Article

Key clinical point: Targeted musculoskeletal ultrasound performed by trained dermatologists improved the accuracy of early psoriatic arthritis (PsA) diagnosis and may eventually decrease referral to rheumatologists.

Major finding: Use of musculoskeletal ultrasound changed the sensitivity and specificity of early PsA screening strategy from 88.2% (95% CI 58.1%-94.6%) and 54.4% (95% CI 44.8%-64.1%) to 70.6% (95% CI 38.4%-81.9%) and 90.4% (95% CI 83.9%-95.6%), respectively. Overall, 45 of the 46 patients were cleared of preliminary diagnosis-based PsA suspicion after musculoskeletal ultrasound.

Study details: This was a prospective study including 140 patients with psoriasis who presented to dermatologists with arthralgia, of which 19 patients were diagnosed with PsA by a rheumatologist.

Disclosures: This study was supported by Novartis Pharma. The authors declared no conflicts of interest.

Source: Grobelski J et al. Prospective double-blind study on the value of musculoskeletal ultrasound by dermatologists as a screening instrument for psoriatic arthritis. Rheumatology (Oxford). 2022 (Dec 22). Doi: 10.1093/rheumatology/keac702

Key clinical point: Targeted musculoskeletal ultrasound performed by trained dermatologists improved the accuracy of early psoriatic arthritis (PsA) diagnosis and may eventually decrease referral to rheumatologists.

Major finding: Use of musculoskeletal ultrasound changed the sensitivity and specificity of early PsA screening strategy from 88.2% (95% CI 58.1%-94.6%) and 54.4% (95% CI 44.8%-64.1%) to 70.6% (95% CI 38.4%-81.9%) and 90.4% (95% CI 83.9%-95.6%), respectively. Overall, 45 of the 46 patients were cleared of preliminary diagnosis-based PsA suspicion after musculoskeletal ultrasound.

Study details: This was a prospective study including 140 patients with psoriasis who presented to dermatologists with arthralgia, of which 19 patients were diagnosed with PsA by a rheumatologist.

Disclosures: This study was supported by Novartis Pharma. The authors declared no conflicts of interest.

Source: Grobelski J et al. Prospective double-blind study on the value of musculoskeletal ultrasound by dermatologists as a screening instrument for psoriatic arthritis. Rheumatology (Oxford). 2022 (Dec 22). Doi: 10.1093/rheumatology/keac702

Key clinical point: Targeted musculoskeletal ultrasound performed by trained dermatologists improved the accuracy of early psoriatic arthritis (PsA) diagnosis and may eventually decrease referral to rheumatologists.

Major finding: Use of musculoskeletal ultrasound changed the sensitivity and specificity of early PsA screening strategy from 88.2% (95% CI 58.1%-94.6%) and 54.4% (95% CI 44.8%-64.1%) to 70.6% (95% CI 38.4%-81.9%) and 90.4% (95% CI 83.9%-95.6%), respectively. Overall, 45 of the 46 patients were cleared of preliminary diagnosis-based PsA suspicion after musculoskeletal ultrasound.

Study details: This was a prospective study including 140 patients with psoriasis who presented to dermatologists with arthralgia, of which 19 patients were diagnosed with PsA by a rheumatologist.

Disclosures: This study was supported by Novartis Pharma. The authors declared no conflicts of interest.

Source: Grobelski J et al. Prospective double-blind study on the value of musculoskeletal ultrasound by dermatologists as a screening instrument for psoriatic arthritis. Rheumatology (Oxford). 2022 (Dec 22). Doi: 10.1093/rheumatology/keac702

Key clinical point: Ustekinumab and tumor necrosis factor inhibitors (TNFi) demonstrated similar efficacy and persistence and were well tolerated as first-line to third-line biologic treatment for psoriatic arthritis (PsA).

Major finding: Over 3 years, treatment with ustekinumab vs TNFi resulted in comparable odds of attaining clinical Disease Activity Index for PsA low disease activity (adjusted odds ratio [aOR] 0.89; 95% CI 0.63-1.26) and remission (aOR 0.72; 95% CI 0.50-1.05), similar risk for stopping/switching treatment (adjusted hazard ratio 0.87; 95% CI 0.68-1.11), and no clinically relevant difference in serious adverse event rates (6.3% vs 7.2%).

Study details: The data come from an analysis of 895 patients with PsA from PsABio, a prospective observational study, who were prescribed first-line to third-line ustekinumab or a TNFi.

Disclosures: This study was sponsored by Janssen. Two authors declared being current or former employees of or owning stocks in Johnson & Johnson or Janssen. Several authors reported receiving personal fees, consulting fees, grants, payments, or honoraria from Janssen and various other sources.

Source: Gossec L et al. Long-term effectiveness and persistence of ustekinumab and TNF inhibitors in patients with psoriatic arthritis: Final 3-year results from the PsABio real-world study. Ann Rheum Dis. 2022 (Dec 13). Doi: 10.1136/ard-2022-222879

Key clinical point: Ustekinumab and tumor necrosis factor inhibitors (TNFi) demonstrated similar efficacy and persistence and were well tolerated as first-line to third-line biologic treatment for psoriatic arthritis (PsA).

Major finding: Over 3 years, treatment with ustekinumab vs TNFi resulted in comparable odds of attaining clinical Disease Activity Index for PsA low disease activity (adjusted odds ratio [aOR] 0.89; 95% CI 0.63-1.26) and remission (aOR 0.72; 95% CI 0.50-1.05), similar risk for stopping/switching treatment (adjusted hazard ratio 0.87; 95% CI 0.68-1.11), and no clinically relevant difference in serious adverse event rates (6.3% vs 7.2%).

Study details: The data come from an analysis of 895 patients with PsA from PsABio, a prospective observational study, who were prescribed first-line to third-line ustekinumab or a TNFi.

Disclosures: This study was sponsored by Janssen. Two authors declared being current or former employees of or owning stocks in Johnson & Johnson or Janssen. Several authors reported receiving personal fees, consulting fees, grants, payments, or honoraria from Janssen and various other sources.

Source: Gossec L et al. Long-term effectiveness and persistence of ustekinumab and TNF inhibitors in patients with psoriatic arthritis: Final 3-year results from the PsABio real-world study. Ann Rheum Dis. 2022 (Dec 13). Doi: 10.1136/ard-2022-222879

Key clinical point: Ustekinumab and tumor necrosis factor inhibitors (TNFi) demonstrated similar efficacy and persistence and were well tolerated as first-line to third-line biologic treatment for psoriatic arthritis (PsA).

Major finding: Over 3 years, treatment with ustekinumab vs TNFi resulted in comparable odds of attaining clinical Disease Activity Index for PsA low disease activity (adjusted odds ratio [aOR] 0.89; 95% CI 0.63-1.26) and remission (aOR 0.72; 95% CI 0.50-1.05), similar risk for stopping/switching treatment (adjusted hazard ratio 0.87; 95% CI 0.68-1.11), and no clinically relevant difference in serious adverse event rates (6.3% vs 7.2%).

Study details: The data come from an analysis of 895 patients with PsA from PsABio, a prospective observational study, who were prescribed first-line to third-line ustekinumab or a TNFi.

Disclosures: This study was sponsored by Janssen. Two authors declared being current or former employees of or owning stocks in Johnson & Johnson or Janssen. Several authors reported receiving personal fees, consulting fees, grants, payments, or honoraria from Janssen and various other sources.

Source: Gossec L et al. Long-term effectiveness and persistence of ustekinumab and TNF inhibitors in patients with psoriatic arthritis: Final 3-year results from the PsABio real-world study. Ann Rheum Dis. 2022 (Dec 13). Doi: 10.1136/ard-2022-222879

Key clinical point: Fluorescence-optical imaging (FOI) successfully detected the early signs of musculoskeletal inflammation in hands and predicted transition from psoriasis to psoriatic arthritis (PsA) at initial stages in patients with psoriasis at risk for PsA.

Major finding: PsA diagnosis was confirmed by clinical evaluations (CE) in 50% of patients with psoriasis at risk for PsA and an additional 30% of patients who were positive on FOI. Compared with previously published annual incidence rates, the incidence rate of PsA was higher among patients positive on FOI but negative on CE (11.8%).

Study details: This was an investigator-initiated prospective two-part observational cohort study including 389 patients with plaque psoriasis who were at risk for PsA.

Disclosures: This study was sponsored by Fraunhofer ITMP and supported by a research grant from Pfizer Germany. Five authors declared being supported by Fraunhofer ITMP. Several authors reported ties with various sources, including Pfizer. GR Burmester reported being on the editorial board of RMD Open.

Source: Koehm M et al. Fluorescence-optical imaging as a promising easy-to-use imaging biomarker to increase early psoriatic arthritis detection in patients with psoriasis: A cross-sectional cohort study with follow-up. RMD Open. 2022;8(2):e002682 (Dec 6). Doi: 10.1136/rmdopen-2022-002682

Key clinical point: Fluorescence-optical imaging (FOI) successfully detected the early signs of musculoskeletal inflammation in hands and predicted transition from psoriasis to psoriatic arthritis (PsA) at initial stages in patients with psoriasis at risk for PsA.

Major finding: PsA diagnosis was confirmed by clinical evaluations (CE) in 50% of patients with psoriasis at risk for PsA and an additional 30% of patients who were positive on FOI. Compared with previously published annual incidence rates, the incidence rate of PsA was higher among patients positive on FOI but negative on CE (11.8%).

Study details: This was an investigator-initiated prospective two-part observational cohort study including 389 patients with plaque psoriasis who were at risk for PsA.

Disclosures: This study was sponsored by Fraunhofer ITMP and supported by a research grant from Pfizer Germany. Five authors declared being supported by Fraunhofer ITMP. Several authors reported ties with various sources, including Pfizer. GR Burmester reported being on the editorial board of RMD Open.

Source: Koehm M et al. Fluorescence-optical imaging as a promising easy-to-use imaging biomarker to increase early psoriatic arthritis detection in patients with psoriasis: A cross-sectional cohort study with follow-up. RMD Open. 2022;8(2):e002682 (Dec 6). Doi: 10.1136/rmdopen-2022-002682

Key clinical point: Fluorescence-optical imaging (FOI) successfully detected the early signs of musculoskeletal inflammation in hands and predicted transition from psoriasis to psoriatic arthritis (PsA) at initial stages in patients with psoriasis at risk for PsA.

Major finding: PsA diagnosis was confirmed by clinical evaluations (CE) in 50% of patients with psoriasis at risk for PsA and an additional 30% of patients who were positive on FOI. Compared with previously published annual incidence rates, the incidence rate of PsA was higher among patients positive on FOI but negative on CE (11.8%).

Study details: This was an investigator-initiated prospective two-part observational cohort study including 389 patients with plaque psoriasis who were at risk for PsA.

Disclosures: This study was sponsored by Fraunhofer ITMP and supported by a research grant from Pfizer Germany. Five authors declared being supported by Fraunhofer ITMP. Several authors reported ties with various sources, including Pfizer. GR Burmester reported being on the editorial board of RMD Open.

Source: Koehm M et al. Fluorescence-optical imaging as a promising easy-to-use imaging biomarker to increase early psoriatic arthritis detection in patients with psoriasis: A cross-sectional cohort study with follow-up. RMD Open. 2022;8(2):e002682 (Dec 6). Doi: 10.1136/rmdopen-2022-002682

Key clinical point: Patient-reported flares occurred more frequently than physician-reported flares and demonstrated moderate agreement with worsening of disease activity in psoriatic arthritis (DAPSA), with patients with psoriatic arthritis (PsA) who reported flares having a significantly more active disease.

Major finding: Overall, 27.0% and 17.6% of patients had patient-reported and physician-reported flares, respectively, with patient-reported flare demonstrating 69.8% crude agreement with DAPSA (prevalence adjusted bias adjusted kappa  =  0.40) and patients reporting vs not reporting disease flare indicating a significantly more active disease for all outcomes (P < .001) except skin lesions (P  =  .01).

Study details: This was a longitudinal observational study including 222 patients with PsA.

Disclosures: This study was supported by unrestricted investigator-initiated research grant from Pfizer. Three authors declared receiving funds, research grants, or support from the US National Institutes of Health and other sources.

Source: Sousa M et al. Patient-defined flares and disease activity worsening in 222 patients with psoriatic arthritis from 14 countries. Joint Bone Spine. 2022;90(3):105511 (Dec 15). Doi: 10.1016/j.jbspin.2022.105511

Key clinical point: Patient-reported flares occurred more frequently than physician-reported flares and demonstrated moderate agreement with worsening of disease activity in psoriatic arthritis (DAPSA), with patients with psoriatic arthritis (PsA) who reported flares having a significantly more active disease.

Major finding: Overall, 27.0% and 17.6% of patients had patient-reported and physician-reported flares, respectively, with patient-reported flare demonstrating 69.8% crude agreement with DAPSA (prevalence adjusted bias adjusted kappa  =  0.40) and patients reporting vs not reporting disease flare indicating a significantly more active disease for all outcomes (P < .001) except skin lesions (P  =  .01).

Study details: This was a longitudinal observational study including 222 patients with PsA.

Disclosures: This study was supported by unrestricted investigator-initiated research grant from Pfizer. Three authors declared receiving funds, research grants, or support from the US National Institutes of Health and other sources.

Source: Sousa M et al. Patient-defined flares and disease activity worsening in 222 patients with psoriatic arthritis from 14 countries. Joint Bone Spine. 2022;90(3):105511 (Dec 15). Doi: 10.1016/j.jbspin.2022.105511

Key clinical point: Patient-reported flares occurred more frequently than physician-reported flares and demonstrated moderate agreement with worsening of disease activity in psoriatic arthritis (DAPSA), with patients with psoriatic arthritis (PsA) who reported flares having a significantly more active disease.

Major finding: Overall, 27.0% and 17.6% of patients had patient-reported and physician-reported flares, respectively, with patient-reported flare demonstrating 69.8% crude agreement with DAPSA (prevalence adjusted bias adjusted kappa  =  0.40) and patients reporting vs not reporting disease flare indicating a significantly more active disease for all outcomes (P < .001) except skin lesions (P  =  .01).

Study details: This was a longitudinal observational study including 222 patients with PsA.

Disclosures: This study was supported by unrestricted investigator-initiated research grant from Pfizer. Three authors declared receiving funds, research grants, or support from the US National Institutes of Health and other sources.

Source: Sousa M et al. Patient-defined flares and disease activity worsening in 222 patients with psoriatic arthritis from 14 countries. Joint Bone Spine. 2022;90(3):105511 (Dec 15). Doi: 10.1016/j.jbspin.2022.105511

Key clinical point: Ultrasound-detected residual inflammation in peripheral articular structures may be present even in patients with psoriatic arthritis (PsA) who have achieved stable minimal disease activity (MDA), with residual inflammation being more prevalent in patients with shorter duration of MDA.

Major finding: Despite stable MDA, 54.2% of patients had ≥1 positive Power Doppler (PD) signal in examined tissues, with 19.4% and 23.6% of patients showing ≥1 joint and enthesis with a positive PD signal, respectively. A higher proportion of patients with ≤12 vs >12 months of sustained MDA had ≥1 ultrasound detected PD lesion (55% vs 41%; P  =  .024).

Study details: This cross-sectional study included 72 patients with PsA who were on biologic or conventional synthetic disease-modifying antirheumatic drugs for ≥12 months and in continuous MDA for ≥6 months.

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

Source: Macchioni P et al. Residual inflammation in psoriatic arthritis patients in stable minimal disease activity. Front Med. 2022;9:1096547 (Dec 20). Doi: 10.3389/fmed.2022.1096547

Key clinical point: Ultrasound-detected residual inflammation in peripheral articular structures may be present even in patients with psoriatic arthritis (PsA) who have achieved stable minimal disease activity (MDA), with residual inflammation being more prevalent in patients with shorter duration of MDA.

Major finding: Despite stable MDA, 54.2% of patients had ≥1 positive Power Doppler (PD) signal in examined tissues, with 19.4% and 23.6% of patients showing ≥1 joint and enthesis with a positive PD signal, respectively. A higher proportion of patients with ≤12 vs >12 months of sustained MDA had ≥1 ultrasound detected PD lesion (55% vs 41%; P  =  .024).

Study details: This cross-sectional study included 72 patients with PsA who were on biologic or conventional synthetic disease-modifying antirheumatic drugs for ≥12 months and in continuous MDA for ≥6 months.

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

Source: Macchioni P et al. Residual inflammation in psoriatic arthritis patients in stable minimal disease activity. Front Med. 2022;9:1096547 (Dec 20). Doi: 10.3389/fmed.2022.1096547

Key clinical point: Ultrasound-detected residual inflammation in peripheral articular structures may be present even in patients with psoriatic arthritis (PsA) who have achieved stable minimal disease activity (MDA), with residual inflammation being more prevalent in patients with shorter duration of MDA.

Major finding: Despite stable MDA, 54.2% of patients had ≥1 positive Power Doppler (PD) signal in examined tissues, with 19.4% and 23.6% of patients showing ≥1 joint and enthesis with a positive PD signal, respectively. A higher proportion of patients with ≤12 vs >12 months of sustained MDA had ≥1 ultrasound detected PD lesion (55% vs 41%; P  =  .024).

Study details: This cross-sectional study included 72 patients with PsA who were on biologic or conventional synthetic disease-modifying antirheumatic drugs for ≥12 months and in continuous MDA for ≥6 months.

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

Source: Macchioni P et al. Residual inflammation in psoriatic arthritis patients in stable minimal disease activity. Front Med. 2022;9:1096547 (Dec 20). Doi: 10.3389/fmed.2022.1096547

Key clinical point: The overall incidence of hematologic malignancies was not higher among patients with psoriatic arthritis (PsA) receiving treatment with tumor necrosis factor inhibitors (TNFi) compared with those who were biological disease-modifying antirheumatic drug (bDMARD) naive or individuals from the general population.

Major finding: Overall, the incidence rate of hematologic malignancies was similar among patients treated with TNFi vs those who were bDMARD naive (incidence rate ratio [IRR] 0.96; 95% CI 0.68-1.35) or individuals in the general population (IRR 1.35; 95% CI 0.98-1.86).

Study details: Findings are from a cohort study including patients with PsA who either initiated first TNFi (n = 10,621) or were bDMARD-naive (n = 18,387) and matched comparators from the general population.

Disclosures: This study was supported by NordForsk and FOREUM. B Delcoigne declared being partly employed by ARTIS/Swedish Biologics Register. Several authors reported receiving grants or research support or serving as consultants for or on speaker’s bureaus of various sources.

Source: Cordtz RL et al. Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: A Nordic cohort study. RMD Open. 2022;8(2):e002776 (Dec 23). Doi: 10.1136/rmdopen-2022-002776

Key clinical point: The overall incidence of hematologic malignancies was not higher among patients with psoriatic arthritis (PsA) receiving treatment with tumor necrosis factor inhibitors (TNFi) compared with those who were biological disease-modifying antirheumatic drug (bDMARD) naive or individuals from the general population.

Major finding: Overall, the incidence rate of hematologic malignancies was similar among patients treated with TNFi vs those who were bDMARD naive (incidence rate ratio [IRR] 0.96; 95% CI 0.68-1.35) or individuals in the general population (IRR 1.35; 95% CI 0.98-1.86).

Study details: Findings are from a cohort study including patients with PsA who either initiated first TNFi (n = 10,621) or were bDMARD-naive (n = 18,387) and matched comparators from the general population.

Disclosures: This study was supported by NordForsk and FOREUM. B Delcoigne declared being partly employed by ARTIS/Swedish Biologics Register. Several authors reported receiving grants or research support or serving as consultants for or on speaker’s bureaus of various sources.

Source: Cordtz RL et al. Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: A Nordic cohort study. RMD Open. 2022;8(2):e002776 (Dec 23). Doi: 10.1136/rmdopen-2022-002776

Key clinical point: The overall incidence of hematologic malignancies was not higher among patients with psoriatic arthritis (PsA) receiving treatment with tumor necrosis factor inhibitors (TNFi) compared with those who were biological disease-modifying antirheumatic drug (bDMARD) naive or individuals from the general population.

Major finding: Overall, the incidence rate of hematologic malignancies was similar among patients treated with TNFi vs those who were bDMARD naive (incidence rate ratio [IRR] 0.96; 95% CI 0.68-1.35) or individuals in the general population (IRR 1.35; 95% CI 0.98-1.86).

Study details: Findings are from a cohort study including patients with PsA who either initiated first TNFi (n = 10,621) or were bDMARD-naive (n = 18,387) and matched comparators from the general population.

Disclosures: This study was supported by NordForsk and FOREUM. B Delcoigne declared being partly employed by ARTIS/Swedish Biologics Register. Several authors reported receiving grants or research support or serving as consultants for or on speaker’s bureaus of various sources.

Source: Cordtz RL et al. Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: A Nordic cohort study. RMD Open. 2022;8(2):e002776 (Dec 23). Doi: 10.1136/rmdopen-2022-002776

Key clinical point: The failure to achieve minimal disease activity (MDA) in the first year after the diagnosis of psoriatic arthritis (PsA) was associated with worse health-related quality of life and health status, functional impairment, fatigue, pain, and higher anxiety and depression.

Major finding: Compared with patients who achieved sustained MDA in the first year after diagnosis, those who did not achieve MDA had higher scores for pain (estimated mean difference [β] 35.38), fatigue (β 17.88), and functional ability (β 0.81; all P < .001) and higher anxiety and depression (both P < .001) during follow-up, which persisted despite treatment intensification.

Study details: This prospective cohort study included 240 patients with newly diagnosed PsA with oligoarthritis or polyarthritis  who were disease-modifying antirheumatic drug naive.

Disclosures: This study was sponsored by UCB Pharma. S Welby and AR Prickett declared being stockholders of UCB.

Source: Snoeck Henkemans SVJ et al. Importance of quick attainment of minimal disease activity for a positive impact on lives of patients with psoriatic arthritis. RMD Open. 2022;8(2):e002706 (Dec 7). Doi: 10.1136/rmdopen-2022-002706

Key clinical point: The failure to achieve minimal disease activity (MDA) in the first year after the diagnosis of psoriatic arthritis (PsA) was associated with worse health-related quality of life and health status, functional impairment, fatigue, pain, and higher anxiety and depression.

Major finding: Compared with patients who achieved sustained MDA in the first year after diagnosis, those who did not achieve MDA had higher scores for pain (estimated mean difference [β] 35.38), fatigue (β 17.88), and functional ability (β 0.81; all P < .001) and higher anxiety and depression (both P < .001) during follow-up, which persisted despite treatment intensification.

Study details: This prospective cohort study included 240 patients with newly diagnosed PsA with oligoarthritis or polyarthritis  who were disease-modifying antirheumatic drug naive.

Disclosures: This study was sponsored by UCB Pharma. S Welby and AR Prickett declared being stockholders of UCB.

Source: Snoeck Henkemans SVJ et al. Importance of quick attainment of minimal disease activity for a positive impact on lives of patients with psoriatic arthritis. RMD Open. 2022;8(2):e002706 (Dec 7). Doi: 10.1136/rmdopen-2022-002706

Key clinical point: The failure to achieve minimal disease activity (MDA) in the first year after the diagnosis of psoriatic arthritis (PsA) was associated with worse health-related quality of life and health status, functional impairment, fatigue, pain, and higher anxiety and depression.

Major finding: Compared with patients who achieved sustained MDA in the first year after diagnosis, those who did not achieve MDA had higher scores for pain (estimated mean difference [β] 35.38), fatigue (β 17.88), and functional ability (β 0.81; all P < .001) and higher anxiety and depression (both P < .001) during follow-up, which persisted despite treatment intensification.

Study details: This prospective cohort study included 240 patients with newly diagnosed PsA with oligoarthritis or polyarthritis  who were disease-modifying antirheumatic drug naive.

Disclosures: This study was sponsored by UCB Pharma. S Welby and AR Prickett declared being stockholders of UCB.

Source: Snoeck Henkemans SVJ et al. Importance of quick attainment of minimal disease activity for a positive impact on lives of patients with psoriatic arthritis. RMD Open. 2022;8(2):e002706 (Dec 7). Doi: 10.1136/rmdopen-2022-002706

Key clinical point: The addition of methotrexate or maintenance of ongoing methotrexate did not significantly enhance the efficacy of ustekinumab in patients with active psoriatic arthritis (PsA), suggesting ustekinumab as an effective therapy for PsA independent of methotrexate.

Major finding: Ustekinumab monotherapy demonstrated non-inferiority over ustekinumab+methotrexate with a comparable Disease Activity Score in 28 joints (DAS28) at week 24 (mean 2.9 vs 3.1; Mann-Whitney estimator 0.5426) and at week 52 (mean 2.8 vs 3.1; Mann-Whitney estimator 0.5461). Overall, serious adverse events occurred in 9% of patients in both treatment groups, but no deaths were reported.

Study details: Findings are from MUST, a phase 3b trial including 173 ustekinumab-naive patients with active PsA who were randomly assigned to receive ustekinumab+methotrexate or ustekinumab+placebo.

Disclosures: This study was supported by Janssen Cilag. Several authors reported receiving grants, contracts, travel support, or honoraria or fees for serving as speakers, consultants, or advisory board members for various sources.

Source: Koehm M et al. Methotrexate plus ustekinumab versus ustekinumab monotherapy in patients with active psoriatic arthritis (MUST): A randomised, multicentre, placebo-controlled, phase 3b, non-inferiority trial. Lancet Rheumatol. 2023;5(1):E14-E23 (Jan 1). Doi: 10.1016/S2665-9913(22)00329-0

Key clinical point: The addition of methotrexate or maintenance of ongoing methotrexate did not significantly enhance the efficacy of ustekinumab in patients with active psoriatic arthritis (PsA), suggesting ustekinumab as an effective therapy for PsA independent of methotrexate.

Major finding: Ustekinumab monotherapy demonstrated non-inferiority over ustekinumab+methotrexate with a comparable Disease Activity Score in 28 joints (DAS28) at week 24 (mean 2.9 vs 3.1; Mann-Whitney estimator 0.5426) and at week 52 (mean 2.8 vs 3.1; Mann-Whitney estimator 0.5461). Overall, serious adverse events occurred in 9% of patients in both treatment groups, but no deaths were reported.

Study details: Findings are from MUST, a phase 3b trial including 173 ustekinumab-naive patients with active PsA who were randomly assigned to receive ustekinumab+methotrexate or ustekinumab+placebo.

Disclosures: This study was supported by Janssen Cilag. Several authors reported receiving grants, contracts, travel support, or honoraria or fees for serving as speakers, consultants, or advisory board members for various sources.

Source: Koehm M et al. Methotrexate plus ustekinumab versus ustekinumab monotherapy in patients with active psoriatic arthritis (MUST): A randomised, multicentre, placebo-controlled, phase 3b, non-inferiority trial. Lancet Rheumatol. 2023;5(1):E14-E23 (Jan 1). Doi: 10.1016/S2665-9913(22)00329-0

Key clinical point: The addition of methotrexate or maintenance of ongoing methotrexate did not significantly enhance the efficacy of ustekinumab in patients with active psoriatic arthritis (PsA), suggesting ustekinumab as an effective therapy for PsA independent of methotrexate.

Major finding: Ustekinumab monotherapy demonstrated non-inferiority over ustekinumab+methotrexate with a comparable Disease Activity Score in 28 joints (DAS28) at week 24 (mean 2.9 vs 3.1; Mann-Whitney estimator 0.5426) and at week 52 (mean 2.8 vs 3.1; Mann-Whitney estimator 0.5461). Overall, serious adverse events occurred in 9% of patients in both treatment groups, but no deaths were reported.

Study details: Findings are from MUST, a phase 3b trial including 173 ustekinumab-naive patients with active PsA who were randomly assigned to receive ustekinumab+methotrexate or ustekinumab+placebo.

Disclosures: This study was supported by Janssen Cilag. Several authors reported receiving grants, contracts, travel support, or honoraria or fees for serving as speakers, consultants, or advisory board members for various sources.

Source: Koehm M et al. Methotrexate plus ustekinumab versus ustekinumab monotherapy in patients with active psoriatic arthritis (MUST): A randomised, multicentre, placebo-controlled, phase 3b, non-inferiority trial. Lancet Rheumatol. 2023;5(1):E14-E23 (Jan 1). Doi: 10.1016/S2665-9913(22)00329-0

Key clinical point: Addition of metformin to the neoadjuvant docetaxel, epirubicin, and cyclophosphamide (TEC) regimen did not improve disease outcomes in patients with breast cancer (BC) and metabolic abnormalities.

Major finding: The total pathological complete response was achieved by a similar proportion of patients receiving TEC vs TEC+metformin (12.5% vs 14.6%; P  =  .777). Neutropenia and leucopenia, the most common grade ≥3 adverse events, were reported by 42.5% and 55.0% of patients in the TEC arm and 22.9% and 45.8% of patients in the TEC+metformin arm, respectively.

Study details: Findings are from the phase 2 NeoMET study including 92 patients with stage IIB/III BC and ≥1 metabolic syndrome component who were randomly assigned to receive six cycles of TEC or TEC+metformin.

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

Source: Huang J, Tong Y et al. Neoadjuvant docetaxel, epirubicin, and cyclophosphamide with or without metformin in breast cancer patients with metabolic abnormality: Results from the randomized phase II NeoMET trial. Breast Cancer Res Treat. 2022 (Dec 16). Doi: 10.1007/s10549-022-06821-y

Key clinical point: Addition of metformin to the neoadjuvant docetaxel, epirubicin, and cyclophosphamide (TEC) regimen did not improve disease outcomes in patients with breast cancer (BC) and metabolic abnormalities.

Major finding: The total pathological complete response was achieved by a similar proportion of patients receiving TEC vs TEC+metformin (12.5% vs 14.6%; P  =  .777). Neutropenia and leucopenia, the most common grade ≥3 adverse events, were reported by 42.5% and 55.0% of patients in the TEC arm and 22.9% and 45.8% of patients in the TEC+metformin arm, respectively.

Study details: Findings are from the phase 2 NeoMET study including 92 patients with stage IIB/III BC and ≥1 metabolic syndrome component who were randomly assigned to receive six cycles of TEC or TEC+metformin.

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

Source: Huang J, Tong Y et al. Neoadjuvant docetaxel, epirubicin, and cyclophosphamide with or without metformin in breast cancer patients with metabolic abnormality: Results from the randomized phase II NeoMET trial. Breast Cancer Res Treat. 2022 (Dec 16). Doi: 10.1007/s10549-022-06821-y

Key clinical point: Addition of metformin to the neoadjuvant docetaxel, epirubicin, and cyclophosphamide (TEC) regimen did not improve disease outcomes in patients with breast cancer (BC) and metabolic abnormalities.

Major finding: The total pathological complete response was achieved by a similar proportion of patients receiving TEC vs TEC+metformin (12.5% vs 14.6%; P  =  .777). Neutropenia and leucopenia, the most common grade ≥3 adverse events, were reported by 42.5% and 55.0% of patients in the TEC arm and 22.9% and 45.8% of patients in the TEC+metformin arm, respectively.

Study details: Findings are from the phase 2 NeoMET study including 92 patients with stage IIB/III BC and ≥1 metabolic syndrome component who were randomly assigned to receive six cycles of TEC or TEC+metformin.

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

Source: Huang J, Tong Y et al. Neoadjuvant docetaxel, epirubicin, and cyclophosphamide with or without metformin in breast cancer patients with metabolic abnormality: Results from the randomized phase II NeoMET trial. Breast Cancer Res Treat. 2022 (Dec 16). Doi: 10.1007/s10549-022-06821-y

Key clinical point: Microcalcifications and breast density, as assessed by the Breast Imaging Reporting and Data System 4th edition (BI-RADS) were associated with a significantly increased risk for breast cancer (BC).

Major finding: Microcalcification appeared to be a significant risk factor for BC irrespective of breast density (adjusted hazard ratio [aHR] 3.09; 95% CI 2.83-3.36). Both microcalcification and high breast density (BI-RADS density classification 4) were associated with a 6.65-fold (95% CI 5.59-7.72) higher risk for BC, with the risk being the highest in postmenopausal women with microcalcifications and high breast density (aHR 7.26; 95% CI 5.01-10.53).

Study details: Findings are from a retrospective cohort study including 3,910,815 women who underwent breast cancer screening, of which 58,315 women were diagnosed with BC during a median follow-up of 10.8 years.

Disclosures: This study was supported by the National Research Foundation of Korea and other sources. The authors declared no conflicts of interest.

Source: Kim S et al. Microcalcifications, mammographic breast density, and risk of breast cancer: A cohort study. Breast Cancer Res. 2022;24:96 (Dec 21). Doi: 10.1186/s13058-022-01594-0

Key clinical point: Microcalcifications and breast density, as assessed by the Breast Imaging Reporting and Data System 4th edition (BI-RADS) were associated with a significantly increased risk for breast cancer (BC).

Major finding: Microcalcification appeared to be a significant risk factor for BC irrespective of breast density (adjusted hazard ratio [aHR] 3.09; 95% CI 2.83-3.36). Both microcalcification and high breast density (BI-RADS density classification 4) were associated with a 6.65-fold (95% CI 5.59-7.72) higher risk for BC, with the risk being the highest in postmenopausal women with microcalcifications and high breast density (aHR 7.26; 95% CI 5.01-10.53).

Study details: Findings are from a retrospective cohort study including 3,910,815 women who underwent breast cancer screening, of which 58,315 women were diagnosed with BC during a median follow-up of 10.8 years.

Disclosures: This study was supported by the National Research Foundation of Korea and other sources. The authors declared no conflicts of interest.

Source: Kim S et al. Microcalcifications, mammographic breast density, and risk of breast cancer: A cohort study. Breast Cancer Res. 2022;24:96 (Dec 21). Doi: 10.1186/s13058-022-01594-0

Key clinical point: Microcalcifications and breast density, as assessed by the Breast Imaging Reporting and Data System 4th edition (BI-RADS) were associated with a significantly increased risk for breast cancer (BC).

Major finding: Microcalcification appeared to be a significant risk factor for BC irrespective of breast density (adjusted hazard ratio [aHR] 3.09; 95% CI 2.83-3.36). Both microcalcification and high breast density (BI-RADS density classification 4) were associated with a 6.65-fold (95% CI 5.59-7.72) higher risk for BC, with the risk being the highest in postmenopausal women with microcalcifications and high breast density (aHR 7.26; 95% CI 5.01-10.53).

Study details: Findings are from a retrospective cohort study including 3,910,815 women who underwent breast cancer screening, of which 58,315 women were diagnosed with BC during a median follow-up of 10.8 years.

Disclosures: This study was supported by the National Research Foundation of Korea and other sources. The authors declared no conflicts of interest.

Source: Kim S et al. Microcalcifications, mammographic breast density, and risk of breast cancer: A cohort study. Breast Cancer Res. 2022;24:96 (Dec 21). Doi: 10.1186/s13058-022-01594-0