Functional MRI studies have been out there for a while, but mechanisms and significance underlying fMRI findings are unclear fMRI study in 38 active PsA pts w/ significant fatigue Altered functional connectivity between posterior insula to cerebellum & superior frontal gyrus https://t.co/3s9CJUg2uN

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Abstract 1421: PsA and 'Brain Fog' Pts w/ #PsA who did not achieve Minimal Disease Activity (MDA) had higher odds of subjective cognitive decline vs those with MDA 🔹 Fatigue, and to a lesser extent depression/anxiety, ↓ this associated risk @RheumNow #ACR25 https://t.co/RohwKJZDzp

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In the SERENA study (n=292), secukinumab reduced PsA incidence to 0.49/100 PY over 5 years in PsO patients with nail involvement, an ~82% drop vs historic non-biologic rates (2.7/100 PY). 98.3% remained PsA-free; PASI 90 achieved in 63%. Abstract#1463 @RheumNow #ACR25 https://t.co/ySOuFJiwge

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This study evaluated effectiveness of SEC in PsA prevention of a subgroup of pts from SELENA: PsO pts w/o PsA & nail dse (n=292) At 5 yrs: 🎯98.3% didn't develop PsA (yEAIR 0.49) 🎯 Sustained PASI, PGA 0/1 💡Longterm SEC effective for PsA prevention? #ACR25 @RheumNow Abs1463 https://t.co/t7P1Oerbrw

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In pooled analysis of 9 PsA trials, 6.9% of secukinumab-treated patients had fungal infections, mostly mild/moderate. Candida rates were low (1.86–2.18/100 PY) and didn’t increase over time. 89.7% resolved fully; only 0.8% led to discontinuation. Abstract 1459 @RheumNow #ACR25 https://t.co/kltMZVEDf9

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Mease et al. What agent to use after failure of first TNFi in PsA. Real world study, 320 patients. Switching to upadacitinib led to better joint responses than second TNFi or IL17i @RheumNow #ACR25 Abstr#1453 https://t.co/SQnN0skw7r

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Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ

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Kharouf et al. Effect of handedness on radiographic damage in PsA. Left-handedness associated increased peripheral damage, especially in left hand. Hypothesis that having to use tools designed for right-handedness increases mechanical stress @RheumNow #ACR25 Abstr#1415 https://t.co/gfGQkrYyc8

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I wouldn't sleep on this. 😴💤 Abstract 1413: In a PsA cohort, restless leg syndrome was linked to: 🔹 ↑ disease activity (polyarthritis, swollen joints, DAPSA) 🔹 Worse physical function (↑ HAQ) 🔹 Fatigue, anxiety, depression, & poorer sleep quality @RheumNow #ACR25

After At-risk RA, time to discuss At-risk PsA patients ARP-PsA Prospective cohort 1400+ pts 8.4% met ARP-PsA criteria (arthralgia + Fam Hx +Pso, not referred via Dermatology) Risk factors: Pso >15 years Pso + Family Hx US synovitis/enthesitis At 1 yr follow-up 30% progressed https://t.co/ZY2ezh8nZN

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Abstract 1431: Radiographic sacroiliitis in #PsA: insights from an Indian cohort - Cervical and lumbosacral spine syndesmophytes were common - Levels C5, C6, and L4 vertebrae frequently involved including syndesmophyte damage w/ non-marginal bridging @RheumNow #ACR25

Picture this 👉radiographic joint damage tied to worse physical function in #PsA: 🔹 ↑ mSS → ↑ HAQ (β=0.003 [0.002–0.004]) 🔹 ↑ mSS → ↓ SF-36 PF (β=−0.10 [−0.15 to −0.05]) 🔹 ↑ # of damaged joints → worse physical function @RheumNow #ACR25 Abstract 1425

Abstrat 1414 Compared to #PsO, early #PsA showed: 🔹 ↑ Dactylitis (66%), Enthesitis (78%), CRP/ESR 🔹 Longer morning stiffness & ↑TJC/SJC 🔹 MRI/US: frequent tenosynovitis & bone changes 🔹 Predictive model combining these features showed Sens 89%, Spec 84% @RheumNow #ACR25