)
Catherine Sims, MD DrCassySims ( View Tweet)
Clinical pearl! Patient-reported treatment success in PsA assoc'd w/ control of arthritis, dactylitis, psoriasis, and health-related QoL. Top 3 pt-reported reasons for tx failure were pain, psoriasis and fatigue. Abs0393 #ACR22 @RheumNow https://t.co/F9RNI7EXcL https://t.co/7DcLaqUqnm
Dr. Rachel Tate uptoTate ( View Tweet)
