ICYMI: Five Takeaways in PsA/SpA at RNL 2024

Rachel Tate, DO

Apr 24, 2024 10:00 am

Editor's note: This article originally appeared February 20, 2024, and is being published again this week to coincide with our Tuesday Night Rheumatology RNL Replay on Spondyloarthritis Spectrum.

Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls.

Dr. Alexis Ogdie discussed ACR, GRAPPA, and EULAR guideline updates. In addition to shared decision making, she shared her mental decision tree which brings us to clinical pearl number one.

Clinical Pearl #1: https://psoriasisdecisionaid.com/decision is a fabulous decision aid that can help you determine next steps for your PsO/PsA patients. It will be updated again this year to reflect additional FDA approved medications.

Dr. Lihi Eder reminded us to recall personal inherent bias along with sex/gender disparities regarding the SpA patient journey.

Clinical Pearl #2: On average, women are diagnosed 2.3 years later than men (with SpA.) Additionally, women tend to have more visits to rheumatology to reach a formal diagnosis. Women tend to have higher pain scores with lower pain thresholds and are more likely to report “diffuse pain” compared to men.

Dr. Kevin Winthrop reviewed the ten-year Shingrix data during his lecture on JAKi.

Clinical Pearl #3: The 10-year Shingrix data showed continued humoral response in “normal” patients, with continued long-term efficacy (dropping only to the mid 70%) suggesting that we may need to boost these patients in the future. In terms of rheumatology patients, the efficacy does drop (more than in normal comparators) but needs to be formally evaluated.
Clinical Pearl #4: Dr. Winthrop instructs his patients to hold JAKi for one week after vaccinations.

Dr. Bruce Stober, dermatology, uses PO or topical JAKi in his patients.

Clinical Pearl #5: For those patients in rheumatology that have atopic dermatitis or facial/neck vitiligo, consider topical ruxolitinib as treatment.

These are just a few of the insightful clinical pearls I gleaned from #RNL2024. I would encourage you to take some time to replay the conference for more insights.