Psoriatic Arthritis ICYMI

The differences between patients who have PsA with axial involvement (AxPsA) and patients who have axial spondyloarthritis with psoriasis (AxSpA+PsO) continue to remain a strong area of interest. Regierer and colleagues recently compared 359 patients with AxPsA vs 181 patients with AxSpA+PsO. These patients were enrolled into the RABBIT-SpA prospective longitudinal cohort study. Given the lack of definition of AxPsA, two definitions were used: 1) clinical judgment by the rheumatologist and 2) imaging (x-ray or MRI) findings. Regardless of clinical or imaging definition used, compared with patients who have AxSpA+PsO those with AxPsA were significantly more often women, were older, were less often HLA-B27 positive, and had more frequent peripheral manifestations but less frequent uveitis. The two diseases thus have significant differences; these should be carefully considered while making treatment decisions.

Another major research focus is on the influence of sex on PsA treatment response. Eder and colleagues conducted a post hoc analysis of pooled data from phase 3 randomized controlled trials that included 816 patients with PsA who received tofacitinib, adalimumab, or placebo. They demonstrate that at 3 months, tofacitinib was more efficacious than placebo, irrespective of sex. However, a higher proportion of men vs women receiving tofacitinib achieved minimal disease activity. This might be due to baseline differences in disease activity. The American College of Rheumatology 20/50/70 response rates were comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib. Thus, sex significantly influences achieving low disease state. Understanding the mechanisms underlying sex differences will help improve treatment response rates in women with PsA.

Atherosclerotic vascular disease (ASVD) is an important comorbidity of PsA. Predicting ASVD remains difficult. The triglyceride-glucose (TyG) index — calculated as ln[fasting triglycerides (in mg/dL) × fasting glucose (in mg/dL)/2] — was recently identified as a marker of insulin resistance and ASVD. Xie and colleagues conducted a cross-sectional study in 165 patients with PsA who underwent carotid ultrasound and had data available for the TyG index. In a model that was adjusted for age, sex, comorbidities, smoking, BMI, low-density lipoprotein cholesterol, psoriasis area and severity index, and disease activity index for PsA, the TyG index was significantly associated with the presence of carotid atherosclerosis (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) as well as carotid artery plaque (aOR 3.61; 95% CI 1.15-11.38). Thus, this easily calculated marker is associated with ASVD independent of demographic, traditional risk factors, and disease activity and needs further evaluation in prospective studies.

The differences between patients who have PsA with axial involvement (AxPsA) and patients who have axial spondyloarthritis with psoriasis (AxSpA+PsO) continue to remain a strong area of interest. Regierer and colleagues recently compared 359 patients with AxPsA vs 181 patients with AxSpA+PsO. These patients were enrolled into the RABBIT-SpA prospective longitudinal cohort study. Given the lack of definition of AxPsA, two definitions were used: 1) clinical judgment by the rheumatologist and 2) imaging (x-ray or MRI) findings. Regardless of clinical or imaging definition used, compared with patients who have AxSpA+PsO those with AxPsA were significantly more often women, were older, were less often HLA-B27 positive, and had more frequent peripheral manifestations but less frequent uveitis. The two diseases thus have significant differences; these should be carefully considered while making treatment decisions.

Another major research focus is on the influence of sex on PsA treatment response. Eder and colleagues conducted a post hoc analysis of pooled data from phase 3 randomized controlled trials that included 816 patients with PsA who received tofacitinib, adalimumab, or placebo. They demonstrate that at 3 months, tofacitinib was more efficacious than placebo, irrespective of sex. However, a higher proportion of men vs women receiving tofacitinib achieved minimal disease activity. This might be due to baseline differences in disease activity. The American College of Rheumatology 20/50/70 response rates were comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib. Thus, sex significantly influences achieving low disease state. Understanding the mechanisms underlying sex differences will help improve treatment response rates in women with PsA.

Atherosclerotic vascular disease (ASVD) is an important comorbidity of PsA. Predicting ASVD remains difficult. The triglyceride-glucose (TyG) index — calculated as ln[fasting triglycerides (in mg/dL) × fasting glucose (in mg/dL)/2] — was recently identified as a marker of insulin resistance and ASVD. Xie and colleagues conducted a cross-sectional study in 165 patients with PsA who underwent carotid ultrasound and had data available for the TyG index. In a model that was adjusted for age, sex, comorbidities, smoking, BMI, low-density lipoprotein cholesterol, psoriasis area and severity index, and disease activity index for PsA, the TyG index was significantly associated with the presence of carotid atherosclerosis (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) as well as carotid artery plaque (aOR 3.61; 95% CI 1.15-11.38). Thus, this easily calculated marker is associated with ASVD independent of demographic, traditional risk factors, and disease activity and needs further evaluation in prospective studies.

The differences between patients who have PsA with axial involvement (AxPsA) and patients who have axial spondyloarthritis with psoriasis (AxSpA+PsO) continue to remain a strong area of interest. Regierer and colleagues recently compared 359 patients with AxPsA vs 181 patients with AxSpA+PsO. These patients were enrolled into the RABBIT-SpA prospective longitudinal cohort study. Given the lack of definition of AxPsA, two definitions were used: 1) clinical judgment by the rheumatologist and 2) imaging (x-ray or MRI) findings. Regardless of clinical or imaging definition used, compared with patients who have AxSpA+PsO those with AxPsA were significantly more often women, were older, were less often HLA-B27 positive, and had more frequent peripheral manifestations but less frequent uveitis. The two diseases thus have significant differences; these should be carefully considered while making treatment decisions.

Another major research focus is on the influence of sex on PsA treatment response. Eder and colleagues conducted a post hoc analysis of pooled data from phase 3 randomized controlled trials that included 816 patients with PsA who received tofacitinib, adalimumab, or placebo. They demonstrate that at 3 months, tofacitinib was more efficacious than placebo, irrespective of sex. However, a higher proportion of men vs women receiving tofacitinib achieved minimal disease activity. This might be due to baseline differences in disease activity. The American College of Rheumatology 20/50/70 response rates were comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib. Thus, sex significantly influences achieving low disease state. Understanding the mechanisms underlying sex differences will help improve treatment response rates in women with PsA.

Atherosclerotic vascular disease (ASVD) is an important comorbidity of PsA. Predicting ASVD remains difficult. The triglyceride-glucose (TyG) index — calculated as ln[fasting triglycerides (in mg/dL) × fasting glucose (in mg/dL)/2] — was recently identified as a marker of insulin resistance and ASVD. Xie and colleagues conducted a cross-sectional study in 165 patients with PsA who underwent carotid ultrasound and had data available for the TyG index. In a model that was adjusted for age, sex, comorbidities, smoking, BMI, low-density lipoprotein cholesterol, psoriasis area and severity index, and disease activity index for PsA, the TyG index was significantly associated with the presence of carotid atherosclerosis (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) as well as carotid artery plaque (aOR 3.61; 95% CI 1.15-11.38). Thus, this easily calculated marker is associated with ASVD independent of demographic, traditional risk factors, and disease activity and needs further evaluation in prospective studies.

Key clinical point: Age, body mass index (BMI), chronic-plaque psoriasis, hospitalization for psoriasis, use of systemic therapy, and genital and nail involvement in psoriasis were the risk factors for psoriatic arthritis (PsA) occurrence in patients with psoriasis.

Major finding: Overall, 226 patients were diagnosed with PsA, with an incidence of 1.9 cases per 100 patient-years. Age between 40-59 years (P < .001), BMI ≥25 (P  =  .015), genital psoriasis (P  =  .027), nail psoriasis (P  =  .038), classic chronic-plaque psoriasis (P  =  .014), previous hospitalization for psoriasis (P < .001), previous use of systemic therapy for psoriasis (P  =  .003), and use of conventional nonbiologic agents (P  =  .014) were significantly associated with PsA occurrence.

Study details: This cohort study included 8895 patients with a confirmed diagnosis of psoriasis from the PsoReal registry.

Disclosures: This study was sponsored by Bristol Myers Squibb. K Heidemeyer and L Naldi declared receiving honoraria from various sources, including AbbVie, Almirall, or Bristol Myers Squibb.

Source: Heidemeyer K et al. Variables associated with joint involvement and development of a prediction rule for arthritis in psoriasis patients. An analysis of the Italian PsoReal database. J Am Acad Dermatol. 2023 (Mar 23). Doi: 10.1016/j.jaad.2023.02.059

Key clinical point: Age, body mass index (BMI), chronic-plaque psoriasis, hospitalization for psoriasis, use of systemic therapy, and genital and nail involvement in psoriasis were the risk factors for psoriatic arthritis (PsA) occurrence in patients with psoriasis.

Major finding: Overall, 226 patients were diagnosed with PsA, with an incidence of 1.9 cases per 100 patient-years. Age between 40-59 years (P < .001), BMI ≥25 (P  =  .015), genital psoriasis (P  =  .027), nail psoriasis (P  =  .038), classic chronic-plaque psoriasis (P  =  .014), previous hospitalization for psoriasis (P < .001), previous use of systemic therapy for psoriasis (P  =  .003), and use of conventional nonbiologic agents (P  =  .014) were significantly associated with PsA occurrence.

Study details: This cohort study included 8895 patients with a confirmed diagnosis of psoriasis from the PsoReal registry.

Disclosures: This study was sponsored by Bristol Myers Squibb. K Heidemeyer and L Naldi declared receiving honoraria from various sources, including AbbVie, Almirall, or Bristol Myers Squibb.

Source: Heidemeyer K et al. Variables associated with joint involvement and development of a prediction rule for arthritis in psoriasis patients. An analysis of the Italian PsoReal database. J Am Acad Dermatol. 2023 (Mar 23). Doi: 10.1016/j.jaad.2023.02.059

Key clinical point: Age, body mass index (BMI), chronic-plaque psoriasis, hospitalization for psoriasis, use of systemic therapy, and genital and nail involvement in psoriasis were the risk factors for psoriatic arthritis (PsA) occurrence in patients with psoriasis.

Major finding: Overall, 226 patients were diagnosed with PsA, with an incidence of 1.9 cases per 100 patient-years. Age between 40-59 years (P < .001), BMI ≥25 (P  =  .015), genital psoriasis (P  =  .027), nail psoriasis (P  =  .038), classic chronic-plaque psoriasis (P  =  .014), previous hospitalization for psoriasis (P < .001), previous use of systemic therapy for psoriasis (P  =  .003), and use of conventional nonbiologic agents (P  =  .014) were significantly associated with PsA occurrence.

Study details: This cohort study included 8895 patients with a confirmed diagnosis of psoriasis from the PsoReal registry.

Disclosures: This study was sponsored by Bristol Myers Squibb. K Heidemeyer and L Naldi declared receiving honoraria from various sources, including AbbVie, Almirall, or Bristol Myers Squibb.

Source: Heidemeyer K et al. Variables associated with joint involvement and development of a prediction rule for arthritis in psoriasis patients. An analysis of the Italian PsoReal database. J Am Acad Dermatol. 2023 (Mar 23). Doi: 10.1016/j.jaad.2023.02.059

Key clinical point: Patients with psoriatic arthritis (PsA) had lower serum vitamin D (25(OH)D₃) levels and bone mineral density (BMD) compared with the general population; however, serum vitamin D levels were higher in patients with PsA vs  psoriasis.

Major finding: The serum 25(OH)D₃ levels in patients with PsA were lower than those in control individuals (mean difference [MD] −6.42; P < .01) but higher than those in patients with psoriasis (MD 2.37; P < .01). Lumbar spine BMD was significantly lower in patients with PsA vs  control individuals (MD −0.08).

Study details: This was a meta-analysis of nine studies, of which four studies included patients with PsA (n = 264) and control individuals from the general population (n = 287) and five studies included patients with PsA (n = 225) and psoriasis (n = 391).

Disclosures: This study was supported by the project “Digitalization and improvement of nutritional care for patients with chronic diseases” cofinanced by the European Regional Development Fund. The authors declared no conflicts of interest.

Source: Radić M et al. Vitamin D in psoriatic arthritis – A systematic review and meta-analysis. Semin Arthritis Rheum. 2023;60:152200 (Apr 1). Doi: 10.1016/j.semarthrit.2023.152200

Key clinical point: Patients with psoriatic arthritis (PsA) had lower serum vitamin D (25(OH)D₃) levels and bone mineral density (BMD) compared with the general population; however, serum vitamin D levels were higher in patients with PsA vs  psoriasis.

Major finding: The serum 25(OH)D₃ levels in patients with PsA were lower than those in control individuals (mean difference [MD] −6.42; P < .01) but higher than those in patients with psoriasis (MD 2.37; P < .01). Lumbar spine BMD was significantly lower in patients with PsA vs  control individuals (MD −0.08).

Study details: This was a meta-analysis of nine studies, of which four studies included patients with PsA (n = 264) and control individuals from the general population (n = 287) and five studies included patients with PsA (n = 225) and psoriasis (n = 391).

Disclosures: This study was supported by the project “Digitalization and improvement of nutritional care for patients with chronic diseases” cofinanced by the European Regional Development Fund. The authors declared no conflicts of interest.

Source: Radić M et al. Vitamin D in psoriatic arthritis – A systematic review and meta-analysis. Semin Arthritis Rheum. 2023;60:152200 (Apr 1). Doi: 10.1016/j.semarthrit.2023.152200

Key clinical point: Patients with psoriatic arthritis (PsA) had lower serum vitamin D (25(OH)D₃) levels and bone mineral density (BMD) compared with the general population; however, serum vitamin D levels were higher in patients with PsA vs  psoriasis.

Major finding: The serum 25(OH)D₃ levels in patients with PsA were lower than those in control individuals (mean difference [MD] −6.42; P < .01) but higher than those in patients with psoriasis (MD 2.37; P < .01). Lumbar spine BMD was significantly lower in patients with PsA vs  control individuals (MD −0.08).

Study details: This was a meta-analysis of nine studies, of which four studies included patients with PsA (n = 264) and control individuals from the general population (n = 287) and five studies included patients with PsA (n = 225) and psoriasis (n = 391).

Disclosures: This study was supported by the project “Digitalization and improvement of nutritional care for patients with chronic diseases” cofinanced by the European Regional Development Fund. The authors declared no conflicts of interest.

Source: Radić M et al. Vitamin D in psoriatic arthritis – A systematic review and meta-analysis. Semin Arthritis Rheum. 2023;60:152200 (Apr 1). Doi: 10.1016/j.semarthrit.2023.152200

Key clinical point: Patients with psoriatic arthritis (PsA) are at a higher risk for overall cancer compared with the general population, highlighting the importance of regular cancer screening among these patients.

Major finding: The risk for overall cancer was slightly higher among patients with PsA vs  age- and sex-matched control individuals (adjusted hazard ratio [aHR] 1.20; 95% CI 1.02-1.41), with the risk being mainly driven by non-melanoma skin cancer (aHR 3.64; 95% CI 1.61-8.23), lymphoma (aHR 2.63, 95% CI 1.30-5.30), and thyroid cancer (aHR 1.83, 95% CI 1.18-2.85).

Study details: The data come from a population-based cohort study including 4688 patients with newly diagnosed PsA and 46,880 age- and sex-matched control individuals without a history of cancer and other coexisting autoimmune diseases from the general population.

Disclosures: This study did not report the source of funding. The authors did not declare conflicts of interest.

Source: Eun Y et al. Risk of cancer in Korean patients with psoriatic arthritis: A nationwide population-based cohort study. RMD Open. 2023;9(1):e002874 (Mar 23). Doi: 10.1136/rmdopen-2022-002874

Key clinical point: Patients with psoriatic arthritis (PsA) are at a higher risk for overall cancer compared with the general population, highlighting the importance of regular cancer screening among these patients.

Major finding: The risk for overall cancer was slightly higher among patients with PsA vs  age- and sex-matched control individuals (adjusted hazard ratio [aHR] 1.20; 95% CI 1.02-1.41), with the risk being mainly driven by non-melanoma skin cancer (aHR 3.64; 95% CI 1.61-8.23), lymphoma (aHR 2.63, 95% CI 1.30-5.30), and thyroid cancer (aHR 1.83, 95% CI 1.18-2.85).

Study details: The data come from a population-based cohort study including 4688 patients with newly diagnosed PsA and 46,880 age- and sex-matched control individuals without a history of cancer and other coexisting autoimmune diseases from the general population.

Disclosures: This study did not report the source of funding. The authors did not declare conflicts of interest.

Source: Eun Y et al. Risk of cancer in Korean patients with psoriatic arthritis: A nationwide population-based cohort study. RMD Open. 2023;9(1):e002874 (Mar 23). Doi: 10.1136/rmdopen-2022-002874

Key clinical point: Patients with psoriatic arthritis (PsA) are at a higher risk for overall cancer compared with the general population, highlighting the importance of regular cancer screening among these patients.

Major finding: The risk for overall cancer was slightly higher among patients with PsA vs  age- and sex-matched control individuals (adjusted hazard ratio [aHR] 1.20; 95% CI 1.02-1.41), with the risk being mainly driven by non-melanoma skin cancer (aHR 3.64; 95% CI 1.61-8.23), lymphoma (aHR 2.63, 95% CI 1.30-5.30), and thyroid cancer (aHR 1.83, 95% CI 1.18-2.85).

Study details: The data come from a population-based cohort study including 4688 patients with newly diagnosed PsA and 46,880 age- and sex-matched control individuals without a history of cancer and other coexisting autoimmune diseases from the general population.

Disclosures: This study did not report the source of funding. The authors did not declare conflicts of interest.

Source: Eun Y et al. Risk of cancer in Korean patients with psoriatic arthritis: A nationwide population-based cohort study. RMD Open. 2023;9(1):e002874 (Mar 23). Doi: 10.1136/rmdopen-2022-002874

Key clinical point: Age at onset of psoriatic arthritis (PsA) influences disease characteristics, with individuals developing PsA at older age having worse functionality and greater structural damage but a lower frequency of enthesitis and dactylitis.

Major finding: Patients with late vs early onset PsA showed greater structural damage (odds ratio [OR] 3.3; 95% CI 1.3-8.1), higher frequency of arthritis in upper limbs (OR 2.8; 95% CI 1.0-7.7), greater loss of functionality (OR 1.3; 95% CI 1.0-1.6), and lower frequency of enthesitis (OR 0.1; 95% CI 0-0.5) and sacroiliitis (OR 0.06; 95% CI 0-0.5).

Study details: This observational cross-sectional study included 231 patients with PsA with <10 years of disease duration from the REGISPONSER and RESPONDIA registries who were categorized into the early onset (≤40 years) or late onset (≥60 years) group depending on age at PsA symptom onset.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Puche-Larrubia MÁ et al. Differences between early vs  late-onset of psoriatic arthritis: Data from the respondia and regisponser registries. Joint Bone Spine. 2023;105563 (Mar 17). Doi: 10.1016/j.jbspin.2023.105563

Key clinical point: Age at onset of psoriatic arthritis (PsA) influences disease characteristics, with individuals developing PsA at older age having worse functionality and greater structural damage but a lower frequency of enthesitis and dactylitis.

Major finding: Patients with late vs early onset PsA showed greater structural damage (odds ratio [OR] 3.3; 95% CI 1.3-8.1), higher frequency of arthritis in upper limbs (OR 2.8; 95% CI 1.0-7.7), greater loss of functionality (OR 1.3; 95% CI 1.0-1.6), and lower frequency of enthesitis (OR 0.1; 95% CI 0-0.5) and sacroiliitis (OR 0.06; 95% CI 0-0.5).

Study details: This observational cross-sectional study included 231 patients with PsA with <10 years of disease duration from the REGISPONSER and RESPONDIA registries who were categorized into the early onset (≤40 years) or late onset (≥60 years) group depending on age at PsA symptom onset.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Puche-Larrubia MÁ et al. Differences between early vs  late-onset of psoriatic arthritis: Data from the respondia and regisponser registries. Joint Bone Spine. 2023;105563 (Mar 17). Doi: 10.1016/j.jbspin.2023.105563

Key clinical point: Age at onset of psoriatic arthritis (PsA) influences disease characteristics, with individuals developing PsA at older age having worse functionality and greater structural damage but a lower frequency of enthesitis and dactylitis.

Major finding: Patients with late vs early onset PsA showed greater structural damage (odds ratio [OR] 3.3; 95% CI 1.3-8.1), higher frequency of arthritis in upper limbs (OR 2.8; 95% CI 1.0-7.7), greater loss of functionality (OR 1.3; 95% CI 1.0-1.6), and lower frequency of enthesitis (OR 0.1; 95% CI 0-0.5) and sacroiliitis (OR 0.06; 95% CI 0-0.5).

Study details: This observational cross-sectional study included 231 patients with PsA with <10 years of disease duration from the REGISPONSER and RESPONDIA registries who were categorized into the early onset (≤40 years) or late onset (≥60 years) group depending on age at PsA symptom onset.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Puche-Larrubia MÁ et al. Differences between early vs  late-onset of psoriatic arthritis: Data from the respondia and regisponser registries. Joint Bone Spine. 2023;105563 (Mar 17). Doi: 10.1016/j.jbspin.2023.105563

Key clinical point: Vitamin D deficiency in patients with psoriatic arthritis (PsA) had worse impact on the retention rate of the first biological disease-modifying antirheumatic drug (bDMARD) and response to methotrexate and was associated with severe disease course in terms of sacroiliitis.

Major finding: The risk for discontinuation of the first bDMARD (hazard ratio [HR] 2.129; P  =  .011) and methotrexate discontinuation because of therapy failure (HR 2.168; P  =  .002) were significantly higher among patients with 25(OH)D level of ≤20 vs  20-30 and ≥30 ng/mL, with the prevalence of sacroiliitis being significantly higher in patients with 25(OH)D level of ≤20 vs  ≥30 ng/mL (P  =  .0001).

Study details: Findings are from a retrospective study including 233 patients with PsA.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Rotondo C et al. Vitamin D status and psoriatic arthritis: Association with the risk for sacroiliitis and influence on the retention rate of methotrexate monotherapy and first biological drug survival—A retrospective study. Int J Mol Sci. 2023;24(6):5368 (Mar 10). Doi: 10.3390/ijms24065368

Key clinical point: Vitamin D deficiency in patients with psoriatic arthritis (PsA) had worse impact on the retention rate of the first biological disease-modifying antirheumatic drug (bDMARD) and response to methotrexate and was associated with severe disease course in terms of sacroiliitis.

Major finding: The risk for discontinuation of the first bDMARD (hazard ratio [HR] 2.129; P  =  .011) and methotrexate discontinuation because of therapy failure (HR 2.168; P  =  .002) were significantly higher among patients with 25(OH)D level of ≤20 vs  20-30 and ≥30 ng/mL, with the prevalence of sacroiliitis being significantly higher in patients with 25(OH)D level of ≤20 vs  ≥30 ng/mL (P  =  .0001).

Study details: Findings are from a retrospective study including 233 patients with PsA.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Rotondo C et al. Vitamin D status and psoriatic arthritis: Association with the risk for sacroiliitis and influence on the retention rate of methotrexate monotherapy and first biological drug survival—A retrospective study. Int J Mol Sci. 2023;24(6):5368 (Mar 10). Doi: 10.3390/ijms24065368

Key clinical point: Vitamin D deficiency in patients with psoriatic arthritis (PsA) had worse impact on the retention rate of the first biological disease-modifying antirheumatic drug (bDMARD) and response to methotrexate and was associated with severe disease course in terms of sacroiliitis.

Major finding: The risk for discontinuation of the first bDMARD (hazard ratio [HR] 2.129; P  =  .011) and methotrexate discontinuation because of therapy failure (HR 2.168; P  =  .002) were significantly higher among patients with 25(OH)D level of ≤20 vs  20-30 and ≥30 ng/mL, with the prevalence of sacroiliitis being significantly higher in patients with 25(OH)D level of ≤20 vs  ≥30 ng/mL (P  =  .0001).

Study details: Findings are from a retrospective study including 233 patients with PsA.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Rotondo C et al. Vitamin D status and psoriatic arthritis: Association with the risk for sacroiliitis and influence on the retention rate of methotrexate monotherapy and first biological drug survival—A retrospective study. Int J Mol Sci. 2023;24(6):5368 (Mar 10). Doi: 10.3390/ijms24065368

Key clinical point: Psoriatic arthritis with axial involvement (axPsA), defined either clinically or by imaging, showed distinct disease manifestations compared with axial spondyloarthritis (axSpA) plus psoriasis, indicating that axPsA and axSpA were distinct entities.

Major finding: Regardless of clinical or imaging definition used, patients with axPsA vs  axSpA+psoriasis were significantly more often women and older individuals and less often human leucocyte antigen-B27 positive (all P < .05), as well as had more frequent peripheral manifestations (P < .001) but less frequent uveitis (P < .001).

Study details: Findings are from the RABBIT-SpA, a prospective longitudinal observational study, including 1395 patients with PsA (359 patients had axial involvement) and 1428 patients with axSpA (181 patients had psoriasis).

Disclosures: The study was supported by AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris. The authors did not report conflicts of interest.

Source: Regierer AC et al. Comparison of patients with axial PsA and patients with axSpA and concomitant psoriasis: An analysis of the German register RABBIT-SpA. RMD Open. 2023;9(1):e002837 (Mar 10). Doi: 10.1136/rmdopen-2022-002837.

Key clinical point: Psoriatic arthritis with axial involvement (axPsA), defined either clinically or by imaging, showed distinct disease manifestations compared with axial spondyloarthritis (axSpA) plus psoriasis, indicating that axPsA and axSpA were distinct entities.

Major finding: Regardless of clinical or imaging definition used, patients with axPsA vs  axSpA+psoriasis were significantly more often women and older individuals and less often human leucocyte antigen-B27 positive (all P < .05), as well as had more frequent peripheral manifestations (P < .001) but less frequent uveitis (P < .001).

Study details: Findings are from the RABBIT-SpA, a prospective longitudinal observational study, including 1395 patients with PsA (359 patients had axial involvement) and 1428 patients with axSpA (181 patients had psoriasis).

Disclosures: The study was supported by AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris. The authors did not report conflicts of interest.

Source: Regierer AC et al. Comparison of patients with axial PsA and patients with axSpA and concomitant psoriasis: An analysis of the German register RABBIT-SpA. RMD Open. 2023;9(1):e002837 (Mar 10). Doi: 10.1136/rmdopen-2022-002837.

Key clinical point: Psoriatic arthritis with axial involvement (axPsA), defined either clinically or by imaging, showed distinct disease manifestations compared with axial spondyloarthritis (axSpA) plus psoriasis, indicating that axPsA and axSpA were distinct entities.

Major finding: Regardless of clinical or imaging definition used, patients with axPsA vs  axSpA+psoriasis were significantly more often women and older individuals and less often human leucocyte antigen-B27 positive (all P < .05), as well as had more frequent peripheral manifestations (P < .001) but less frequent uveitis (P < .001).

Study details: Findings are from the RABBIT-SpA, a prospective longitudinal observational study, including 1395 patients with PsA (359 patients had axial involvement) and 1428 patients with axSpA (181 patients had psoriasis).

Disclosures: The study was supported by AbbVie, Amgen, Biogen, Celltrion, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB, and Viatris. The authors did not report conflicts of interest.

Source: Regierer AC et al. Comparison of patients with axial PsA and patients with axSpA and concomitant psoriasis: An analysis of the German register RABBIT-SpA. RMD Open. 2023;9(1):e002837 (Mar 10). Doi: 10.1136/rmdopen-2022-002837.

Key clinical point: Triglyceride-glucose (TyG) index demonstrated a positive and robust association with the occurrence of carotid atherosclerosis (CA) and carotid artery plaque (CAP) in patients with psoriatic arthritis, independent of traditional cardiovascular and PsA risk factors.

Major finding: The TyG index was substantially higher in patients with vs  without CA (8.82 vs  8.54; P  =  .002) or CAP (8.88 vs  8.55; P  =  .001), with significant associations observed between continuous TyG and occurrence of CA (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) and CAP (aOR 3.61; 95% CI 1.15-11.38).

Study details: Findings are from a cross-sectional study including 165 patients with confirmed diagnosis of PsA who underwent carotid ultrasound and had data available for corresponding TyG index.

Disclosures: This study was supported by the National Natural Science Foundation. The authors declared no conflicts of interest.

Source: Xie W et al. Association between triglyceride‑glucose index and carotid atherosclerosis in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Mar 10). Doi: 10.1093/rheumatology/kead100

Key clinical point: Triglyceride-glucose (TyG) index demonstrated a positive and robust association with the occurrence of carotid atherosclerosis (CA) and carotid artery plaque (CAP) in patients with psoriatic arthritis, independent of traditional cardiovascular and PsA risk factors.

Major finding: The TyG index was substantially higher in patients with vs  without CA (8.82 vs  8.54; P  =  .002) or CAP (8.88 vs  8.55; P  =  .001), with significant associations observed between continuous TyG and occurrence of CA (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) and CAP (aOR 3.61; 95% CI 1.15-11.38).

Study details: Findings are from a cross-sectional study including 165 patients with confirmed diagnosis of PsA who underwent carotid ultrasound and had data available for corresponding TyG index.

Disclosures: This study was supported by the National Natural Science Foundation. The authors declared no conflicts of interest.

Source: Xie W et al. Association between triglyceride‑glucose index and carotid atherosclerosis in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Mar 10). Doi: 10.1093/rheumatology/kead100

Key clinical point: Triglyceride-glucose (TyG) index demonstrated a positive and robust association with the occurrence of carotid atherosclerosis (CA) and carotid artery plaque (CAP) in patients with psoriatic arthritis, independent of traditional cardiovascular and PsA risk factors.

Major finding: The TyG index was substantially higher in patients with vs  without CA (8.82 vs  8.54; P  =  .002) or CAP (8.88 vs  8.55; P  =  .001), with significant associations observed between continuous TyG and occurrence of CA (adjusted odds ratio [aOR] 2.69; 95% CI 1.02-7.11) and CAP (aOR 3.61; 95% CI 1.15-11.38).

Study details: Findings are from a cross-sectional study including 165 patients with confirmed diagnosis of PsA who underwent carotid ultrasound and had data available for corresponding TyG index.

Disclosures: This study was supported by the National Natural Science Foundation. The authors declared no conflicts of interest.

Source: Xie W et al. Association between triglyceride‑glucose index and carotid atherosclerosis in patients with psoriatic arthritis. Rheumatology (Oxford). 2023 (Mar 10). Doi: 10.1093/rheumatology/kead100

Key clinical point: Real-life study confirms the efficacy, safety, and high retention rate of secukinumab in patients with moderate-to-severe psoriatic arthritis (PsA), with male sex being an independent predictor of treatment response.

Major finding: The mean 28-Joint Disease Activity Score using C-reactive protein was significantly lower at week 52 vs  baseline (2.2 vs  5.8; P  =  .0001), suggesting remission, with men vs  women being more likely to achieve inactive disease or remission (odds ratio 5.16; 95% CI 1.35-26.63). The treatment retention rate at 1-year follow-up was 75%, with none of the patients discontinuing due to adverse events.

Study details: The data come from a retrospective study including 85 patients with moderate-to-severe PsA (n = 56) or ankylosing spondylitis (n = 29) treated with secukinumab and followed for 52 weeks.

Disclosures: This study did not receive any funding, except open access funding through Projekt DEAL, Germany. The authors declared no conflicts of interest.

Source: Molica Colella F et al. Effectiveness and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: A 52-week real-life study in an Italian cohort. Adv Rheumatol. 2023;63(1):15 (Mar 27). Doi: 10.1186/s42358-023-00295-2

Key clinical point: Real-life study confirms the efficacy, safety, and high retention rate of secukinumab in patients with moderate-to-severe psoriatic arthritis (PsA), with male sex being an independent predictor of treatment response.

Major finding: The mean 28-Joint Disease Activity Score using C-reactive protein was significantly lower at week 52 vs  baseline (2.2 vs  5.8; P  =  .0001), suggesting remission, with men vs  women being more likely to achieve inactive disease or remission (odds ratio 5.16; 95% CI 1.35-26.63). The treatment retention rate at 1-year follow-up was 75%, with none of the patients discontinuing due to adverse events.

Study details: The data come from a retrospective study including 85 patients with moderate-to-severe PsA (n = 56) or ankylosing spondylitis (n = 29) treated with secukinumab and followed for 52 weeks.

Disclosures: This study did not receive any funding, except open access funding through Projekt DEAL, Germany. The authors declared no conflicts of interest.

Source: Molica Colella F et al. Effectiveness and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: A 52-week real-life study in an Italian cohort. Adv Rheumatol. 2023;63(1):15 (Mar 27). Doi: 10.1186/s42358-023-00295-2

Key clinical point: Real-life study confirms the efficacy, safety, and high retention rate of secukinumab in patients with moderate-to-severe psoriatic arthritis (PsA), with male sex being an independent predictor of treatment response.

Major finding: The mean 28-Joint Disease Activity Score using C-reactive protein was significantly lower at week 52 vs  baseline (2.2 vs  5.8; P  =  .0001), suggesting remission, with men vs  women being more likely to achieve inactive disease or remission (odds ratio 5.16; 95% CI 1.35-26.63). The treatment retention rate at 1-year follow-up was 75%, with none of the patients discontinuing due to adverse events.

Study details: The data come from a retrospective study including 85 patients with moderate-to-severe PsA (n = 56) or ankylosing spondylitis (n = 29) treated with secukinumab and followed for 52 weeks.

Disclosures: This study did not receive any funding, except open access funding through Projekt DEAL, Germany. The authors declared no conflicts of interest.

Source: Molica Colella F et al. Effectiveness and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: A 52-week real-life study in an Italian cohort. Adv Rheumatol. 2023;63(1):15 (Mar 27). Doi: 10.1186/s42358-023-00295-2

Key clinical point: Tofacitinib was more effective and as safe as placebo in men and women with psoriatic arthritis (PsA); however, men were more likely to achieve minimal disease activity (MDA) with tofacitinib due to differences in baseline disease activity.

Major finding: At 3 months, tofacitinib was more efficacious than placebo irrespective of sex (P < .001); however, MDA was achieved by a higher proportion of men vs  women receiving tofacitinib (P < .05), although the American College of Rheumatology 20/50/70 response was comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib at doses of 5 mg (67.5% and 70.2%, respectively) or 10 mg (70.0% and 72.8%, respectively) twice daily.

Study details: This post hoc analysis of data pooled from phase 3 randomized controlled trials included 816 patients with PsA who received tofacitinib, adalimumab, or placebo.

Disclosures: This study was sponsored by Pfizer. Some authors declared being employees, holding shares, or having other ties with various sources, including Pfizer.

Source: Eder L et al. Sex differences in the efficacy, safety and persistence of patients with psoriatic arthritis treated with tofacitinib: A post-hoc analysis of phase 3 trials and long-term extension. RMD Open. 2023;9:e002718 (Mar 23). Doi: 10.1136/rmdopen-2022-002718

Key clinical point: Tofacitinib was more effective and as safe as placebo in men and women with psoriatic arthritis (PsA); however, men were more likely to achieve minimal disease activity (MDA) with tofacitinib due to differences in baseline disease activity.

Major finding: At 3 months, tofacitinib was more efficacious than placebo irrespective of sex (P < .001); however, MDA was achieved by a higher proportion of men vs  women receiving tofacitinib (P < .05), although the American College of Rheumatology 20/50/70 response was comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib at doses of 5 mg (67.5% and 70.2%, respectively) or 10 mg (70.0% and 72.8%, respectively) twice daily.

Study details: This post hoc analysis of data pooled from phase 3 randomized controlled trials included 816 patients with PsA who received tofacitinib, adalimumab, or placebo.

Disclosures: This study was sponsored by Pfizer. Some authors declared being employees, holding shares, or having other ties with various sources, including Pfizer.

Source: Eder L et al. Sex differences in the efficacy, safety and persistence of patients with psoriatic arthritis treated with tofacitinib: A post-hoc analysis of phase 3 trials and long-term extension. RMD Open. 2023;9:e002718 (Mar 23). Doi: 10.1136/rmdopen-2022-002718

Key clinical point: Tofacitinib was more effective and as safe as placebo in men and women with psoriatic arthritis (PsA); however, men were more likely to achieve minimal disease activity (MDA) with tofacitinib due to differences in baseline disease activity.

Major finding: At 3 months, tofacitinib was more efficacious than placebo irrespective of sex (P < .001); however, MDA was achieved by a higher proportion of men vs  women receiving tofacitinib (P < .05), although the American College of Rheumatology 20/50/70 response was comparable. The incidence of treatment-emergent adverse events was similar in men and women receiving tofacitinib at doses of 5 mg (67.5% and 70.2%, respectively) or 10 mg (70.0% and 72.8%, respectively) twice daily.

Study details: This post hoc analysis of data pooled from phase 3 randomized controlled trials included 816 patients with PsA who received tofacitinib, adalimumab, or placebo.

Disclosures: This study was sponsored by Pfizer. Some authors declared being employees, holding shares, or having other ties with various sources, including Pfizer.

Source: Eder L et al. Sex differences in the efficacy, safety and persistence of patients with psoriatic arthritis treated with tofacitinib: A post-hoc analysis of phase 3 trials and long-term extension. RMD Open. 2023;9:e002718 (Mar 23). Doi: 10.1136/rmdopen-2022-002718