ACR 2025 PsA Topic Podcasts Compilation 3 Save

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

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Hi, my name is Akhil Sood reporting for RheumNow. In psoriatic arthritis, we often think about disease control across several domains, including the skin, the tendons, and the joints. Over the last few decades, we've seen an explosion of biologic and targeted therapies, including many that have been highlighted here at ACTR twenty five. What about brain fog, a symptom many of our patients often complain of, in psoriatic arthritis? Abstract fourteen twenty one takes a closer look at this approach.

Using data from a large national registry of patients with psoriatic arthritis or spondyloarthritis, investigators examined the relationship between disease activity and brain fog. They focused on a known target treatment called minimal disease activity. This includes number of tender or swollen joints, limited skin involvement, and tendon involvement. And it looks at patient reported outcomes including their assessment of disease activity, functional status, and pain. So what do they find?

Patients who did not achieve minimal disease activity had a significantly higher odds of brain fog, and this relationship seemed to be partly explained by fatigue, depression, and anxiety. So what's the takeaway? While brain fog is a patient reported outcome, it may be linked to disease activity and mental health factors. So next time you're assessing a patient with psoriatic arthritis and active disease, consider asking about their brain fog. It may give clues to the underlying disease activity.

This is Ecclesioude reporting for RheumNow. Thank you.

Hi. I'm Anthony Chan reporting here from ACR twenty five in Chicago. And today, want to share with you a very interesting, poster, an abstract which is number O eight four nine, which looks at the, risk of cardiovascular deaths and mortality, with the use of GLP one receptor agonist in psoriatic arthritis. This was the retrospective analysis looking at a significant number of patients with psoriatic arthritis who also was started on GLP one receptor agonist for treatment of their comorbidity, namely type two diabetes. We know that these GLP one receptor agonists, drugs such as semaglutide and liraglutide, have been known to, not only reduce weight, but also to have a protective effect in terms of cardiovascular and renal protection.

The purpose of this study was to see whether it could also translate to reducing cardiovascular risk in patients with psoriatic arthritis. As we know, our patients with psoriatic arthritis have an increased risk of cardiovascular deaths and mortality. So this was a design where they used the TriNetX data where they had four thousand over patients with PSA who were on GLP one receptor agonist and around eighty six thousand patients who were not on GLP one receptor agonist. They matched the patient using a one to one propensity score matching on demographics, diagnosis, medications. And the outcome were major cardiovascular events or MACE and also all cause mortality.

The after matching, the results were that the GLP one receptor agonist patients who on this treatment had lower risk of MACE and also had lower risk of overall mortality compared to those who were not on the treatment. The demographic showed that those who are on GLP one receptor agonist, they tended to be slightly older, and also there were more females who are on this treatment, compared to those who are not on the GLP one agonist. The population was predominantly white patients in both groups. The limitations are obviously based on the study was the coding of these patients that they obviously were based on a database, from TriNetX, so there's potentially, there could be potential coding errors in this, and this was highlighted in the presentation today. I think this is an interesting, presentation because we have been looking into how GLP one receptor agonist may offer protective cardiovascular survival benefits in our patients with psoriatic arthritis, especially those patients who have the concurrent comorbidities, namely obesity and also type two diabetes.

What this study shows today is that there's potentially a potential role for not only management of inflammation in psoriatic arthritis, but also management of the metabolic phenomenon that also happens together in these patients with psoriatic arthritis. So I think further research certainly would be, important firstly to understand the mechanisms behind the metabolic and also inflammatory and vascular, connection between these mechanisms. And secondly, to study how this long term comorbidity, can be reduced by the use of, GLP one receptor agonist. I'm Anthony Chan reporting here for, RheumNow in ACR twenty five in Chicago.

Hi, I'm Doctor. Elaine Husney. I'm here at the RheumNow booth and excited to welcome you again to day two of ACR twenty twenty five convergence. I am leading with a group of people on interesting psoriatic arthritis topics at the meeting. I'm going to go over specifically abstract number fourteen twenty six, and I find this really interesting.

It's called understanding the drivers of PASDAI back pain scores in psoriatic arthritis patients. So as you know, PASDAI, very commonly used, very easy to use. Many of us use this in clinic It's one of the most common tools for assessing back pain. What's interesting is that five out of the six questions are pretty focused on general health measures over specific axial measures. And so this raises some concerns about what this tool is actually measuring.

And in psoriatic arthritis, where we are trying to pick up patients early with axial involvement because it does have implications for treatment, BasDi is commonly used. So in this particular study, they aim to evaluate the utility of VASDY in a observational cohort of psoriatic arthritis patients. So there was quite a big number, about ten fifty nine patients that got VASDY every six months was used in this cohort and the items in their conclusion that influenced PASDAI scores included age, sex, peripheral joints, and skin disease regardless of their axial symptoms. It makes you wonder how accurately does BasDye reflect the axial component of psoriatic arthritis. I think this abstract to me was interesting to note to kind of remind us about the components of BasDye and maybe there is some room to improve in thinking about a more precise or accurate scoring system that can be used to pick up axial disease earlier in psoriatic arthritis.

Hi, everyone. This is Aurelie Naj from Glasgow reporting live from ACR twenty twenty five in Chicago. We are day two. It's been an absolute joy to move around through the poster hole and go from session to session. And there's one poster that caught my attention today, and it's about handedness, dominant hand, and PSA.

And why is it that interesting for me? Because usually we know very well that biomechanic stress can be involved in disease activity, joint damage in psoriatic arthritis in particular, And we often ask patients, at least I do often in my clinics, I say, hey, you know, what is your dominant hand? And usually you find more disease activity there, but is this also associated with more joint damage? So, this poster was number 1415, fourteen fifteen. And it was looking at a cohort of patients.

So, it was a prospective PSA cohort from international cohorts, three 59 patients and they were able to look at what their dominant hand was and it was self reported and as you expect, it was roughly ninety percent of right hand dominant people and about ten percent of left hand. Those who were left handed interestingly were older, had a longer PSA duration and a higher BMI. I'm not so sure why and they were not really able to explain that either but certainly what they did when they did their linear mixed model analysis, they did account for these differences in the two groups in the first place. The other thing that I found quite interesting is that they looked at x rays and decided to score for damage but they didn't use the modified Sharpe score. They used the modified Steine Broker score which is easier but it might be less sensitive.

So anyway, what they found is that left handedness is associated overall with the worst prognosis after having adjusted on the variables that were described earlier, which I found quite interesting, but also that left handed people had worse erosion scores on both hands, which also was quite interesting, but in particular in the left hand and the association between being left handed or know handedness and damage was higher, was stronger in the people with left handed situation, which was the explanation they gave was, you know, interesting. So, it could be more mechanical stress due to less things in life being made for left handed people, in particular tools, and so it could be that, or it could be also a different thing. It could be a confounder that we've missed, or it could be the fact that also they did not use the Sharpe score and so maybe they missed some damage or association using this score. And finally, the last thing that I wanted to say is that this has not been reproduced in any other cohort. So this is something definitely to look into, that's quite interesting.

And also how can we prevent this as a consequence is something I'd be quite keen to look more into. Anyways, I'm gonna let you go now and invite you to join RheumNow. Have a look at the website and follow me on Twitter orilyromo. See you around.