Psoriatic arthritis

A large prospective psoriatic arthritis (PsA) study examined the enthesitis outcomes when PsA patients received conventional (cDMARDs) or targeted disease-modifying antirheumatic drugs (tDMARDs) and showed an overall 86% response rates, regardless of the medication used.

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on RheumNow.com Ustekinumab (IL-12/23i) phase 2 study was successful in #SLE; but the phase 3 LOTUS study of 512 pts, UST was NOT superior to PBO (SRI-4 44% v 56%) at 1 year. Study was halted for lack of efficacy (but no safety concerns). https://bit.ly/3RvPzDm

Adding a corticosteroid shot to exercise therapy significantly improved symptoms of chronic Achilles tendinopathy, a 100-person randomized trial found.

With the recent publication of the third iteration of the GRAPPA Psoriatic Arthritis (PsA) treatment recommendations, it seems to be an auspicious time to reflect on some key considerations that arose during the development of the recommendations, as well as to look towards what the future may hold.

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

An interesting study in Lancet Rheumatology shows that psoriatic arthritis patients not responding to methotrexate alone can respond after adding or escalating adalimumab on top of methotrexate to reach minimal disease activity (MDA) response. 

Drug survival may be the best measure of efficacy and safety. A study of novel therapy durability (survival) in patients with RA, axial spondyloarthritis, PsA, and psoriasis shows that while all these drugs are approved for said conditions, drug survival varies by condition, suggesting an ongoing need for individualized treatment.

With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.

The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) treatment recommendations have been updated and the 2021 evidence-based guidance is rich in treatment recommendations based on the key disease "domains" - peripheral arthritis, axial disease, enthesitis, dactylitis, skin and nail psoriasis; with new PsA related domains uveitis and inflammatory bowel disease.

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

A pooled analyses of data from eight, phase 2 and 3 randomized clinical trials shows bimekizumab, a dual IL-17A/F inhibitor, to be effective in plaque psoriasis and was well tolerated aside from an increased incidence of mild to moderate oral candidiasis. 

POS0309 at EULAR 2022 highlighted both similarities and differences between our patients and ourselves when it comes to PsA disease and treatment strategies. 

The British Society of Rheumatology has published their updated 2022 recommendations for the use of biologics and targeted synthetic treatments in patients with psoriatic arthritis. These guidelines follow initial treatment with a single conventional systemic disease-modifying anti-rheumatic drug, typically methotrexate typically. They noted that up to 50% of people with PsA require biologic or targeted synthetic (b/ts)DMARD therapy. 

Bags are packed, ready to go, but wait there’s more abstracts to show. The big news today were the “late breaking” abstracts. This is usually a favorite session of many as this is where the newest of study data often is showcased.  Here are my favorite late-breakers from Day 4.