ACR 2025 PsA Topic Podcasts Compilation 6 Save

This is an ACR twenty twenty five podcast coming to you from Chicago. Hope you enjoy it.

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Hi, everyone. My name is Brian Jaros, and we are coming to you live here from ACR 2025.

Hi, my name is Doctor. Elaine Husney. I'm a rheumatologist from the Cleveland Clinic, and Brian and I are gonna kick off with, From Pain to Wellness in psoriatic arthritis.

Yeah, so this was a topic I was really excited to talk about. You'll hear definitely a lot during this conference about the new, therapeutics, biologics that we have in this disease state, which is definitely exciting, but I think this topic explores other questions of how do we comprehensively or holistically treat these patients with psoriatic arthritis outside of just the medications that we're giving them. So to kick us off, Elaine's gonna tell us about abstract number 2,327. This is persistent pain in psoriatic arthritis, a distinct phenotype of depression, fatigue, and catastrophizing.

Yes, thanks Brian. This is a really, interesting, work done, at NYU. They have a great combined psoriasis psoriatic arthritis, clinic. This, is an abstract with, Rebecca Haberman who's talking about, pain in psoriatic diseases. So they recruited about 91 patients, and they split them up into three groups.

So this is commonly the groups that we see, right? Patient, with active PSA, a patient that has persistent pain but no swollen joints, and then a control group or those that are in remission. And interestingly what they found, they looked at many, many different patient reported outcomes. The ones that I thought was interesting was when they were comparing the persistent pain no swollen joint group versus remission, they found that they did have higher PROs related to catastrophizing pain, higher depression, not necessarily anxiety, higher fatigue, and overall just less quality of life unfortunately issues. And so what they found is that that was equal I believe to the active group.

The group that was having both tender and swollen joints and pain. So I think this really highlights that there are groups that we need to pay maybe closer attention to, right Brian? So perhaps even those with persistent pain, we need to really understand their quality of life and their measurements and maybe we can intervene early and really improve their overall quality of life.

I completely agree, and that is a very perfect segue to talking about what interventions do we have, what ways can we help these patients recognize them early and exactly improve these quality of life metrics that, of course, to patients, you know, are very meaningful. So now I'll bring us to abstract zero three seven one. This is lifestyle Coaching in Psoriatic Arthritis, Pilot Findings from an Online Coaching Program. Elaine will also tell us about this. This is a project she was intimately involved with.

So tell us how you came up with this and a little bit about the project.

Thanks so much for highlighting this. I think as we know, our keynote speaker was on wellness. Right? And so I think the issue of physician burnout and all these issues are all around us. But what can we do for our patients?

And so we have something called e coaching at the Cleveland Clinic, which just like it sounds, you know, we go to the patient. Right? We don't have to have them come make an appointment for a practitioner. We do this all through email. And these e coaches are well trained to connect with a patient and to see what they can do with their chronic illness.

So we have four pillars that we work with. The e coaches work on mindfulness, they work on exercise, they work on diet, as well as sleep. So in this particular abstract, we enrolled, just a little over 80, patients, 86 patients to be exact, and we they all had psoriatic, diseases and we looked at their patient reported outcomes before and after e coaching. And so e coaching is really just like it sounds. We connect with them by email at least twice a week is what has shown to be very helpful for the patients.

If you do it less than that, sometimes you don't get as good of a result. And we noticed that they had improvement in their self efficacy, improvement in their symptom management, and improvement in their medication management. So I think all of this is really good. They can work on whichever pillar they want. So if they have sleep issues, can focus on that.

If they have mindfulness issues, they can work on meditation. Or if they need to do all four, they can. But we go to them in the e coaching. So I'm hoping that, you know, maybe in a larger study, maybe in other institutions, that they will pick up on, you know, maybe the use of an e coach, which is really a low touch, you know, low cost alternative to really addressing some of those lifestyle pillars.

Definitely. And I imagine just thinking about the patients that I treat, a lot of them would be interested in this sort of platform. What was the reception that you've heard from patients about this experience and participating in e coaching?

Yeah. I think, you know, interestingly, there was a lot of overwhelming, like, yes. I wanna do this. And then I think when they got into it and saw that it was a little bit of homework, we felt a little bit of a pause. So I think we do have to set some expectations.

This is not like you can sign up and then all of these pillars will get miraculously better. Sure. So but we are able to slowly step by step, you know, help them through each of the pillars. And I think once they understand understand that, we did get, you know, over 90%, you know, satisfaction. But I think you bring up a really good point.

I don't think, it is something that is just a a one hit wonder once a week. Right? You really need to put in time, be consistent. Our project was over ten weeks.

I see. Okay. And it sounds like from your perspective, you think in terms of future directions, larger studies, larger cohorts of patients, is there anything else you see in kind of the wellness sphere of opportunities for improvement in psoriatic arthritis?

Great question. I think most people inherently want to get better. Right? They inherently want to address these lifestyle, but they just don't know how. So I don't think it's a matter of trying to convince people.

I don't think anyone's gonna say, I want less sleep. Right? So so I don't think we have to do that, but I think we have to do much better on how to get there.

Awesome. Awesome. Well, thank you so much for joining me today, Elaine. And that's all we have for today. We'll see you at the next video.

Thanks.

And I

think Jack has to, encourage us to say who's the pain and who's the wellness of our group. Right? So so we'll let the audience decide.

Take care, everybody.

Hello. I'm Anthony Chan reporting for RheumNow here at ACR twenty twenty five in Chicago. One of the questions that we need in a in psoriatic arthritis is head to head studies where we can compare the efficacy of biologics, with each other. And this is particularly so in the area after a patient has failed TNF inhibitor. And today, there was a late breaking abstract, which is l b zero six, which is a study that comes from Germany which addresses this question.

In this study, they studied patients who had failed TNF, and then they were either randomized to either having secukinumab or istakinumab. So the comparison was to see whether at the end of this study whether they had improvement in their health assessment questionnaire. The HACDI score was used as their primary outcome. And also they looked at other scores including joint counts. There were hundred and nineteen patients randomized equally one to one into either the sacrokinumab group or the istakinumab group.

All these patients met Casper criteria for PSA and the mean age was around 53 years. There were some patients who were had a higher body weight of greater than hundred kilogram, roughly about a third in both groups. And the features were were then analyzed section. These patients had the efficacy outcome, which is the primary outcome, which is the HAC DI. And at the end of twenty eight weeks, the patients who were randomised to sacukinumab, seven percent of them achieved the HAC DI compared to twenty seven percent in the istakinumab group.

The patients who are also in the secukinumab group also had better results in terms of their secondary outcomes, which were the joint counts, the pain scores, skin outcomes, and also the patient reported outcomes. These improvements were seen very early by week two and were sustained up to week twenty eight. There were no new safety signals for the secukinumab and histikenide groups other than what is known in previous studies, and these, were well tolerated. What I took away from this study, is three things. Firstly, that, there are differences in terms of choice of treatment in our patients, after TNF inhibitor.

Secondly, these changes can be very beneficial and meaningful for the patients in both in all the factors that affect these patients with psoriatic arthritis. And I think this study called, again, is one of the many studies now that we will see where we can look at more head to head comparisons between biologic drugs, especially in this group of patients who may have failed some of the other earlier treatments, either conventional synthetic or biologic DMARDs. I'm Anthony Chan reporting here for RheumNow, ACR twenty twenty five.

Hi, everyone. This is Aureli Nash from Glasgow, Scotland. We are day three of ACR twenty five in Chicago. As yesterday and the day before, very exciting, lots of science. And I have a very fresh poster from the late breaking abstracts poster tour.

It's l b zero zero eight presented by Philip Meese, and it's about isocubeb. So I don't know if you remember, but last year, our ACR, we saw the phase two results of this molecule. It's a small molecule, an affibody, which is targeting IL 17 a, so specific of IL 17 a. And the phase two in psoriatic arthritis was actually quite impressive. It showed in particular a very good results on anxiety scores, which according to the company that has it, because of the size of the affibody, it would be able to go more into the the tissues.

Well, that's not been demonstrated yet, but that was the idea behind it. And certainly, the phase three was long awaited, and so the results of the fifty two weeks were presented this time. And so there were three arms. There was a placebo arm. It was three fifty patients roughly.

Placebo arm. The drug one hundred and sixty milligram weekly and then every other week in two separate groups. And the primary outcome was the ACR 50 at sixteen weeks and then after sixteen weeks patients would crossover and those who got the placebo then got the active compound up to fifty two weeks. So the results are really good. Sixty percent sorry.

Fifty percent of patients with ACR fifty response at fifty two weeks, Minimal disease activity, fifty percent. ACR 70 between thirty five and forty percent depending on the group. And then PASI, hundred again, fifty five to sixty five percent. So very good. When it comes to anxieties though, because I was particularly curious about that.

So they had sixty percent of their baseline population with anxieties, but the leads anxiety scores were actually quite low. It was about two. And so they weren't really able to show the same signal. I spoke to the to the authors, and they were they seemed to be saying that in those people with the highest endositis scores, they seem to have a really high efficiency, but it's not something that was presented. And I guess we'll have to wait for the manuscript to be published to look specifically into that.

I would also be super keen to see if there are specific granularity in terms of phenotypes that seem to be responding better. But, again, for that, we'll have to to wait for the manuscript safety profile. Very similar to as a selective I s seventeen a. So low we we, you know, we don't find specifically the candidosis issues in this in this population with this inhibitor. A no new safety signal overall.

So definitely something to look forward to. Look into the manuscript and then see also, obviously, how that will compare in terms of efficacy to also IL seventeen inhibitor. Stay tuned on RheumNow for more content and follow me on Twitter at AureliRomo. See you later.

Good morning, everyone. I'm here at ACR Convergence twenty twenty five meeting in Chicago. This is day three. It's been a very exciting meeting, and I'm here with Doctor. Uta Kils from Germany.

She has a very interesting abstract where she is using an app to modify pain behavior in patients with axial spondyloarthritis. Welcome Uta.

Yeah, thank you for inviting me and giving this short presentation on my randomized controlled trial. So in this study we used a digital health application that can be prescribed in Germany via the normal health insurance system and this health app comprises the digital behavioral change technique approach and it consists of seven different educational sessions on pain, on chronicity of pain but also how to improve pain and pain interference with daily activity and the patient can follow, learn about it and then use self management strategies that they have been educated in the app to improve their health outcomes.

So in this study, you actually had two groups, one that did not use the app and one that used the app.

Correct.

It was a controlled study between the two groups. And so what did you find the results? What were the results?

Yeah, the results were very promising. So we used the primary endpoint as the pain related interference on daily activity in patients with actual SPA and we found a significant improvement in patients who used the app compared to the standard of care patients. Interestingly, and that was also our hypothesis, we used an intervention of twelve weeks. Our hypothesis was that the pain level itself is not changing over this short period of time and that was in fact the case. And I think that's really an important lesson to learn that not only pain is an important outcome but also pain related interference on daily activities and patients who used the app rated the app very favourable and also reported a global impression of change more frequently compared to patients who did not use the app.

That's wonderful news. For our patients in real world, how can we get hold of this app for them to use?

Yeah, at the moment, told you it's a commercially available app. It's in German language and it's commissioned in Germany. So I think this specific app cannot be used outside Germany at the moment. However, I think this construct of digital behavioral change technique is a technique that is open, available and can be applied to our actual SPA patients worldwide.

Thank you so much, that was amazing.

Thank you, it was a pleasure.