Dermatology

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Predicting Psoriatic Arthritis in Psoriasis: How Close Are We?

Nelly Ziade

Psoriatic arthritis (PsA) affects approximately 30% of patients with psoriasis (PsO), and diagnostic delays are associated with worse prognosis, making early detection crucial. At EULAR 2025, several studies highlighted progress in prediction strategies. Here's my review of three of them.

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#Enpatoran a #TLRi in Phase2 #SLE #RCT -previous data + small #cutaneous #lupus study various doses &PBO approx 25/group Interesting data - seems to ⬇️#IFN + endpoints 👀 for more to come! Safe so far #EULAR2025 @RheumNow @eular_org LateBreaking I https://t.co/OtgiasBerX

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Janet Pope @Janetbirdope( View Tweet )
Sacroiliac joint involvement in #Psoriatic_arthritis 🔹️681 patients 🔹️Age 45 🔹️31% MRI-positive sacroiliitis 🔹️29% radiographic sacroiliitis 🔹️AxPsS associated with: peripheral arthritis, dactylitis, nail psoriasis POS0297 #EULAR2025 @RheumNow https://t.co/gKANc6mNZB

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
Tips for Dx RP: 1. Suspect the dx and recognize chondritis. 2. Rule out mimickers 3.Tracheal involvement shows swelling>stenosis (helps ≠from GCA) 4. CV, heme, derm manifestations 🧐VEXAS. 5. biopsy not useful unless ≠ from GCA. Fantastic session by @Lupusreference https://t.co/W4DgfeRULF

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Adela Castro @AdelaCastro222( View Tweet )
Using high-resolution peripheral quantitative computed tomography (HR-pQCT), patients with psoriatic arthritis (PsA) & psoriasis (PsO) show reduced cortical volumetric bone mineral density (vBMD) & thinner cortex vs controls. Bone mechanics impaired: reduced stiffness & failure https://t.co/ghH2cwOYJc

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
A machine learning (ML) model using electronic medical record (EMR) data from 396,000 Mayo Clinic primary care patients identified undiagnosed psoriatic arthritis (PsA) with area under the curve (AUC) 79.6%. Key predictors: psoriasis, joint pain, tenosynovitis, https://t.co/VsYevnJEjK

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#digital #ulcers in #scleroderma🎯 Retrospective #iloprost vs #selexipag 👇 BIG advantage of oral #prostacyclin receptor #agonist vs iloprost healing faster ⬇️ulcers Selexipag used in iloprost failures; ⬇️IV access WOW! RCT needed #OP035 #EULAR2025 @RheumNow @eular_org https://t.co/6y9LwIlQkd

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Janet Pope @Janetbirdope( View Tweet )
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Predictors and Outcomes in Systemic Sclerosis

EurekAlert!

The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will fulfil the 2013 ACR/EULAR SSc criteria within 5 years.

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IL17

Expanding the IL-17 Therapeutic Landscape

Adela Castro, MD

IL-17 inhibitors are an effective therapeutic for a broad spectrum of inflammatory and autoimmune diseases and its blockade has revolutionized management of diseases such as psoriasis, psoriatic arthritis and SpA. Is there a need for more medications within the same therapeutic class?

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Prédiction of PsA from PsO. Stockholm cohort, n=672): •PsA incidence 21.1/1000 PY. •AUC 0.80 for both referral and prognostic models. •Predictors: HLA-B27, uveitis, enthesial pain, TJC, hsCRP, BMI, SAA, GlycA. •Early identification feasible. Abstract OP0178 @RheumNow https://t.co/dxdChN6VZy

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
OP0179: In a psoriasis cohort, 68% of PsA onset sites showed prior subclinical inflammation (26% tender, 32% US+, 42% both). Should we redefine when PsA truly begins? @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

Data from Dutch registry SpA-Net explored prevalence using new definitions for D2M axSpA. -Smoking and psoriasis were characteristics associated with D2M disease. -In the three variations explored, the lowest prevalence was observed in the variation based purely on objective https://t.co/h3f4ORQl0F

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Adela Castro @AdelaCastro222( View Tweet )
Delighted to present the @bmsnews data on #scleroderma #eular2025. Breakfree-1 data showing CAR-T is well tolerated with beneficial effects on skin and FVC and composite endpoint, the revised CRISS. https://t.co/E5jlYYHowM

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Dr. Dinesh Khanna @sclerodermaUM( View Tweet )
Target trial emulation study data from British Dermatologists Biologics & Immunomodulators Register, compared 231 PSO Rx w/ MTX + Adalimumab against 1553 PSO on ADA. @1Yr MTX did not augment ADA only responses based on Rx survival (79% vs 78%) or PASI75 (49% vs 52%). https://t.co/Lrpuhfarsb
Dr. John Cush @RheumNow( View Tweet )
Global incidence of alopecia areata increased betw 1990 - 2021; from 20.43 million (19.77-21.09 million) in 1990 to 30.89 million in 2021 ( range of 29.95-31.82 million) - highest in USA 550/100,000. High in N.America, S.America, Southeast Asia, Australia. Lowestin Africa, Middle https://t.co/GxrZPY5NBc
Dr. John Cush @RheumNow( View Tweet )
Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/3RbDFVtJR5

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Dr. John Cush @RheumNow( View Tweet )
Target trial emulation study data from British Dermatologists Biologics & Immunomodulators Register, compared 231 PSO Rx w/ MTX + Adalimumab against 1553 PSO on ADA. @1Yr MTX did not augment ADA only responses based on Rx survival (79% vs 78%) or PASI75 (49% vs 52%). https://t.co/DSYNd9P5Om
Dr. John Cush @RheumNow( View Tweet )
Global incidence of alopecia areata increased betw 1990 - 2021; from 20.43 million (19.77-21.09 million) in 1990 to 30.89 million in 2021 ( range of 29.95-31.82 million) - highest in USA 550/100,000. High in N.America, S.America, Southeast Asia, Australia. Lowestin Africa, Middle https://t.co/d3WA3CRFRC
Dr. John Cush @RheumNow( View Tweet )
Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/pBo1IDe8pQ

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Dr. John Cush @RheumNow( View Tweet )
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Should You Add MTX to a TNF Inhibitor in Psoriasis?

Jack Cush, MD

Target emulation trial shows adding methotrexate (MTX) to adalimumab (ADA) does not augment the effectiveness and persistence of adalimumab alone in treating plaque psoriasis in adults. 

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IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/2sIgMYK7xo
Dr. John Cush @RheumNow( View Tweet )
PPACMAN Consensus Recs. for CV risk in PSO/PSA published for Rheums/Derms/PCPs - check BP, Wt, Lipids, Cr. - Look for HTN, DM, smoking, obesity, metabolic synd. - Risk stratify w/ hsCRP, Lipids - Lifestyle management https://t.co/MkgYopTNAX https://t.co/6yyxVIxpC0

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Dr. John Cush @RheumNow( View Tweet )
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Belimumab in SLE with Mucocutaneous or Vasculitis Findings

Jack Cush, MD

A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.

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2025 ACR Guideline for the Treatment of SLE

Jack Cush, MD

The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. 

Overall, the goals of SLE management are to achieve remission or a low level disease activity, reduce

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Lupus Clinical Slides: Set 1 https://t.co/zFQqHfl8Ch https://t.co/kvVNAS17ec

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

Laura Coates
heel enthesitis spur calcaneal

With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

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Pain in Psoriatic Arthritis

Philip Mease, MD
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Pain is typically ranked by both patients and physicians as the most important symptom of psoriatic arthritis (PsA) to assess and treat. Although the predominant concept of the etiology of pain in PsA is that of inflammation in peripheral joints, entheses, and bone signaling through peripheral nociceptive fibers, perceived as pain in the central nervous system, it is actually more complex than that. The ability of a treatment to ameliorate pain is one of the principle measures of its effectiveness. Thus pain improvement or worsening are key determinants of shared decision making about treatment in PsA.  Read Post
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