Dietary Interventions in PsA Save
Dr. Peter Nash reports on several abstracts at the 2026 EULAR meeting in London, including: OP069; OP070 and POS0050.
Transcription
Peter Nash reporting for RheumNow, EULAR London 2026. This is another interesting PsA abstract further to the one I previously presented. OPO70, led by Leehya, took patients with moderately active PsA — their BMIs were between 25 and 40, a lot of them quite heavy, over 30 to 34 — stable on treatment, many on a biologic, and they either got a Mediterranean diet or a weight loss diet or standard of care with some leaflets about diet.
And guess what happened at 24 weeks? The patients nearly all lost weight. There wasn't any difference between the different diets, but their disease activity improved significantly just by losing weight. And by week 12, they improved MDA, they improved PASDAS scores. And the amount lost was proportional to the clinical improved outcomes. So the first abstract talked about weight reduction and the BMI predicted who'd respond. This abstract talks about weight loss.
Then we move to another couple of abstracts that looked at the GLP-1 agonists. OPO69, Laura Coates. We've now seen the TOGETHER study published and reported — the IL-17 inhibitor ixekizumab combined with the GLP-1 agonist tirzepatide compared with ixekizumab alone — and they had significant improvements in outcome: ACR50 plus PSACI 100 in those patients that were on the combination, and the weight loss was significant and made a difference to outcome, particularly pain and function.
And then there were two real-world studies. One, POS50, by Venerto, which looked at the same combination but in a real-life study with propensity score matching. So they took a small number of patients and started them on a biologic plus the GLP-1 agonist and matched them with patients who were just starting the biologic, and again the outcome was significantly improved if you started the weight loss drug. And there was another small study that looked at the same thing.
Rheumatologists need to get on board with these drugs, learn how to use them, take them back off the endocrinologists and the weight loss doctors, and act to start the first script and talk all your patients with a BMI over 30 into, in a short period of time — maybe 6 months — losing 10 or 15 kilos. If it's unaffordable, then stop and try and fight to keep the weight off. Many people are now microdosing to keep the weight off.
And guess what happened at 24 weeks? The patients nearly all lost weight. There wasn't any difference between the different diets, but their disease activity improved significantly just by losing weight. And by week 12, they improved MDA, they improved PASDAS scores. And the amount lost was proportional to the clinical improved outcomes. So the first abstract talked about weight reduction and the BMI predicted who'd respond. This abstract talks about weight loss.
Then we move to another couple of abstracts that looked at the GLP-1 agonists. OPO69, Laura Coates. We've now seen the TOGETHER study published and reported — the IL-17 inhibitor ixekizumab combined with the GLP-1 agonist tirzepatide compared with ixekizumab alone — and they had significant improvements in outcome: ACR50 plus PSACI 100 in those patients that were on the combination, and the weight loss was significant and made a difference to outcome, particularly pain and function.
And then there were two real-world studies. One, POS50, by Venerto, which looked at the same combination but in a real-life study with propensity score matching. So they took a small number of patients and started them on a biologic plus the GLP-1 agonist and matched them with patients who were just starting the biologic, and again the outcome was significantly improved if you started the weight loss drug. And there was another small study that looked at the same thing.
Rheumatologists need to get on board with these drugs, learn how to use them, take them back off the endocrinologists and the weight loss doctors, and act to start the first script and talk all your patients with a BMI over 30 into, in a short period of time — maybe 6 months — losing 10 or 15 kilos. If it's unaffordable, then stop and try and fight to keep the weight off. Many people are now microdosing to keep the weight off.
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