MTX vs etanercept vs combo in PsA
ACR20 at 24 wks: 50%, 60%, 65%
Contrast TEMPO study in RA where combo therapy was better than monotherapy
Also: MTX monotherapy effective
Abs L11
Roundup – Cush, Kavanaugh #ACR18 @RheumNow

— D White (@WIRheum) October 24, 2018

Pooled analysis from 3 PSA+12 PSO trials on ixekizumab RCTs. Reassuring that incidence of IBD relatively low with significant pt year f/u (https://t.co/icWfGIEnxt @RheumNow #ACR18

— Dr. Arthur Lau (@ArthurRheum) October 24, 2018

ETN plus MTX combo better for skin PSO outcomes, but not a huge improvement for joints… but remember this study used ETN 50 q week (not twice weekly like used for PSO) @RheumNow

— Dr. Arthur Lau (@ArthurRheum) October 24, 2018

Dr. Cush
ABSTRACT: L11
Etanercept & MTX As Monotherapy or in Combination in Patients with Psoriatic Arthritis: A Phase 3, Double-Blind, Randomized Controlled Study —Addition of MTX to ETN did not improve efficacy compared with ETN alone. #ACR18 @Rheumnowhttps://t.co/6y8OTEVgPB

— Suleman Bhana, MD (@DrBhana) October 24, 2018

We had a great discussion and will post it soon. https://t.co/N7dWlp3zz2

— Dr. John Cush (@RheumNow) October 24, 2018

#ACR18 Late Breaking Abstracts#L17 Bimekizumab (anti-IL17 A & F) in PsA. Superior ACR50 vs PBO at wk 12, increase in response to wk24, sustained to wk48. No major new safety signals (candida 5%, LFTs, 1 suicidal ideation).
Would be interesting to see vs IL17A alone.@RheumNow pic.twitter.com/r41yRb55Y7

— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 23, 2018

L17 Ph2 48 wk trial dual neutralization of IL‑17A and IL‑17F w/bezilkumab in PsA: at wk 12 ACR 50
And PASI and maintained at wk 48. Serious AEs around 4% at wks24&48, not dose related; most common nasopharyngitis. Oral candidiasis 10/206 (4.9%) at wk48 in BZK. #acr18 @rheumnow

— Olga Petryna (@DrPetryna) October 23, 2018

Study shows potential role of NK cells in PsA pathogenesis. HLA B21 – M may be a genetic marker that differentiates PsA from PsO. https://t.co/2Q4eYbHv2J @RheumNow #ACR18 #2787

— Dr. Rachel Tate (@uptoTate) October 23, 2018

#ACR18 poster 2138: pattern of MTX use for PsA in US claims database. Almost half of those initiated on MTX discontinue within a year of starting therapy. Are benefits<harms for majority in PsA?@RheumNow pic.twitter.com/ewPHgNsaob

— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 23, 2018

Abst 1206 Verhoeven (France) US of 136 #AS / #PsA patients – Positive US findings manubristernal/Sternoclavicular in 37% rising to 63% after 5yrs – 55% had ant. Chest wall pain. #ACR18 @rheumnow [Note to self: Must start scanning those joints!]

— Philip Gardiner (@PhilipGardiner) October 22, 2018

Plenary 1821 #PsA RCT Filgotinib (JAK1 inhib) in Psa EQUATOR study (Philip Mease) – Promising improvements in patients with active PsA- 65 in each group, 16 weeks. Sig results vs. Placebo, but one patient died (pneumonia). #ACR18 @rheumnow

— Philip Gardiner (@PhilipGardiner) October 22, 2018

Do we need more drug development and novel therapies to better treat Psoriatic arthritis in the future?

— Dr. John Cush (@RheumNow) October 23, 2018

Do we need more drug development and novel therapies to better treat Psoriatic arthritis in the future?

— Dr. John Cush (@RheumNow) October 23, 2018

#ACR18 #1866 Genovese: Incidence of IBD in Ps/PsA treated with Ixekizumab in 15 RCTs. All trials excluded *active* IBD. Incidence rates low (0.25/1000pt-yrs for flare; 1.35/1000py for new IBD); many of these continued in trial.

Risk of IBD real, but low. @RheumNow pic.twitter.com/JZRyCKmICt

— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 22, 2018

Abstract 1628
They are not the same disease and this will be more clinically relevant as the treatment options grow.
HLAB27+/Male and younger age->AS#ACR18 @rheumnow pic.twitter.com/h6FBQOlzVo

— Julio Gonzalez (@japaoli19) October 22, 2018

AbstractL11
Not surprisingly Etanercept monotherapy was superior to MTX mono and as good as combo Tx in PsA but MTX mono did have decent ACR response at W16#ACR18 @rheumnow pic.twitter.com/QzZhZMDE6u

— Julio Gonzalez (@japaoli19) October 22, 2018

HLA-B alleles B*35, B*8, and B*38 may be associated with sacroiliitis in PsA pts. #1625 https://t.co/OjfBBtg3u8 @RheumNow #ACR18

— Dr. Rachel Tate (@uptoTate) October 22, 2018

Abst1608 Study from Toronto suggests Carotid ultrasound as a screening tool for PsD w/high CV risk. Incidence of CVE higher in sub clinical pts w/bilateral carotid
plaques compared to unilateral/no plaques (3.96 vs. 0.54 events per 100 person years; p<0.001) #ACR18 @RheumNow pic.twitter.com/iScyjFhdy0

— Olga Petryna (@DrPetryna) October 22, 2018

1821 16wk Ph2 trial: + effect of filgotinibe 200mg/d in PsA after cDMARD failure.ACR20 80.0% FIL & 33.3% PBO (p<0.0001), PASI75 45.2% &15.0% (p=0.0034).
Comparable AEs(FIL: 56.9%; PBO: 59.1%).Infection FIL21.5%; PBO: 21.2%. 1 fatal PNA &1HZ in FIL. No malign #acr18 @rheumnow pic.twitter.com/2deC1X2PSf

— Olga Petryna (@DrPetryna) October 22, 2018

FIL showed superior efficacy, ACR20, versus PBO in pts with PsA. No new safety signals were identified. #1821 https://t.co/c1XlE7pXb8 @RheumNow #ACR18

— Dr. Rachel Tate (@uptoTate) October 22, 2018

Severity of sonographic enthesitis correlates with measures of disease activity, joint damage and patient function in early PsA #1591 https://t.co/ByzRKkeWZd @RheumNow #ACR18

— Dr. Rachel Tate (@uptoTate) October 22, 2018

Abst1591 enthesitis as a potential marker of disease severity in early PsA by Dr. Lihi Eder: higher sonographic enthesitis score correlates w/ PGA(β 1.9, 95% CI
0.3, 3.5), HAQ (β 9.7, 95% CI 3.9, 15.5), SJC (β 1.3, 95% CI
0.6, 1.8) &TJC (β 1.2, 95% CI 0.6, 1.8) #ACR18 @RheumNow

— Olga Petryna (@DrPetryna) October 22, 2018

Abstract 640 Studied the rates of joint replacement surgery in psoriatic arthritis patients between 1995 – 2015, noting a sharp increase after 2003 when biologics were introduced for PsA – Question is why? #ACR18 pic.twitter.com/6U8jJSLok8

— Dr. John Cush (@RheumNow) October 22, 2018

Minimal changes in mTSS were observed in the majority of PsA pts treated with IXEQ2W or IXEQ4W over 3 year period. #662 https://t.co/htjuK8YiGM @RheumNow #ACR18 pic.twitter.com/jnJLoQpoTd

— Dr. Rachel Tate (@uptoTate) October 21, 2018

Baseline patient global assessment in tx naive PsA patients was the single best predictor for receiving TNFi. #681 https://t.co/E07EJax59O @RheumNow #ACR18 pic.twitter.com/x98lEHTFSb

— Dr. Rachel Tate (@uptoTate) October 21, 2018

"The problem is that psoriatic disease has been a disease of hand-me downs… this is now a disease which is standing on its own two feet. It merits consideration not just as rheumatoid with a rash". The always entertaining Iain McInnes at the #ACR18 Review Course @RheumNow

— David Liew (@drdavidliew) October 20, 2018

We need to do a better job. Our RA and PSA patients are not getting the flu shot because they are afraid. Stress the safety of the vaccine. #ACR18 @RheumNow Abstract 231 pic.twitter.com/NXp0ebnxzV

— William Shergy (@WilliamShergy) October 21, 2018

Abst 632 cross-sectional stdy: gender differences in disease activity perception in pts w/PsA. PROs significantly ⬆️ in F: 4.7 (2.8), 0.86 (0.69) & 4.1 (2.5) vs 3.4 (2.9), 0.46 (0.60) & 2.7 (2.3) in M for PGA, HAQ-DI and PsAID12, respectively (all p < 0.001). #ACR18 @RheumNow

— Olga Petryna (@DrPetryna) October 21, 2018

Abst212 retrospective study from Hong Kong: RA, PsA&AS crude mortality declined in the last 20 yrs. most significant decrease in CV death (p<0.001). Deaths from infection increased significantly #ACR18 @RheumNow pic.twitter.com/509OsYOOPB

— Olga Petryna (@DrPetryna) October 21, 2018

No relationship between nail disorders and peripheral arthritis/enthesitis found in patients with PsO or PsA on US. #679 https://t.co/aqkbcON0fv @RheumNow #ACR18 pic.twitter.com/0SXzew8mcM

— Dr. Rachel Tate (@uptoTate) October 21, 2018