Psoriatic arthritis

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Early DMARD Initiation Benefits in Psoriatic Arthritis

Jack Cush, MD

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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❓️Is early intensive therapy with combination csDMARDs or TNFi superior to standard step care for the treatment of moderate to severe #psoriatic_arthritis? 🅰️ Yes 🔅Check out the SPEED RCT presented by @DrLauraCoates at #EULAR2025 OP0089 @RheumNow #Strategy

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Efficacy and safety of deucravacitinib up to week 52 in the POETYK PsA-2 study •ACR20 at W16: 54.2% (deucravacitinib) vs 39.4% (placebo), p=0.0002 •PASI75: 40.9% vs 15.4%, p<0.0001 •MDA: 25.6% vs 14.7%, p=0.0007 •FACIT-F: +2.5 vs +1.8 •SAE: 1.9% (low) TYK2 inhibition shows https://t.co/PLJytueZDt
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Sex differences in biologic response in PsA. DISCOVER-2 post hoc analysis showed: •Radiographic progression at Week ♂️: 2.22 units ♀️: 1.10 units •Early ACR-like response (cDAPSA LDA at 8wks) linked to less damage in men (0.39 vs 2.24) Women less likely to progress https://t.co/hvRxKTMJT5
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Early intensive therapy in PsA. STAMP RCT in early PsA: •ACR50 at 3mo: 43% (early secukinumab) vs 22% (SoC) •MDA at 3mo: 48% vs 25% •PASI90 at 3mo: 60% vs 22% By 12months: outcomes similar, but early secukinumab led to faster control and fewer therapy escalations. https://t.co/Mn0uW3cckf
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Can IL-17F signalling be modulated by treatment with TNFi? In PsA pts non responders to previous TNFi, there was increased expression of IL17F-related gene signature. Suggesting a potential mechanism for the consistent level of clinical response observed with BKZ. Abstract https://t.co/6r59MWZAE1
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Case series of 22 PsA pts treats w/ combination bioDMARDs & JAKi,TYK2i or APR IL17i + JAKi 10.5 PY = 1 mild infectious stomatitis IL23i + JAKi 3.7 PY = no AE IL-17i + TYK2i 8.5 PY = 2 mild upper respiratory infections IL-23i + TYK2i 8.3 PY = 2 mild URIs, 1 folliculitis TNFi + https://t.co/hxhTxmJpbN
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ICYMI: Combination treatments in Psoriatic Arthritis

Antoni Chan, MD, PhD

Despite the advances in the treatment of PsA with biologic (bDMARD) and targeted synthetic (tsDMARD), less than half of patients with this condition achieved remission or low disease activity. Combination DMARD treatment is often used in order to achieve remission or minimal disease activity.

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ICYMI: Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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Complex-to-Manage PsA: The GRAPPA Framework and Definition Dr. Nelly Ziade discusses abstract OP0175 presented at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/cyDUCGU6Pc https://t.co/jdsTEB3Rqw

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Assessment of Peripheral Arthritis in Spondyloarthritis Dr. Antoni Chan talks with Dr. Dafne Capelusnik about abstract POS0257 presented at the 2025 EULAR meeting in Barcelona. https://t.co/E6l6qvNnox https://t.co/gLbMjF406q

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GRAPPA vs. EULAR on Complex/Difficult-to-Manage Psoriatic Arthritis Following the establishment of formal definitions for Difficult-to-Treat Rheumatoid Arthritis (D2T RA) by EULAR and Difficult-to-Manage axial Spondyloarthritis (D2M axSpA) by ASAS, the “Difficult” framework has https://t.co/NYgivNRgUV
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HLA-B27 Testing in Practice

Jack Cush, MD

A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined.

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National Psoriasis Found. Consensus Defines On-Treatment Remission in Plaque Psoriasis as 0% BSA and MD global=0 for at least 6 months while on treatment. For both clinical practice and clinical trials. https://t.co/QJg0ZIQ5Mv https://t.co/0FnbFcpXQB

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Eular 2025 PsA Topic Panel https://t.co/wJ08aKGZfJ https://t.co/6OvkIeOT76

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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation

MedPage Today

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

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Difficult to Treat Psoriatic Arthritis Dr. Eric Ruderman shares his perspectives on data being presented at the 2025 EULAR meeting in Barcelona, Spain. https://t.co/AdKILLc12Y https://t.co/4pB0OH2Gup

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GRAPPA vs. EULAR on Complex/Difficult-to-Manage Psoriatic Arthritis

Nelly Ziade

The “Difficult” framework has now reached PsA. At EULAR 2025, two independent definitions were presented: one by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis and another by EULAR. This short review explores the similarities and differences between these definitions

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Secukinumab & Uveitis = Unclear? Post hoc study of 11 SEC RCTs finds lower uveitis risk in AxSpA (N 1980; SEC 150 1.29/100PYs vs 1.72/100PY in PBO), but not in PsA (N 2453; SEC 300 0.71/100PY vs  zero w/ placebo) https://t.co/Gv9HheBU7l https://t.co/SlnrLRwmmn

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Predicting Psoriatic Arthritis in Psoriasis: How Close Are We? 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 https://t.co/RLz1FoQxvc
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Expanding the IL-17 Therapeutic Landscape 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. https://t.co/Q7Thp1HJAL
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Putting IL17i into ‘focus’ for SpA-associated uveitis The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than https://t.co/AUEct0FxmU
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Psoriatic Arthritis: Hit hard and Early Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
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Trends and Innovations from Barcelona (6.20.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week.

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Deucravacitinib's Place in the PsA Treatment Algorithm? Dr. Eric Ruderman offers his perspective on where deucravacitinib will fit in the treatment algorithm and trials presented at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/6Ozrvr5IMt https://t.co/w7FJs4wir9

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Recent Blogs

Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis

Robert Chao, MD
heel enthesitis spur calcaneal
A colleague of mine once told me an interesting story of how her father, who was a doctor, misdiagnosed his wife with fibromyalgia when she actually had psoriatic arthritis with enthesitis all along. I would venture out and say that the average physician would have trouble evaluating enthesitis because even we, as rheumatologists do!  Read Post

Best of 2022: Toss of a Coin - How do You Choose PsA Medication?

M. Elaine Husni, MD, MPH
Coin toss
When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they?  Read Post
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