Clinical Edge Journal Scan

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: No single first-line treatment for advanced hepatocellular carcinoma demonstrated superior outcomes across all measures, therefore treatment should be based on individual goals.

Major finding: Lenvatinib ranked highest for overall response rate for patients with advanced/unresectable HCC, followed by atezolizumab plus bevacizumab and nivolumab. For progression-free survival, the top-ranked treatments was atezolizumab + bevacizumab, followed by lenvatinib.

Study details: The data come from a meta-analysis of 27 randomized, controlled trials of first-line therapies for hepatocellular carcinoma. The treatments compared in the studies were Treatments compared were atezolizumab plus bevacizumab, brivanib, donafenib, dovitinib, FOLFOX4, lenvatinib, linifanib, nintedanib, nivolumab, sorafenib, sunitinib, vandetanib, 11 sorafenib combination therapies, and 3 other combination therapies. 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Han Y et al. World J. Gastroenterol. 2021 May 21. doi: 10.3748/wjg.v27.i19.2415.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: The EZ albumin-bilirubin (ALBI) score was significantly correlated with the original and more complex ALBI score as a biomarker of liver injury.

Major finding: The correlation coefficient of the EZ-ALBI score with the standard ALBI score was 0.965 (P < 0.001). In multivariate analysis, factors including EZ-ALBI grade 2 and 3 were independently associated with increased mortality.

Study details: The data come from 3,794 patients newly diagnosed with HCC who were prospectively enrolled in the study and later analyzed.

Disclosures: The study was supported by the Taipei Veterans General Hospital. The researchers had no financial conflicts to disclose.  

Source: Ho S-Y et al. Hepatol Res. 2021 May 26. doi:10.1111/hepr.13671.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

Key clinical point: Over a median follow-up of 36.7 months, safety and efficacy based on complications and rates of overall survival were not significantly different between hepatocellular carcinoma patients treated with radiofrequency ablation (RFA) and those treated with microwave ablation (MWA).

Major finding: Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%).

Study details: The data come from a retrospective study of 201 consecutive adult patients with hepatocellular carcinoma who underwent either radiofrequency ablation (150 patients) or microwave ablation (51 patients) at a single center between January 2012 and December 2016.

Disclosures: The study was supported by the Guangzhou Science and Technology Program and the Innovative Research Group Project of the National Natural Science Foundation of China.  The researchers had no financial conflicts to disclose.  

Source: Han X et al. Abdom Radiol. 2021 May 25. doi: 10.1007/s00261-021-03105-9.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

First is an article from Elshaarawy O et al. who looked at preoperative and postoperative models to evaluate postresection survival. Between December 2010 and January 2017, 120 patients who underwent resection with curative intent, were analyzed for survival, liver decompensation, and posthepatectomy liver failure (PHLF). It will come as no surprise that HCC recurrence following resection adversely affected survival (hazard ratio (HR) = 11.67, 95%CI: 4.19-32.52, P < 0.001). Also affecting survival were the preoperative MELD score [HR = 1.37, 95%CI: 1.16-1.62, P < 0.001] and grades A through C of the PHLF score. Significant independent predictors of postoperative liver decompensation were the preoperative MELD score >10 [odds ratio (OR) = 2.7, 95%CI: 1.2-5.7, P = 0.013], tumor diameter >5 cm (OR = 5.4, 95%CI: 2-14.8, P = 0.001) and duration of hospital stay (6. 8 days vs 11.26 days; OR = 2.5, 95%CI: 1.5-4.2, P = 0.001).

Next, Lei GY et al. undertook a retrospective study of 244 patients with HCC who underwent hepatic resection with curative intent between January 200 and December 2017. They found that the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%. Significant predictors of mortality Child-Pugh score (p < 0.001), intraoperative blood loss (P = 0.013), the 50-50 criteria for PHLF (P < 0.001) on postoperative day 5, and peak serum bilirubin >119 µmol/L (P = 0.007) on postoperative day 3. In these patients, the overall postoperative 90-day mortality rate for HCC patients after hepatic resection was 5.3%.

Taken together, these studies confirm that underlying liver function both before and after surgery is a key predictor of how well a patient is likely to do after curative-intent surgery. Excellent multidisciplinary care remains important for patient well-being.

Finally, for patients who are not candidates for liver resection, Han X et al. evaluated the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) in a retrospective study of 201 consecutive patients whose tumors were within Milan criteria, but were in challenging locations for resection. RFA was performed in 150 patients, while 51 patients underwent MWA between January 2012 and December 2016.  Median follow-up was 36.7 months. Cumulative overall survival rates at 1, 3, and 5 years were 97.9%, 92.3%, and 80.6%, respectively, for MWA patients and 96.4%, 87.4%, and 78.2%, respectively, for RFA patients (P = 0.450).  Major complication rates also were similar between the two groups (3.3% vs. 3.9%). The authors concluded that both procedures are equally safe and effective in patients with HCC.

Key clinical point: Psoriatic arthritis (PsA) adversely affected maternal outcomes in pregnant women; however, there was no adverse effect on neonatal outcomes.

Major finding: The risk for cesarean delivery (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.27-1.66), preterm birth (OR, 1.48; 95% CI, 1.24-1.78), preeclampsia (OR, 1.45; 95% CI, 1.13-1.85), and gestational hypertension (OR, 1.49; 95% CI, 1.09-2.06) was significantly higher in pregnant women with PsA vs. general population. However, no statistically increased risk for fetal complications was observed in women with PsA.

Study details: Findings are from a meta-analysis of 16 observational studies including more than 46,909 cases of psoriasis/PsA with over 53,541 pregnancies and more than 4,771,352 healthy controls with over 8,044,996 pregnancies.

Disclosures: This study was funded by the National Natural Science Foundation of China. All authors declared no conflicts of interest.

Source: Xie W et al. Rheumatology (Oxford). 2021 Apr 20. doi: 10.1093/rheumatology/keab357.

Key clinical point: Psoriatic arthritis (PsA) adversely affected maternal outcomes in pregnant women; however, there was no adverse effect on neonatal outcomes.

Major finding: The risk for cesarean delivery (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.27-1.66), preterm birth (OR, 1.48; 95% CI, 1.24-1.78), preeclampsia (OR, 1.45; 95% CI, 1.13-1.85), and gestational hypertension (OR, 1.49; 95% CI, 1.09-2.06) was significantly higher in pregnant women with PsA vs. general population. However, no statistically increased risk for fetal complications was observed in women with PsA.

Study details: Findings are from a meta-analysis of 16 observational studies including more than 46,909 cases of psoriasis/PsA with over 53,541 pregnancies and more than 4,771,352 healthy controls with over 8,044,996 pregnancies.

Disclosures: This study was funded by the National Natural Science Foundation of China. All authors declared no conflicts of interest.

Source: Xie W et al. Rheumatology (Oxford). 2021 Apr 20. doi: 10.1093/rheumatology/keab357.

Key clinical point: Psoriatic arthritis (PsA) adversely affected maternal outcomes in pregnant women; however, there was no adverse effect on neonatal outcomes.

Major finding: The risk for cesarean delivery (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.27-1.66), preterm birth (OR, 1.48; 95% CI, 1.24-1.78), preeclampsia (OR, 1.45; 95% CI, 1.13-1.85), and gestational hypertension (OR, 1.49; 95% CI, 1.09-2.06) was significantly higher in pregnant women with PsA vs. general population. However, no statistically increased risk for fetal complications was observed in women with PsA.

Study details: Findings are from a meta-analysis of 16 observational studies including more than 46,909 cases of psoriasis/PsA with over 53,541 pregnancies and more than 4,771,352 healthy controls with over 8,044,996 pregnancies.

Disclosures: This study was funded by the National Natural Science Foundation of China. All authors declared no conflicts of interest.

Source: Xie W et al. Rheumatology (Oxford). 2021 Apr 20. doi: 10.1093/rheumatology/keab357.

Key clinical point: Joint tenderness showed poor association with imaging signs of inflammation in patients with psoriatic arthritis (PsA).

Major finding: Tender or swollen joint count showed no significant correlations with imaging inflammation sum-scores. Negligible to weak correlation (rho, −0.31 to 0.38) was observed between imaging inflammation sum-scores and the respective clinical joint counts, patient-reported outcomes, and composite scores with no consistently significant results.

Study details: This was a cross-sectional study of 41 patients with active PsA assessed by ultrasound and magnetic resonance imaging (MRI) for joint swelling.

Disclosures: The study was financially supported by AbbVie. Some of the authors reported receiving research grants, consulting fees, and speaker fees from various sources including AbbVie.

Source: Felbo SK et al. Rheumatology (Oxford). 2021 Apr 24. doi: 10.1093/rheumatology/keab384.

Key clinical point: Joint tenderness showed poor association with imaging signs of inflammation in patients with psoriatic arthritis (PsA).

Major finding: Tender or swollen joint count showed no significant correlations with imaging inflammation sum-scores. Negligible to weak correlation (rho, −0.31 to 0.38) was observed between imaging inflammation sum-scores and the respective clinical joint counts, patient-reported outcomes, and composite scores with no consistently significant results.

Study details: This was a cross-sectional study of 41 patients with active PsA assessed by ultrasound and magnetic resonance imaging (MRI) for joint swelling.

Disclosures: The study was financially supported by AbbVie. Some of the authors reported receiving research grants, consulting fees, and speaker fees from various sources including AbbVie.

Source: Felbo SK et al. Rheumatology (Oxford). 2021 Apr 24. doi: 10.1093/rheumatology/keab384.

Key clinical point: Joint tenderness showed poor association with imaging signs of inflammation in patients with psoriatic arthritis (PsA).

Major finding: Tender or swollen joint count showed no significant correlations with imaging inflammation sum-scores. Negligible to weak correlation (rho, −0.31 to 0.38) was observed between imaging inflammation sum-scores and the respective clinical joint counts, patient-reported outcomes, and composite scores with no consistently significant results.

Study details: This was a cross-sectional study of 41 patients with active PsA assessed by ultrasound and magnetic resonance imaging (MRI) for joint swelling.

Disclosures: The study was financially supported by AbbVie. Some of the authors reported receiving research grants, consulting fees, and speaker fees from various sources including AbbVie.

Source: Felbo SK et al. Rheumatology (Oxford). 2021 Apr 24. doi: 10.1093/rheumatology/keab384.

Key clinical point: In a cohort of at-risk patients with symptoms suggestive of coronary artery disease (CAD), the prevalence of coronary artery calcification (CAC) was higher in patients with psoriatic arthritis (PsA) compared with those without psoriasis or PsA.

Major finding: The prevalence of CAC score greater than 0 was significantly higher in patients with PsA vs. those without psoriasis or PsA (adjusted odds ratio, 1.28; 95% confidence interval, 1.00-1.64).

Study details: This was a cross-sectional study of 46,022 patient’s at-risk patients with symptoms suggestive of CAD from the Danish national computed tomography angiography registry, among which 1,356 had psoriasis, 370 had PsA whereas, 44,296 patients formed the reference nonpsoriasis/PsA cohort.

Disclosures: The study did not report any source of funding. No conflicts of interest were reported.

Source: Tinggaard AB et al. J Intern Med. 2021 May 12. doi: 10.1111/joim.13311.

Key clinical point: In a cohort of at-risk patients with symptoms suggestive of coronary artery disease (CAD), the prevalence of coronary artery calcification (CAC) was higher in patients with psoriatic arthritis (PsA) compared with those without psoriasis or PsA.

Major finding: The prevalence of CAC score greater than 0 was significantly higher in patients with PsA vs. those without psoriasis or PsA (adjusted odds ratio, 1.28; 95% confidence interval, 1.00-1.64).

Study details: This was a cross-sectional study of 46,022 patient’s at-risk patients with symptoms suggestive of CAD from the Danish national computed tomography angiography registry, among which 1,356 had psoriasis, 370 had PsA whereas, 44,296 patients formed the reference nonpsoriasis/PsA cohort.

Disclosures: The study did not report any source of funding. No conflicts of interest were reported.

Source: Tinggaard AB et al. J Intern Med. 2021 May 12. doi: 10.1111/joim.13311.

Key clinical point: In a cohort of at-risk patients with symptoms suggestive of coronary artery disease (CAD), the prevalence of coronary artery calcification (CAC) was higher in patients with psoriatic arthritis (PsA) compared with those without psoriasis or PsA.

Major finding: The prevalence of CAC score greater than 0 was significantly higher in patients with PsA vs. those without psoriasis or PsA (adjusted odds ratio, 1.28; 95% confidence interval, 1.00-1.64).

Study details: This was a cross-sectional study of 46,022 patient’s at-risk patients with symptoms suggestive of CAD from the Danish national computed tomography angiography registry, among which 1,356 had psoriasis, 370 had PsA whereas, 44,296 patients formed the reference nonpsoriasis/PsA cohort.

Disclosures: The study did not report any source of funding. No conflicts of interest were reported.

Source: Tinggaard AB et al. J Intern Med. 2021 May 12. doi: 10.1111/joim.13311.

Key clinical point: In patients with psoriasis or psoriatic arthritis (PsA), the risk for hospitalized serious infection was lower among those who initiated ustekinumab than other biologics and apremilast.

Major finding: Compared with ustekinumab, the risk for hospitalized serious infection was higher for adalimumab (combined weighted hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.34-2.06), apremilast (HR, 1.42; 95% CI, 1.02-1.96), certolizumab (HR, 1.09; 95% CI, 0.68-1.75), etanercept (HR, 1.39; 95% CI, 1.01-1.90), golimumab (HR, 1.74; 95% CI, 1.00-3.03), infliximab (HR, 2.92; 95% CI, 1.80-4.72), ixekizumab (HR, 2.98; 95% CI, 1.20-7.41), and secukinumab (HR, 1.84; 95% CI, 1.24-2.72).

Study details: Findings are from a population-based cohort study of 123,383 patients with psoriasis/PsA who initiated 1 among ustekinumab, adalimumab, apremilast, certolizumab, etanercept, golimumab, ixekizumab, or secukinumab between 2009 and 2018.

Disclosures: This study was sponsored by the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. SC Kim, RJ Desai, and JF Merola reported receiving research grants from and/or working as consultants/investigators for various sources. The remaining authors declared no conflicts of interest.

Source: Jin Y et al. Arthritis Care Res (Hoboken). 2021 May 10. doi: 10.1002/acr.24630.

Key clinical point: In patients with psoriasis or psoriatic arthritis (PsA), the risk for hospitalized serious infection was lower among those who initiated ustekinumab than other biologics and apremilast.

Major finding: Compared with ustekinumab, the risk for hospitalized serious infection was higher for adalimumab (combined weighted hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.34-2.06), apremilast (HR, 1.42; 95% CI, 1.02-1.96), certolizumab (HR, 1.09; 95% CI, 0.68-1.75), etanercept (HR, 1.39; 95% CI, 1.01-1.90), golimumab (HR, 1.74; 95% CI, 1.00-3.03), infliximab (HR, 2.92; 95% CI, 1.80-4.72), ixekizumab (HR, 2.98; 95% CI, 1.20-7.41), and secukinumab (HR, 1.84; 95% CI, 1.24-2.72).

Study details: Findings are from a population-based cohort study of 123,383 patients with psoriasis/PsA who initiated 1 among ustekinumab, adalimumab, apremilast, certolizumab, etanercept, golimumab, ixekizumab, or secukinumab between 2009 and 2018.

Disclosures: This study was sponsored by the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. SC Kim, RJ Desai, and JF Merola reported receiving research grants from and/or working as consultants/investigators for various sources. The remaining authors declared no conflicts of interest.

Source: Jin Y et al. Arthritis Care Res (Hoboken). 2021 May 10. doi: 10.1002/acr.24630.

Key clinical point: In patients with psoriasis or psoriatic arthritis (PsA), the risk for hospitalized serious infection was lower among those who initiated ustekinumab than other biologics and apremilast.

Major finding: Compared with ustekinumab, the risk for hospitalized serious infection was higher for adalimumab (combined weighted hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.34-2.06), apremilast (HR, 1.42; 95% CI, 1.02-1.96), certolizumab (HR, 1.09; 95% CI, 0.68-1.75), etanercept (HR, 1.39; 95% CI, 1.01-1.90), golimumab (HR, 1.74; 95% CI, 1.00-3.03), infliximab (HR, 2.92; 95% CI, 1.80-4.72), ixekizumab (HR, 2.98; 95% CI, 1.20-7.41), and secukinumab (HR, 1.84; 95% CI, 1.24-2.72).

Study details: Findings are from a population-based cohort study of 123,383 patients with psoriasis/PsA who initiated 1 among ustekinumab, adalimumab, apremilast, certolizumab, etanercept, golimumab, ixekizumab, or secukinumab between 2009 and 2018.

Disclosures: This study was sponsored by the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. SC Kim, RJ Desai, and JF Merola reported receiving research grants from and/or working as consultants/investigators for various sources. The remaining authors declared no conflicts of interest.

Source: Jin Y et al. Arthritis Care Res (Hoboken). 2021 May 10. doi: 10.1002/acr.24630.

Key clinical point: In a real-life cohort of patients with psoriatic arthritis (PsA), using drugs with the same (cycling) mode of action (MoA) after the failure of the previous one was not remarkably better than using the drug with a different MoA (swapping) than the previously failed drug.

Major finding: Drug retention rate was not significantly different between the group that underwent swapping vs. cycling (hazard ratio [HR] 0.95; 95% confidence interval [CI], 0.52-1.74), and effectiveness of swapping was not different from that observed in the first-line prescription group (HR, 1.45; 95% CI, 0.83-2.52).

Study details: This was a monocentric medical records review study of 183 patients with PsA treated with biologic disease-modifying antirheumatic drugs (DMARDs) or targeted synthetic DMARDs. The medical records were grouped into cycling, swapping, or first-line groups.

Disclosures: The authors did not identify any source of funding. The authors declared no conflicts of interest.

Source: Ariani A et al. Medicine (Baltimore). 2021 Apr 23. doi: 10.1097/MD.0000000000025300.

Key clinical point: In a real-life cohort of patients with psoriatic arthritis (PsA), using drugs with the same (cycling) mode of action (MoA) after the failure of the previous one was not remarkably better than using the drug with a different MoA (swapping) than the previously failed drug.

Major finding: Drug retention rate was not significantly different between the group that underwent swapping vs. cycling (hazard ratio [HR] 0.95; 95% confidence interval [CI], 0.52-1.74), and effectiveness of swapping was not different from that observed in the first-line prescription group (HR, 1.45; 95% CI, 0.83-2.52).

Study details: This was a monocentric medical records review study of 183 patients with PsA treated with biologic disease-modifying antirheumatic drugs (DMARDs) or targeted synthetic DMARDs. The medical records were grouped into cycling, swapping, or first-line groups.

Disclosures: The authors did not identify any source of funding. The authors declared no conflicts of interest.

Source: Ariani A et al. Medicine (Baltimore). 2021 Apr 23. doi: 10.1097/MD.0000000000025300.

Key clinical point: In a real-life cohort of patients with psoriatic arthritis (PsA), using drugs with the same (cycling) mode of action (MoA) after the failure of the previous one was not remarkably better than using the drug with a different MoA (swapping) than the previously failed drug.

Major finding: Drug retention rate was not significantly different between the group that underwent swapping vs. cycling (hazard ratio [HR] 0.95; 95% confidence interval [CI], 0.52-1.74), and effectiveness of swapping was not different from that observed in the first-line prescription group (HR, 1.45; 95% CI, 0.83-2.52).

Study details: This was a monocentric medical records review study of 183 patients with PsA treated with biologic disease-modifying antirheumatic drugs (DMARDs) or targeted synthetic DMARDs. The medical records were grouped into cycling, swapping, or first-line groups.

Disclosures: The authors did not identify any source of funding. The authors declared no conflicts of interest.

Source: Ariani A et al. Medicine (Baltimore). 2021 Apr 23. doi: 10.1097/MD.0000000000025300.

Key clinical point: Upadacitinib showed consistent improvement in signs and symptoms of psoriatic arthritis (PsA) with no new significant safety signals in patients with an inadequate response to biologic disease-modifying antirheumatic drugs (bDMARDs).

Major finding: At 56 weeks, the proportion of patients achieving American College of Rheumatology 20/50/70 and Psoriasis Area Severity Index 75/90/100 responses was 59.7%/40.8%/24.2% and 52.3%/40.8%/26.9%, respectively, with upadacitinib 15 mg and 59.2%/38.5%/26.6% and 58.8%/47.3%/35.1%, respectively, with upadacitinib 30 mg. Improvement was consistent through the study period with both upadacitinib doses with a safety profile consistent with that known previously.

Study details: Findings are from phase 3 SELECT-PsA 2 study, involving 641 patients with PsA who had an inadequate response to at least 1 bDMARD and were randomly allocated to receive upadacitinib 15 mg, 30 mg once daily (OD), or placebo switched to upadacitinib 15 mg or 30 mg OD at week 24.

Disclosures: SELECT-PsA 2 trial was funded by AbbVie. The authors reported receiving grants/consulting fees, speaker fees from, being employees of, and stockholder from various sources including AbbVie.

Source: Mease PJ et al. Rheumatol Ther. 2021 Apr 28. doi: 10.1007/s40744-021-00305-z.

Key clinical point: Upadacitinib showed consistent improvement in signs and symptoms of psoriatic arthritis (PsA) with no new significant safety signals in patients with an inadequate response to biologic disease-modifying antirheumatic drugs (bDMARDs).

Major finding: At 56 weeks, the proportion of patients achieving American College of Rheumatology 20/50/70 and Psoriasis Area Severity Index 75/90/100 responses was 59.7%/40.8%/24.2% and 52.3%/40.8%/26.9%, respectively, with upadacitinib 15 mg and 59.2%/38.5%/26.6% and 58.8%/47.3%/35.1%, respectively, with upadacitinib 30 mg. Improvement was consistent through the study period with both upadacitinib doses with a safety profile consistent with that known previously.

Study details: Findings are from phase 3 SELECT-PsA 2 study, involving 641 patients with PsA who had an inadequate response to at least 1 bDMARD and were randomly allocated to receive upadacitinib 15 mg, 30 mg once daily (OD), or placebo switched to upadacitinib 15 mg or 30 mg OD at week 24.

Disclosures: SELECT-PsA 2 trial was funded by AbbVie. The authors reported receiving grants/consulting fees, speaker fees from, being employees of, and stockholder from various sources including AbbVie.

Source: Mease PJ et al. Rheumatol Ther. 2021 Apr 28. doi: 10.1007/s40744-021-00305-z.

Key clinical point: Upadacitinib showed consistent improvement in signs and symptoms of psoriatic arthritis (PsA) with no new significant safety signals in patients with an inadequate response to biologic disease-modifying antirheumatic drugs (bDMARDs).

Major finding: At 56 weeks, the proportion of patients achieving American College of Rheumatology 20/50/70 and Psoriasis Area Severity Index 75/90/100 responses was 59.7%/40.8%/24.2% and 52.3%/40.8%/26.9%, respectively, with upadacitinib 15 mg and 59.2%/38.5%/26.6% and 58.8%/47.3%/35.1%, respectively, with upadacitinib 30 mg. Improvement was consistent through the study period with both upadacitinib doses with a safety profile consistent with that known previously.

Study details: Findings are from phase 3 SELECT-PsA 2 study, involving 641 patients with PsA who had an inadequate response to at least 1 bDMARD and were randomly allocated to receive upadacitinib 15 mg, 30 mg once daily (OD), or placebo switched to upadacitinib 15 mg or 30 mg OD at week 24.

Disclosures: SELECT-PsA 2 trial was funded by AbbVie. The authors reported receiving grants/consulting fees, speaker fees from, being employees of, and stockholder from various sources including AbbVie.

Source: Mease PJ et al. Rheumatol Ther. 2021 Apr 28. doi: 10.1007/s40744-021-00305-z.