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Psoriatic arthritis

Psoriatic Arthritis and Pregnancy

Mar 20, 2023

At RheumNow Live this weekend, Dr. Christina Chambers, an epidemiologist at the University of California San Diego and the principal investigator of MotherToBaby Pregnancy Studies, reviewed the available data on psoriatic arthritis and pregnancy. There is little evidence at this time that

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@RheumNow's review of new drug approvals during 2022 at #RNL2023
Biosimilars are coming! Multiple adalimumab biosimilars this year - will we see a dramatic price difference? @RheumNow #RNL2023
Biosimilar to biosimilar switching of Infliximab , ⁦@RheumNow⁩ Kavanaugh #RNL2023 Communications is a key always. Discuss with your patient always, and show them the data.
Risk of adverse outcomes in PsA pregnancies More pre eclampsia More Cesarian section More preterms By Dr.Chambers #RNL2023 ⁦@RheumNow⁩
Dr. Eric Ruderman with an excellent review of the JAK/STAT pathway especially for PsA treatment @RheumNow #RNL2023
#RNL2023 Year in Review COMPLETE-PsA: DMARDs for PsA! LEF+MTX better than MTX alone, 78 total patients PASDAS at week 16: 59% for MTX+LEF vs 34% MTX+PBO More treatment discontinuations (10 vs 3) in combo group due to GI intolerance @RheumNow
Check out MothertoBaby fact sheets by the NIH and LactRX (by mother to baby) app for pregnancy, disease, and medications. Dr. C. Chambers highlighted this today at #RNL2023 @RheumNow
#RNL2023 Year in Review Male response better than female response in patients with PsA in SELECT-PsA evaluating UPA/ADA. More targeted studies needed @RheumNow
#RNL2023 Year in Review BE COMPLETE: P3 trial Bimekizumab for PsA in TNF inadequate responses at 16 weeks 160 mg BKZ SQ q4w vs PBO ACR50 43%, PBO 7% PASI 1000: BKZ 58.5% vs PBO 4.5% Safety: oral candidiasis: 2.6% BKZ vs PBO 0% @RheumNow
Talk to me about candidiasis. BKZ showed increased safety signals for candida infections. I fear infxns may be under reported (after approval and in use) if patients see other physicians for treatment vs their rheumatologist/derm. Thoughts on this signal? #RNL2023 @rheumnow
TYK2 in plaque psoriasis By Eric Ruderman #RNL2023 ⁦@RheumNow⁩ Safer? No lab monitoring And it works
TYK2 signalling Vs JAK signalling summary #RNL2023
Approach to pregnancy in patients with PsA , By Dr.Chambers #RNL2023 ⁦@RheumNow⁩
Prevalence of PsA in women of reproductive age, By Dr.Chambers #RNL2023 ⁦@RheumNow⁩
Dr. Laura Coates on PsA treatment: - Applying treat to target associated with better quality of life - low disease activity is a reasonable target Do you use PROs in managing your PsA pts? Perhaps we should @RheumNow #RNL2023
Why do PROs matter? @DrLauraCoates reviewed this slide regarding the increased survival curve in end-stage cancer patients when we monitor PROs. @RheumNow #RNL2023
29 pts w/PsA Sine Psoriasis: 16F/13M, mean age 45 yrs w/ PsA ~6.2 yrs. 54% had 1st-degree relatives with PsA. 66% had DIP arthritis, 39% polyarticular, 36% oligoarticular, 25% were axial. Nail findings seen in 89%, enthesitis 59%, dactylitis 62%
Preterm deliveries in PsA pregnancies were more pronounced with 1- first pregnancy. 2- Discontinuation of biologic prior to pregnancy. By Dr.Chambers #RNL2023 ⁦@RheumNow⁩
Neonatal outcomes: Small for gestational age more common with an Adjusted OR off 2.42 and statistically significant. By Dr.Chambers #RNL2023 ⁦@RheumNow⁩
Pregnancy and #PsA Risk of preterm delivery if ➡️first pregnancy ➡️biologic stopped pre-pregnancy Dr Chambers at #RNL2023
Why JAKinibs in PsA ?! By Eric Ruderman #RNL2023 ⁦@RheumNow⁩ Also inflammatory bowel disease and most recently Upadacitinib for crohns disease.
Jaks are every where in Psoriatic disease domains, By Eric Ruderman #RNL2023 ⁦@RheumNow⁩ Good news, especially with Updacitinib recently and Crohn’s disease ( full package).
⚠️Only 12-43% of #PsA patients achieved remission or very low disease activity From systematic review in RWE presented by @DrLauraCoates #RNL2023
Treat to target approach in PsA Systematic rev: 12-43% pts achieved target of very low disease activity or remission Pts and docs agree: remission is primary goal, but Low disease activity is acceptable alternative @DrLauraCoates at #RNL2023 @Rheumnow