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Year in Review - Psoriatic Arthritis 2019

Major new insights into the treatment of psoriatic arthritis dominated the headlines during the past year, with a head-to-head trial comparing IL-17A inhibition with tumor necrosis factor blockade, another study considering whether methotrexate can improve outcomes with anti-TNF therapy in PsA, and an investigation into the effects of biologic therapy on bone.

Physical Activity Lowers Fracture Risk in Post-Menopausal Women

An analysis from the Women’s Health Initiative study shows that postmenopausal women who participate in vigorous physical activity have a statistically lower risk of total and site-specific fractures

EXCEED Study: Cosentyx Equals Humira in Psoriatic Arthritis

Novartis has announced the results of the EXCEED trial that pitted its IL-17 inhibitor, Cosentyx (secukinumab - SEC) against Humira (adalimumab - ADA) in patients with active psoriatic arthritis. The trial demonstrated that SEC was not non-inferior to ADA, but failed to meet its primary endpoint of superiority over ADA as far as drug efficacy.

Rinvoq (upadacitinib) Effective in Psoriatic Arthritis

Yesterday, AbbVie reported the top-line study results showing the efficacy of Rinvoq (upadacitinib - UPAD) adult patients with active psoriatic arthritis who previously had an inadequate response to a biologic DMARD.

RheumNow Podcast – Ghastly, Ghoulish News (10.31.19)

Dr. Jack Cush reviews recent journal articles and info bits from the past week on RheumNow.com. 

The Global Burden of Rheumatoid Arthritis 2017

The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) from 2017 analyzed the burden of rheumatoid arthritis (RA) for 195 countries between 1990 to 2017 and surmised that RA is a major global public health challenge, with increasing prevalence and incidence rates.

Outcomes in Juvenile Idiopathic Arthritis

Arthritis Research & Therapy reports on a prospective cohort of children with juvenile idiopathic arthritis (JIA) shows that the incidence has held steady at 12.8/100,000 children, but that the frequency uveitis and the need for orthopedic surgery has decreased in the last 20 years.

Frequent DMARD Discontinuations During Rheumatoid Pregnancies

A Canadian population-based study shows that pregnant women with rheumatoid arthritis (RA) frequently discontinue their DMARD medications, especially in the first trimester.

Psoriasis Risk Increased with TNF Inhibitors in Juveniles

Children with inflammatory diseases who were treated with tumor necrosis factor (TNF) inhibitors had a higher rate of incident psoriasis than those not exposed to these biologics, a single-center retrospective study found.

Methotrexate and the Risk of Lung Disease

Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.

Novel Inhibition of MSU Crystal Inflammation

Researchers from Washington State University have shown that inhibition of tumor growth factor-β (TGF-β)-activated kinase 1 (TAK1) can effectively downregulate inflammatory mediators and suppress inflammation caused by gout.

The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).
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