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Are TYK2 inhibitors ‘ticked’ to be part of the JAK family?
Are TYK2 inhibitors JAK inhibitors? Are they effective in PsA? Are they safer than JAKi? Read on to learn more.
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Updates in Psoriatic Arthritis at EULAR 2022
At EULAR 2022, I look forward to key topics and presentations in psoriatic arthritis (PsA). Here's a preview of nine studies I'm particularly interested in at this meeting.
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Kading et al reports axial disease in 1/3 of patients with PsA, 55% females, 45% HLA-B27+, in 20% there was spinal but no SI joint involvement. Starts to define the Axial PsA patient as more female, less HLA-B27+ and may have only spinal inflammation #EULAR2022 @RheumNow OP0026
Dr. Antoni Chan synovialjoints ( View Tweet)
Important to capture MDA in the first year! Failure to achieve MDA in 1st year after PsA diagnosis associated with worse quality of life persisting despite intensified treatment.
@RheumNow #EULAR2022 ABST#OP0028 https://t.co/FrO569J10S
Robert B Chao, MD doctorRBC ( View Tweet)
No longer a "seronegative" disease?
Serological collagen biomarkers (degradation markers of type I and VI collagen) can differentiate PsO pts from PsA.
Potential biomarkers of MSK involvement?
@RheumNow #EULAR2022 ABST#OP0031 https://t.co/vS6mD5PUxw
Robert B Chao, MD doctorRBC ( View Tweet)
6 psoriatic disease specific risk factors associated with incident cardiovascular events in PsA/PsO patients: PsO area, TJC, SJC, HAQ score, ESR, daily use of NSAIDs
@RheumNow #EULAR2022 #ABSTOP0030
Robert B Chao, MD doctorRBC ( View Tweet)
Do biomarkers correlate with change in disease activity in #PsA? Esp IL17F not so much other IL17s, and IL6, IL23. Ian McInnes ? next steps 🤷♀️ to separate responder and non responder @RheumNow #EULAR2022 OP0024 https://t.co/JMmENRa80t
Janet Pope Janetbirdope ( View Tweet)
Proton Rahman discusses #PsA and #fatigue ⬇️ in #Guselkumab RCTs. 2/3 of fatigue was explained by pt factors - pt global and pain, skin, joints, CRP, function drove the data. Ask pt and treat what is treatable.
#OP0025 @eular @RheumNow https://t.co/x4T6sPEi8o
Janet Pope Janetbirdope ( View Tweet)
Cdn cohort of #PsA and CV events - u risk factors were associated with MACE and NSAIDS ⬆️ risk and TNFi ⬇️risk and poor HAQ⬆️ risk. #OP0030 @RheumNow @eular_org Too small events, lipids often absent and spanning 30+ yrs.
Janet Pope Janetbirdope ( View Tweet)
AxSpA and AxPsA 2 sides of the same coin or 2 different diseases? Divergent IL-23i efficacy data seem to suggest the latest.
German GESPIC AxPsA cohort:
*More frequently 🚺
*Less frequently B27+
*20% isolated Ax involvement
@Rheumnow OP0026 #EULAR2022 https://t.co/FZP9nEyG7J
Aurelie Najm AurelieRheumo ( View Tweet)
More from the VITAL study Dr Costenbader @karen_kc123 et al. 5 year supplementation followed 2 year follow up. Vit D 2000iu ⬇️incident autoimmune disease 21%. RA, PMR, psoriasis trend towards reduction. No effect omega-3 @RheumNow #EULAR2022 OP0038 https://t.co/kbKqDhtN9z https://t.co/HcFXbweEPm
Links:
Richard Conway RichardPAConway ( View Tweet)
in case you're interesting in the causal diagram for the mediation modelling for this:
far from proven, but certainly does raise some questions about a potential advantage of IL-23 inhibitors in a crowded PsA market #EULAR2022 @RheumNow https://t.co/bSuE3tDHUO
David Liew drdavidliew ( View Tweet)
#What’sHot? Axial PsA cohort as some drugs seem to work differently in axPsA vs axSpA Less HLAB27+, less male, 17% isolated axial in PsA #OP0026 @RheumNow #EULAR2022 @eular_org https://t.co/I0azSymVrr
Janet Pope Janetbirdope ( View Tweet)
Minimal disease activity achivement by PsA domain over 2y, in guselkumab phase 3
Everyone goes on about skin efficacy with guselkumab, but pretty good early on for enthesitis & swollen joints too... has challenged my uninformed thinking!
POS1067 #EULAR2022 #IL23 @RheumNow https://t.co/chCWeFd05o
David Liew drdavidliew ( View Tweet)
🔜 Remission in PsA : the earlier the better ⏰
Dutch cohort (DEPAR) 300+pts
Failure to achieve MDA 1yr post diagnosis
🧨worst QoL yr 1️⃣2️⃣&3️⃣
🧨↗️bioDMARDs use over time
🧨no recovery
#OP0028 #EULAR2022 @RheumNow https://t.co/IS6ySIQvBP
Aurelie Najm AurelieRheumo ( View Tweet)
Can you train #dermatologists to do ultrasound to detect #PsA if pt has joint pain. POCUS of up to 3 painful joints. US ⬆️derm suspicion of PsA- but this is not feasible in busy offices and no reimbursement @RheumNow #EULAR2022 @eular_org OP0029 https://t.co/9a3gDgIBp0
Janet Pope Janetbirdope ( View Tweet)
How do we treat fatigue in our PsA patients? Guselkumab PsA trials showed systemic disease activity/function, joint manifestations, and skin involvement accounted for 62% of variability in fatigue. How do we account for the other 38%?
@RheumNow #EULAR2022 ABST#OP0025
Robert B Chao, MD doctorRBC ( View Tweet)
#Bestinclass #EULAR2022 #PsA @RheumNow #OP0027 #CVE #MACE with #Tofacitinib in #psoriatic #arthritis and #PsO with median 3 to 4 yrs Rx. 40% metabolic syndrome which is high. There was no comparison. As expected hose with ⬆️MACE risks had more outcomes. https://t.co/sTjFHsUxzi
Janet Pope Janetbirdope ( View Tweet)
Rahman et al. Factors associated with fatigue and its improvement in trials IL23i guselkumab. Disease activity/function (34%), joints (16%), skin (12%) but 38.5% of fatigue variability remains unexplained. @RheumNow #EULAR2022 OP0025 https://t.co/C08R0IWM3S https://t.co/QnCvPwEwKS
Links:
Richard Conway RichardPAConway ( View Tweet)
Musculoskeletal US used by dermatologists helped increasedspecificity of PsA detection, leading to fewer false suspicions of PsA earlier diagnosis of psoriatic arthritis.
@RheumNow #EULAR2022 ABST#OP0029
Robert B Chao, MD doctorRBC ( View Tweet)
