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Are we really treating Psoriatic disease if we only address active disease domains and T2T?

Rachel Tate, DO

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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Don’t be ‘ticked’: TYK2 is not a JAK!

Janet Pope, MD, MPH, FRCPC

Recently the FDA approved deucravacitinib, a highly selective TYK2 inhibitor for psoriasis. Trials are positive in psoriatic arthritis and a phase II study in SLE. What about the effects? Presentations from the ACR22 meeting may provide answers.

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“Hey PRESTO!” – Early identification of psoriatic arthritis

Patricia Harkins, MD

Despite a wealth of treatment options, a number of notable unmet needs remain in PsA, most notably the significant diagnostic delay that many patients endure. We are all aware that those with psoriatic skin disease are the most at risk cohort for PsA. Identifying patients with psoriasis who have, or are at increased risk of PsA, appears to be the low hanging fruit that we just can’t fully seem to grasp.

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Industry Abstract Previews of ACR 2022

Jack Cush, MD

The pharmaceutical companies have will showcase their featured clinical trials and abstracts at ACR 2022.  These are their best studies for you to review and evaluate as part of your to-do list.

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2022 EULAR Recommendations for Screening and Prophylaxis of Chronic and Opportunistic Infections

Jack Cush, MD

A EULAR Task force has developed recommendations for screening and prophylaxis of chronic and opportunistic infections in patients with autoimmune inflammatory rheumatic diseases (AIIRD).

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Women with Rheumatic Disease (11.4.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.  New regulatory decisions about JAK inhibitors and why do women with rheumatic diseases have unfair outcomes?

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EMA Crack Down on JAK Inhibitors

Jack Cush, MD

The European Medicines Agency’s (EMA's) safety committee (PRAC) has issued a recommendation that the use of oral JAK inhibitors (tofacitinib, baricitinib, upadacitinib and filgotinib) be limited to certain at-risk patients unless no other suitable treatment alternatives are available.

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🤕 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

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Dr. Rachel Tate uptoTate ( View Tweet)
Rates of MACE and VTE with upadacitinib were infrequent and consistent with background rates in RA, PsA and AS patients. Factors associated with MACE/VTE: age>65, HTN, DM, smoking, history CV event/VTE Abs#0510 @RheumNow #ACR22 https://t.co/AjtJF0p3QK
Robert B Chao, MD doctorRBC ( View Tweet)
Do you consider ttmt successful? Question Christeen et al. asked to 100+ PsA pts. 1/3 pts said no, they had > TJC, > SJC, > Pso & > dactylitis. Failure also w/: pain 24%, pso 15%, fatigue 12% and < ability to be active 9%. https://t.co/dQseCNSDBS Abstr #0393 #ACR22 @Rheumnow https://t.co/kGlmscsKL7

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Aurelie Najm AurelieRheumo ( View Tweet)
Interesting observation: Late-onset PsA assoc'd w/ male sex, greater structural damage, higher frequency of arthritis, and greater loss of functionality (BASFI). Interestingly, shorter time of symptom duration to dx. Abs 0377 #ACR22 @RheumNow https://t.co/m15c37FltD https://t.co/3LRy4Ltde6

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Dr. Rachel Tate uptoTate ( View Tweet)
So does PsA affect your capacity to work? DISCOVER-2 analysis: It’s presenteeism, not absenteeism which is the issue PsA pts drag themselves into work, but treating them helps them actually do their job. We need to fund more rheumatologists! ABST0509 @RADoctor #ACR22 @RheumNow https://t.co/Jnac6mV9O5
David Liew drdavidliew ( View Tweet)
@DiegoBenavent et al: Gender impacts disease outcomes in PsA and SpA. Women > BASDAI, >BASFI, > ASDAS, >ASDAS Hi, and > EQ-5D. Not so surprising considering higher ratio for Fibromyalgia in W ASDAS not asso w/ gender in AxSPA. https://t.co/kBxvAi5qZw Abstr #0381 #ACR22 @Rheumnow https://t.co/vxdtlKpT3l

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Aurelie Najm AurelieRheumo ( View Tweet)
Dr Scher shares his algorithm Rx for #PsA in clinical practice #acrreview #acr22 ⁦@RheumNow⁩ https://t.co/0xB1KwpfW7
TheDaoIndex KDAO2011 ( View Tweet)
Does #COVID19 #vaccine work in #psoriaticarthritis? @RheumNow #ACR22 Abstract #0389 🤚 HR for infection and hospitalization similar between controls and PsA after 2nd vaccination 🤚#Enbrel (OR 2.39) and #JAKi (OR 9.90) higher risk of infection and hospitalization

Catherine Sims, MD DrCassySims ( View Tweet)

Withdrawing IL17i will more likely cause a relapse, but pts will respond when reintroduced -Dr Scher #PsA @rheumnow #acr22 #acrreview https://t.co/FvWVuQGJda
TheDaoIndex KDAO2011 ( View Tweet)
Multinatinal cross-sectional survey of 2270 PsA pts shows despite comparable Dz duration, presentation, biologic use (54%), Women had worse QOL, more disability and work activity impairment (but less comorbidities) https://t.co/1KbDuxaMFf https://t.co/SsbSHQNsPV

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Dr. John Cush RheumNow ( View Tweet)
Celebrating my 10,000 followers on TikTok. @Rheum101 is where I make videos teaching rheumatology to the general public in 3 min bites. Topics include #SLE #Steroids #RA #ANA #RheumLabs #DMARDS #biologics #JAKi #osteoporosis #PsA and more #RheumEducation #NotMedicalAdvice https://t.co/WEXspp5v28
TheDaoIndex KDAO2011 ( View Tweet)
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