Key clinical point: A structured 12-month weight-loss treatment with very low energy diet (VLED) showed positive effects on body weight and physical fitness without affecting the muscle strength in patients with psoriatic arthritis (PsA) and obesity.

Major finding: At month 12, the median weight loss was 16.1 kg in patients with PsA and obesity and 16.6 kg in control individuals with obesity. At month 6, the muscle strength of the lower extremities and physical functioning improved in patients with PsA and control individuals (all P < .001), which were maintained till month 12 (all P < .01). The hand-grip strength remained unchanged in both the groups.

Study details: The findings are a secondary analysis of a prospective open intervention study including 46 patients with PsA and body mass index of ≥33 kg/m² and 52 matched control individuals with obesity, all of whom received weight-loss treatment with VLED.

Disclosures: This study was supported by the Swedish state, Health and Medical Care Executive Board of the Västra Götaland, and other sources. The authors declared no conflicts of interest.

Source: Bilberg A et al. The impact of a structured weight-loss treatment on physical fitness in patients with psoriatic arthritis and obesity compared to matched controls: a prospective interventional study. Clin Rheumatol. 2022 (Jun 1). Doi: 10.1007/s10067-022-06164-5

Key clinical point: A structured 12-month weight-loss treatment with very low energy diet (VLED) showed positive effects on body weight and physical fitness without affecting the muscle strength in patients with psoriatic arthritis (PsA) and obesity.

Major finding: At month 12, the median weight loss was 16.1 kg in patients with PsA and obesity and 16.6 kg in control individuals with obesity. At month 6, the muscle strength of the lower extremities and physical functioning improved in patients with PsA and control individuals (all P < .001), which were maintained till month 12 (all P < .01). The hand-grip strength remained unchanged in both the groups.

Study details: The findings are a secondary analysis of a prospective open intervention study including 46 patients with PsA and body mass index of ≥33 kg/m² and 52 matched control individuals with obesity, all of whom received weight-loss treatment with VLED.

Disclosures: This study was supported by the Swedish state, Health and Medical Care Executive Board of the Västra Götaland, and other sources. The authors declared no conflicts of interest.

Source: Bilberg A et al. The impact of a structured weight-loss treatment on physical fitness in patients with psoriatic arthritis and obesity compared to matched controls: a prospective interventional study. Clin Rheumatol. 2022 (Jun 1). Doi: 10.1007/s10067-022-06164-5

Key clinical point: A structured 12-month weight-loss treatment with very low energy diet (VLED) showed positive effects on body weight and physical fitness without affecting the muscle strength in patients with psoriatic arthritis (PsA) and obesity.

Major finding: At month 12, the median weight loss was 16.1 kg in patients with PsA and obesity and 16.6 kg in control individuals with obesity. At month 6, the muscle strength of the lower extremities and physical functioning improved in patients with PsA and control individuals (all P < .001), which were maintained till month 12 (all P < .01). The hand-grip strength remained unchanged in both the groups.

Study details: The findings are a secondary analysis of a prospective open intervention study including 46 patients with PsA and body mass index of ≥33 kg/m² and 52 matched control individuals with obesity, all of whom received weight-loss treatment with VLED.

Disclosures: This study was supported by the Swedish state, Health and Medical Care Executive Board of the Västra Götaland, and other sources. The authors declared no conflicts of interest.

Source: Bilberg A et al. The impact of a structured weight-loss treatment on physical fitness in patients with psoriatic arthritis and obesity compared to matched controls: a prospective interventional study. Clin Rheumatol. 2022 (Jun 1). Doi: 10.1007/s10067-022-06164-5

Key clinical point: Monocyte chemotactic protein-1 (MCP-1) can serve as a biomarker for diagnosing asymptomatic diastolic dysfunction (DD) in patients with psoriatic arthritis (PsA).

Major finding: The serum MCP-1 concentration was significantly higher in patients with vs. without DD (366.6 vs. 277.5 pg/mL; P = .0017). Patients with serum MCP-1 concentration of >347.6 vs. ≤347.6 pg/mL had a 7.74-fold higher chance of developing DD (specificity 86.36%; sensitivity 55%) and showed a higher late peak diastolic mitral inflow velocity characterized by a lower E/A ratio (0.68 vs. 1.11; P = .000002).

Study details: Findings are from a random, prospective study including 63 patients with axial and peripheral PsA and without clinical manifestations of heart failure.

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

Source: Bursac IU et al. Predictive value of monocyte chemoattractant protein-1 in the development of diastolic dysfunction in patients with psoriatic arthritis. Dis Markers. 2022;2022: 4433313 (Jun 3). Doi:  10.1155/2022/4433313

Key clinical point: Monocyte chemotactic protein-1 (MCP-1) can serve as a biomarker for diagnosing asymptomatic diastolic dysfunction (DD) in patients with psoriatic arthritis (PsA).

Major finding: The serum MCP-1 concentration was significantly higher in patients with vs. without DD (366.6 vs. 277.5 pg/mL; P = .0017). Patients with serum MCP-1 concentration of >347.6 vs. ≤347.6 pg/mL had a 7.74-fold higher chance of developing DD (specificity 86.36%; sensitivity 55%) and showed a higher late peak diastolic mitral inflow velocity characterized by a lower E/A ratio (0.68 vs. 1.11; P = .000002).

Study details: Findings are from a random, prospective study including 63 patients with axial and peripheral PsA and without clinical manifestations of heart failure.

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

Source: Bursac IU et al. Predictive value of monocyte chemoattractant protein-1 in the development of diastolic dysfunction in patients with psoriatic arthritis. Dis Markers. 2022;2022: 4433313 (Jun 3). Doi:  10.1155/2022/4433313

Key clinical point: Monocyte chemotactic protein-1 (MCP-1) can serve as a biomarker for diagnosing asymptomatic diastolic dysfunction (DD) in patients with psoriatic arthritis (PsA).

Major finding: The serum MCP-1 concentration was significantly higher in patients with vs. without DD (366.6 vs. 277.5 pg/mL; P = .0017). Patients with serum MCP-1 concentration of >347.6 vs. ≤347.6 pg/mL had a 7.74-fold higher chance of developing DD (specificity 86.36%; sensitivity 55%) and showed a higher late peak diastolic mitral inflow velocity characterized by a lower E/A ratio (0.68 vs. 1.11; P = .000002).

Study details: Findings are from a random, prospective study including 63 patients with axial and peripheral PsA and without clinical manifestations of heart failure.

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

Source: Bursac IU et al. Predictive value of monocyte chemoattractant protein-1 in the development of diastolic dysfunction in patients with psoriatic arthritis. Dis Markers. 2022;2022: 4433313 (Jun 3). Doi:  10.1155/2022/4433313

Key clinical point: Inflammatory and metabolic parameters, including visceral adiposity, potentially contribute to subclinical coronary artery disease (CAD) in patients with psoriatic arthritis (PsA).

Major finding: CAD was significantly associated with visceral adiposity (standardized β 0.681; P = .002), and fluorodeoxyglucose (FDG) uptake in the bone marrow (standardized β 0.488; P = .008), liver (standardized β 0.619; P < .001), spleen (standardized β 0.523; P = .004), and subcutaneous adipose tissue (standardized β 0.524; P = .003). Visceral (P = .005) and subcutaneous (P = .004) adiposity and liver FDG uptake (P = .03) were higher in patients with PsA vs. controls without PsA.

Study details: Findings are from a cross-sectional analysis of a prospective study including 39 patients with biologic-naive PsA and 56 age-sex matched controls without PsA.

Disclosures: This study was funded by the US National Institute of Allergy and Infectious Disease, the US National Heart, Lung, and Blood Institute, and National Psoriasis Foundation. N Mehta declared serving as consultant and receiving grants and other payments from several sources.

Source: Schwartz DM et al. PET/CT-based characterization of 18F-FDG uptake in various tissues reveals novel potential contributions to coronary artery disease in psoriatic arthritis. Front Immunol. 2022;13:909760 (Jun 2). Doi: 10.3389/fimmu.2022.909760

Key clinical point: Inflammatory and metabolic parameters, including visceral adiposity, potentially contribute to subclinical coronary artery disease (CAD) in patients with psoriatic arthritis (PsA).

Major finding: CAD was significantly associated with visceral adiposity (standardized β 0.681; P = .002), and fluorodeoxyglucose (FDG) uptake in the bone marrow (standardized β 0.488; P = .008), liver (standardized β 0.619; P < .001), spleen (standardized β 0.523; P = .004), and subcutaneous adipose tissue (standardized β 0.524; P = .003). Visceral (P = .005) and subcutaneous (P = .004) adiposity and liver FDG uptake (P = .03) were higher in patients with PsA vs. controls without PsA.

Study details: Findings are from a cross-sectional analysis of a prospective study including 39 patients with biologic-naive PsA and 56 age-sex matched controls without PsA.

Disclosures: This study was funded by the US National Institute of Allergy and Infectious Disease, the US National Heart, Lung, and Blood Institute, and National Psoriasis Foundation. N Mehta declared serving as consultant and receiving grants and other payments from several sources.

Source: Schwartz DM et al. PET/CT-based characterization of 18F-FDG uptake in various tissues reveals novel potential contributions to coronary artery disease in psoriatic arthritis. Front Immunol. 2022;13:909760 (Jun 2). Doi: 10.3389/fimmu.2022.909760

Key clinical point: Inflammatory and metabolic parameters, including visceral adiposity, potentially contribute to subclinical coronary artery disease (CAD) in patients with psoriatic arthritis (PsA).

Major finding: CAD was significantly associated with visceral adiposity (standardized β 0.681; P = .002), and fluorodeoxyglucose (FDG) uptake in the bone marrow (standardized β 0.488; P = .008), liver (standardized β 0.619; P < .001), spleen (standardized β 0.523; P = .004), and subcutaneous adipose tissue (standardized β 0.524; P = .003). Visceral (P = .005) and subcutaneous (P = .004) adiposity and liver FDG uptake (P = .03) were higher in patients with PsA vs. controls without PsA.

Study details: Findings are from a cross-sectional analysis of a prospective study including 39 patients with biologic-naive PsA and 56 age-sex matched controls without PsA.

Disclosures: This study was funded by the US National Institute of Allergy and Infectious Disease, the US National Heart, Lung, and Blood Institute, and National Psoriasis Foundation. N Mehta declared serving as consultant and receiving grants and other payments from several sources.

Source: Schwartz DM et al. PET/CT-based characterization of 18F-FDG uptake in various tissues reveals novel potential contributions to coronary artery disease in psoriatic arthritis. Front Immunol. 2022;13:909760 (Jun 2). Doi: 10.3389/fimmu.2022.909760

Key clinical point: Compared with the general population, patients with psoriatic arthritis (PsA) had a higher prevalence of cardiovascular events (CVE) and cardiovascular risk factors (CVRF) in real-life conditions, with CVRF being higher in patients with PsA as estimated using either SCORE-PsA or QRISK2-PsA cardiovascular risk algorithms.

Major finding: Patients with PsA vs. controls had a higher prevalence of CVE (8.7% vs. 4.1%; P = .03) and CVRF, such as high body mass index (26.6 vs. 25.2; P = .001), triglyceride level (1.24 vs. 1.06; P = .001) and hypertension (34.4% vs. 26.3%; P = .03). The proportion of patients with PsA who were estimated to have a very high CVRF (≥10%) increased when SCORE (25.4% to 27.4%) and QRISK2 (44.9% to 53.2%) equations considered the additional risk attributable to PsA.

Study details: Findings are from an observational, cross-sectional, case-control study including 207 patients with PsA and 414 matched controls.

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

Source: Degboe Y et al. Increased cardiovascular risk in psoriatic arthritis: results from a case-control monocentric study. Front Med. 2022;8:785719 (May 19). Doi: 10.3389/fmed.2022.785719

Key clinical point: Compared with the general population, patients with psoriatic arthritis (PsA) had a higher prevalence of cardiovascular events (CVE) and cardiovascular risk factors (CVRF) in real-life conditions, with CVRF being higher in patients with PsA as estimated using either SCORE-PsA or QRISK2-PsA cardiovascular risk algorithms.

Major finding: Patients with PsA vs. controls had a higher prevalence of CVE (8.7% vs. 4.1%; P = .03) and CVRF, such as high body mass index (26.6 vs. 25.2; P = .001), triglyceride level (1.24 vs. 1.06; P = .001) and hypertension (34.4% vs. 26.3%; P = .03). The proportion of patients with PsA who were estimated to have a very high CVRF (≥10%) increased when SCORE (25.4% to 27.4%) and QRISK2 (44.9% to 53.2%) equations considered the additional risk attributable to PsA.

Study details: Findings are from an observational, cross-sectional, case-control study including 207 patients with PsA and 414 matched controls.

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

Source: Degboe Y et al. Increased cardiovascular risk in psoriatic arthritis: results from a case-control monocentric study. Front Med. 2022;8:785719 (May 19). Doi: 10.3389/fmed.2022.785719

Key clinical point: Compared with the general population, patients with psoriatic arthritis (PsA) had a higher prevalence of cardiovascular events (CVE) and cardiovascular risk factors (CVRF) in real-life conditions, with CVRF being higher in patients with PsA as estimated using either SCORE-PsA or QRISK2-PsA cardiovascular risk algorithms.

Major finding: Patients with PsA vs. controls had a higher prevalence of CVE (8.7% vs. 4.1%; P = .03) and CVRF, such as high body mass index (26.6 vs. 25.2; P = .001), triglyceride level (1.24 vs. 1.06; P = .001) and hypertension (34.4% vs. 26.3%; P = .03). The proportion of patients with PsA who were estimated to have a very high CVRF (≥10%) increased when SCORE (25.4% to 27.4%) and QRISK2 (44.9% to 53.2%) equations considered the additional risk attributable to PsA.

Study details: Findings are from an observational, cross-sectional, case-control study including 207 patients with PsA and 414 matched controls.

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

Source: Degboe Y et al. Increased cardiovascular risk in psoriatic arthritis: results from a case-control monocentric study. Front Med. 2022;8:785719 (May 19). Doi: 10.3389/fmed.2022.785719

Key clinical point: The prevalence of crystals in the synovial fluid was higher in patients with psoriatic arthritis (PsA) than in those with gonarthrosis and indicated increased disease activity and declining physical abilities in patients with PsA.

Major finding: Synovial fluid crystals were present in a significantly higher proportion of patients with PsA vs. gonarthrosis (23.7% vs. 0%; P < .001), with the presence of crystals being associated with an increased odds of severe pain (odds ratio [OR] 157.25), high disease activity (OR 15.96), and severe disability (OR 13.60; all P < .001).

Study details: Findings are from a retrospective case-control study including 156 patients with PsA and 50 patients with gonarthrosis.

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

Source: Geneva-Popova M et al. Assessment of crystals in the synovial fluid of psoriatic arthritis patients in relation to disease activity. Diagnostics (Basel). 2022;12(5):1260 (May 18). Doi:  10.3390/diagnostics12051260

Key clinical point: The prevalence of crystals in the synovial fluid was higher in patients with psoriatic arthritis (PsA) than in those with gonarthrosis and indicated increased disease activity and declining physical abilities in patients with PsA.

Major finding: Synovial fluid crystals were present in a significantly higher proportion of patients with PsA vs. gonarthrosis (23.7% vs. 0%; P < .001), with the presence of crystals being associated with an increased odds of severe pain (odds ratio [OR] 157.25), high disease activity (OR 15.96), and severe disability (OR 13.60; all P < .001).

Study details: Findings are from a retrospective case-control study including 156 patients with PsA and 50 patients with gonarthrosis.

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

Source: Geneva-Popova M et al. Assessment of crystals in the synovial fluid of psoriatic arthritis patients in relation to disease activity. Diagnostics (Basel). 2022;12(5):1260 (May 18). Doi:  10.3390/diagnostics12051260

Key clinical point: The prevalence of crystals in the synovial fluid was higher in patients with psoriatic arthritis (PsA) than in those with gonarthrosis and indicated increased disease activity and declining physical abilities in patients with PsA.

Major finding: Synovial fluid crystals were present in a significantly higher proportion of patients with PsA vs. gonarthrosis (23.7% vs. 0%; P < .001), with the presence of crystals being associated with an increased odds of severe pain (odds ratio [OR] 157.25), high disease activity (OR 15.96), and severe disability (OR 13.60; all P < .001).

Study details: Findings are from a retrospective case-control study including 156 patients with PsA and 50 patients with gonarthrosis.

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

Source: Geneva-Popova M et al. Assessment of crystals in the synovial fluid of psoriatic arthritis patients in relation to disease activity. Diagnostics (Basel). 2022;12(5):1260 (May 18). Doi:  10.3390/diagnostics12051260

Key clinical point: Patients with psoriatic arthritis (PsA) who had a personal history of psoriasis (pPsA) or a family history of psoriasis and current psoriatic lesions (fPsA/PSO) showed a higher disease activity (DA) and more severe axial joint destruction than those with merely a family history of psoriasis (fPsA).

Major finding: Patients with fPsA/PSO vs. fPsA had higher Disease Activity (DA) Index for PsA (DAPSA; 21.94 vs. 18.41; P = .046) and Bath Ankylosing Spondylitis DA Index (BASDAI; 4.09 vs. 3.74; P = .031) scores and more severe sacroiliitis (odds ratio [OR] 0.508; P = .037). The DAPSA (P = .927) and BASDAI (P = .716) scores were similar in patients with pPsA and fPsA/PSO.

Study details: Findings are from a prospective single-center, cross-sectional study including 296 patients with PsA, of which 145 had pPsA, 96 had fPsA, and 55 had fPsA/PSO.

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

Source: Li S-S et al. Exploring the association between history of psoriasis (PSO) and disease activity in patients with psoriatic arthritis (PsA). Rheumatol Ther. 2022 (May 17). Doi: 10.1007/s40744-022-00455-8

Key clinical point: Patients with psoriatic arthritis (PsA) who had a personal history of psoriasis (pPsA) or a family history of psoriasis and current psoriatic lesions (fPsA/PSO) showed a higher disease activity (DA) and more severe axial joint destruction than those with merely a family history of psoriasis (fPsA).

Major finding: Patients with fPsA/PSO vs. fPsA had higher Disease Activity (DA) Index for PsA (DAPSA; 21.94 vs. 18.41; P = .046) and Bath Ankylosing Spondylitis DA Index (BASDAI; 4.09 vs. 3.74; P = .031) scores and more severe sacroiliitis (odds ratio [OR] 0.508; P = .037). The DAPSA (P = .927) and BASDAI (P = .716) scores were similar in patients with pPsA and fPsA/PSO.

Study details: Findings are from a prospective single-center, cross-sectional study including 296 patients with PsA, of which 145 had pPsA, 96 had fPsA, and 55 had fPsA/PSO.

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

Source: Li S-S et al. Exploring the association between history of psoriasis (PSO) and disease activity in patients with psoriatic arthritis (PsA). Rheumatol Ther. 2022 (May 17). Doi: 10.1007/s40744-022-00455-8

Key clinical point: Patients with psoriatic arthritis (PsA) who had a personal history of psoriasis (pPsA) or a family history of psoriasis and current psoriatic lesions (fPsA/PSO) showed a higher disease activity (DA) and more severe axial joint destruction than those with merely a family history of psoriasis (fPsA).

Major finding: Patients with fPsA/PSO vs. fPsA had higher Disease Activity (DA) Index for PsA (DAPSA; 21.94 vs. 18.41; P = .046) and Bath Ankylosing Spondylitis DA Index (BASDAI; 4.09 vs. 3.74; P = .031) scores and more severe sacroiliitis (odds ratio [OR] 0.508; P = .037). The DAPSA (P = .927) and BASDAI (P = .716) scores were similar in patients with pPsA and fPsA/PSO.

Study details: Findings are from a prospective single-center, cross-sectional study including 296 patients with PsA, of which 145 had pPsA, 96 had fPsA, and 55 had fPsA/PSO.

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

Source: Li S-S et al. Exploring the association between history of psoriasis (PSO) and disease activity in patients with psoriatic arthritis (PsA). Rheumatol Ther. 2022 (May 17). Doi: 10.1007/s40744-022-00455-8

Key clinical point: Difficult-to-treat (D2T) patients with psoriatic arthritis (PsA) have a higher prevalence of fibromyalgia, higher body mass index (BMI), and more comorbidities than non-D2T patients with PsA.

Major finding: The potential D2T vs. non-D2T patients had a significantly higher prevalence of fibromyalgia (22.9% vs. 7.2%; P = .022) and a higher median BMI (27.7 vs. 25.7; P = .032), Functional Comorbidity Index value (1 vs. 0; P = .021), disease activity index value (17.2 vs. 7.1; P < .01), pain level (7 vs. 2.5; P < .01), and Health Assessment Questionnaire Disability Index value (1 vs. 0.25; P < .001). Treatment failure with ≥2 biological or targeted synthetic disease-modifying antirheumatic drugs was observed in 100% vs. 8.5% of D2T vs. non-D2T patients, respectively.

Study details: This retrospective analysis of a longitudinal cohort included 106 patients with PsA, of which 36 patients were considered potential D2T candidates.

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

Source: Perrotta FM et al. Clinical characteristics of potential “difficult-to-treat” patients with psoriatic arthritis: A retrospective analysis of a longitudinal cohort. Rheumatol Ther. 2022 May 25. doi: 10.1007/s40744-022-00461-w.

Key clinical point: Difficult-to-treat (D2T) patients with psoriatic arthritis (PsA) have a higher prevalence of fibromyalgia, higher body mass index (BMI), and more comorbidities than non-D2T patients with PsA.

Major finding: The potential D2T vs. non-D2T patients had a significantly higher prevalence of fibromyalgia (22.9% vs. 7.2%; P = .022) and a higher median BMI (27.7 vs. 25.7; P = .032), Functional Comorbidity Index value (1 vs. 0; P = .021), disease activity index value (17.2 vs. 7.1; P < .01), pain level (7 vs. 2.5; P < .01), and Health Assessment Questionnaire Disability Index value (1 vs. 0.25; P < .001). Treatment failure with ≥2 biological or targeted synthetic disease-modifying antirheumatic drugs was observed in 100% vs. 8.5% of D2T vs. non-D2T patients, respectively.

Study details: This retrospective analysis of a longitudinal cohort included 106 patients with PsA, of which 36 patients were considered potential D2T candidates.

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

Source: Perrotta FM et al. Clinical characteristics of potential “difficult-to-treat” patients with psoriatic arthritis: A retrospective analysis of a longitudinal cohort. Rheumatol Ther. 2022 May 25. doi: 10.1007/s40744-022-00461-w.

Key clinical point: Difficult-to-treat (D2T) patients with psoriatic arthritis (PsA) have a higher prevalence of fibromyalgia, higher body mass index (BMI), and more comorbidities than non-D2T patients with PsA.

Major finding: The potential D2T vs. non-D2T patients had a significantly higher prevalence of fibromyalgia (22.9% vs. 7.2%; P = .022) and a higher median BMI (27.7 vs. 25.7; P = .032), Functional Comorbidity Index value (1 vs. 0; P = .021), disease activity index value (17.2 vs. 7.1; P < .01), pain level (7 vs. 2.5; P < .01), and Health Assessment Questionnaire Disability Index value (1 vs. 0.25; P < .001). Treatment failure with ≥2 biological or targeted synthetic disease-modifying antirheumatic drugs was observed in 100% vs. 8.5% of D2T vs. non-D2T patients, respectively.

Study details: This retrospective analysis of a longitudinal cohort included 106 patients with PsA, of which 36 patients were considered potential D2T candidates.

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

Source: Perrotta FM et al. Clinical characteristics of potential “difficult-to-treat” patients with psoriatic arthritis: A retrospective analysis of a longitudinal cohort. Rheumatol Ther. 2022 May 25. doi: 10.1007/s40744-022-00461-w.

Key clinical point: Golimumab reduced disease activity and improved work productivity, activity, and the quality of life (QoL) in patients with psoriatic arthritis (PsA).

Major finding: At 24 months after golimumab initiation, there was significant decrease in mean Clinical Disease Activity Index (−21.7; P < .0001), along with improvement in total work productivity impairment (P = .0186), presenteeism (P = .0007), activity impairment (P < .0001), and mean QoL (−8.3; P < .0001) scores.

Study details: Findings are from a prospective study including patients with PsA (n = 69), rheumatoid arthritis (n = 95), and axial spondyloarthritis (n = 69) who initiated golimumab; of these 110 patients were followed-up for 24 months.

Disclosures: This study was funded by MSD Austria. The authors declared no conflicts of interest.

Source: Dejaco C et al. A prospective study to evaluate the impact of golimumab therapy on work productivity and activity, and quality of life in patients with rheumatoid arthritis, psoriasis arthritis and axial spondyloarthritis in a real life setting in Austria: The GO-ACTIVE study. Front Med. 2022;9:881943 (Jun 2). Doi: 10.3389/fmed.2022.881943

Key clinical point: Golimumab reduced disease activity and improved work productivity, activity, and the quality of life (QoL) in patients with psoriatic arthritis (PsA).

Major finding: At 24 months after golimumab initiation, there was significant decrease in mean Clinical Disease Activity Index (−21.7; P < .0001), along with improvement in total work productivity impairment (P = .0186), presenteeism (P = .0007), activity impairment (P < .0001), and mean QoL (−8.3; P < .0001) scores.

Study details: Findings are from a prospective study including patients with PsA (n = 69), rheumatoid arthritis (n = 95), and axial spondyloarthritis (n = 69) who initiated golimumab; of these 110 patients were followed-up for 24 months.

Disclosures: This study was funded by MSD Austria. The authors declared no conflicts of interest.

Source: Dejaco C et al. A prospective study to evaluate the impact of golimumab therapy on work productivity and activity, and quality of life in patients with rheumatoid arthritis, psoriasis arthritis and axial spondyloarthritis in a real life setting in Austria: The GO-ACTIVE study. Front Med. 2022;9:881943 (Jun 2). Doi: 10.3389/fmed.2022.881943

Key clinical point: Golimumab reduced disease activity and improved work productivity, activity, and the quality of life (QoL) in patients with psoriatic arthritis (PsA).

Major finding: At 24 months after golimumab initiation, there was significant decrease in mean Clinical Disease Activity Index (−21.7; P < .0001), along with improvement in total work productivity impairment (P = .0186), presenteeism (P = .0007), activity impairment (P < .0001), and mean QoL (−8.3; P < .0001) scores.

Study details: Findings are from a prospective study including patients with PsA (n = 69), rheumatoid arthritis (n = 95), and axial spondyloarthritis (n = 69) who initiated golimumab; of these 110 patients were followed-up for 24 months.

Disclosures: This study was funded by MSD Austria. The authors declared no conflicts of interest.

Source: Dejaco C et al. A prospective study to evaluate the impact of golimumab therapy on work productivity and activity, and quality of life in patients with rheumatoid arthritis, psoriasis arthritis and axial spondyloarthritis in a real life setting in Austria: The GO-ACTIVE study. Front Med. 2022;9:881943 (Jun 2). Doi: 10.3389/fmed.2022.881943

Telemedicine for patients with liver disease has made progress in recent years, but some key hurdles remain. Strategies that rely on patient ownership of mobile devices or reliable internet access will likely miss patients who have the greatest need for remote access.

This is one of the conclusions from a county-by-county study of access to liver specialty care and mortality, using data drawn from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (WONDER). The study was led by Jacqueline B. Henson, MD, of the Division of Gastroenterology, department of medicine, Duke University, Durham, N.C., and published in Hepatology.
 

Low-access areas

“Ultimately, no single telehealth strategy will be successful in all areas, and these will need to be tailored at the local and state level,” the authors wrote. “They will also depend on the persistence of policy changes enacted during the pandemic which made use and reimbursement for telehealth less restrictive.”

The researchers found that 69.5% of American counties had no gastrointestinal physicians. Moreover, 41.1% of counties were more than 100 miles away from a liver transplant (LT) center; 33.7% had no GI physicians and were more than 100 miles from a LT center. These categories represented populations of 48.8 million, 53.7 million, and 17.8 million. These counties had higher poverty rates, more unemployment, and lower educational attainment than did those that had GI physicians or were closer to LT centers. Distance from LT centers was associated with higher liver-related mortality (r = 0.24; P < .001) and density of GI providers (r = –0.12; P < .001).

Reduced access to specialty care for liver disease was also associated with decreased access to technology, including cell phones, smart phones, and internet service. Among counties in the highest death quartile and lowest access to care, 35.5% of households had no computer, 43.1% had no home internet, and only 19.2% of these had internet at broadband speeds.

“Use of platforms with lower internet speed requirements and that are compatible with mobile devices may help extend access, as could partnerships with local primary care and GI clinics,” they concluded. Further work should be done at the local and state levels to better understand the optimal strategies to reach their populations of need.
 

Missing ‘baseline ingredients’

Commenting on the study, Nancy Reau, MD, professor of medicine and chief of hepatology at Rush University Medical Center, Chicago, said that “anyone who takes care of vulnerable populations, whether elderly individuals or those who may be socioeconomically disadvantaged, realizes that we have to improve access to medical resources, and telehealth is certainly an attractive way of doing that.”

She added that a key message from the study is that attempts to improve access to disadvantaged populations, no matter how well-intentioned, are likely to provide the most benefit to those who have more resources than others. For example, not everyone has access to a smart phone or tablet: “Even if you have a tablet [or cell phone], you might have to go to the public library to get high speed internet, or you may not even have a public library. So, when something sounds like a great idea, such as expanding the academic footprint or access to integrative medicine through something like a virtual option, a lot of the individuals that you are targeting may not be able to engage,” said Dr. Reau.

For those working to expand access, it’s critical to get the perspective of underserved communities and remember that every patient is unique. Physicians may treat patients who are poor, or from disadvantaged areas, who nevertheless have successful telehealth visits. But that doesn’t mean everyone’s experience will be similar. “You can’t use those who have been successful in accessing telemedicine as an example for everyone else. Just because one person can do it doesn’t mean that everyone else can. Involving a practitioner or an advocate from the area that you’re trying to reach is imperative,” she explained.

The COVID-19 pandemic led to a big push for telehealth, and it may be tempting to believe that the transition to telehealth has been smooth. This study “demonstrates in a very granular way that a large number of Americans have no access to high-speed internet, or if they do, many don’t have access to the tools that would let them engage this way. You can’t make assumptions and use them to build a product,” continued Dr. Reau.

Innovative options are needed, such as working with primary care providers in rural or disadvantaged areas to setup pop-up hot spots where e-consultations could be performed. Working directly with broadband internet providers to set up access in specific locations for telehealth, or using products like Amazon Echo Show as a portal for telehealth, can also be tried. “Think about being innovative and recognize that these areas probably don’t have the baseline ingredients we thought they had,” suggested Dr. Reau.

The authors reported having no financial support. Dr. Reau has no relevant financial disclosures.

Telemedicine for patients with liver disease has made progress in recent years, but some key hurdles remain. Strategies that rely on patient ownership of mobile devices or reliable internet access will likely miss patients who have the greatest need for remote access.

This is one of the conclusions from a county-by-county study of access to liver specialty care and mortality, using data drawn from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (WONDER). The study was led by Jacqueline B. Henson, MD, of the Division of Gastroenterology, department of medicine, Duke University, Durham, N.C., and published in Hepatology.
 

Low-access areas

“Ultimately, no single telehealth strategy will be successful in all areas, and these will need to be tailored at the local and state level,” the authors wrote. “They will also depend on the persistence of policy changes enacted during the pandemic which made use and reimbursement for telehealth less restrictive.”

The researchers found that 69.5% of American counties had no gastrointestinal physicians. Moreover, 41.1% of counties were more than 100 miles away from a liver transplant (LT) center; 33.7% had no GI physicians and were more than 100 miles from a LT center. These categories represented populations of 48.8 million, 53.7 million, and 17.8 million. These counties had higher poverty rates, more unemployment, and lower educational attainment than did those that had GI physicians or were closer to LT centers. Distance from LT centers was associated with higher liver-related mortality (r = 0.24; P < .001) and density of GI providers (r = –0.12; P < .001).

Reduced access to specialty care for liver disease was also associated with decreased access to technology, including cell phones, smart phones, and internet service. Among counties in the highest death quartile and lowest access to care, 35.5% of households had no computer, 43.1% had no home internet, and only 19.2% of these had internet at broadband speeds.

“Use of platforms with lower internet speed requirements and that are compatible with mobile devices may help extend access, as could partnerships with local primary care and GI clinics,” they concluded. Further work should be done at the local and state levels to better understand the optimal strategies to reach their populations of need.
 

Missing ‘baseline ingredients’

Commenting on the study, Nancy Reau, MD, professor of medicine and chief of hepatology at Rush University Medical Center, Chicago, said that “anyone who takes care of vulnerable populations, whether elderly individuals or those who may be socioeconomically disadvantaged, realizes that we have to improve access to medical resources, and telehealth is certainly an attractive way of doing that.”

She added that a key message from the study is that attempts to improve access to disadvantaged populations, no matter how well-intentioned, are likely to provide the most benefit to those who have more resources than others. For example, not everyone has access to a smart phone or tablet: “Even if you have a tablet [or cell phone], you might have to go to the public library to get high speed internet, or you may not even have a public library. So, when something sounds like a great idea, such as expanding the academic footprint or access to integrative medicine through something like a virtual option, a lot of the individuals that you are targeting may not be able to engage,” said Dr. Reau.

For those working to expand access, it’s critical to get the perspective of underserved communities and remember that every patient is unique. Physicians may treat patients who are poor, or from disadvantaged areas, who nevertheless have successful telehealth visits. But that doesn’t mean everyone’s experience will be similar. “You can’t use those who have been successful in accessing telemedicine as an example for everyone else. Just because one person can do it doesn’t mean that everyone else can. Involving a practitioner or an advocate from the area that you’re trying to reach is imperative,” she explained.

The COVID-19 pandemic led to a big push for telehealth, and it may be tempting to believe that the transition to telehealth has been smooth. This study “demonstrates in a very granular way that a large number of Americans have no access to high-speed internet, or if they do, many don’t have access to the tools that would let them engage this way. You can’t make assumptions and use them to build a product,” continued Dr. Reau.

Innovative options are needed, such as working with primary care providers in rural or disadvantaged areas to setup pop-up hot spots where e-consultations could be performed. Working directly with broadband internet providers to set up access in specific locations for telehealth, or using products like Amazon Echo Show as a portal for telehealth, can also be tried. “Think about being innovative and recognize that these areas probably don’t have the baseline ingredients we thought they had,” suggested Dr. Reau.

The authors reported having no financial support. Dr. Reau has no relevant financial disclosures.

Telemedicine for patients with liver disease has made progress in recent years, but some key hurdles remain. Strategies that rely on patient ownership of mobile devices or reliable internet access will likely miss patients who have the greatest need for remote access.

This is one of the conclusions from a county-by-county study of access to liver specialty care and mortality, using data drawn from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (WONDER). The study was led by Jacqueline B. Henson, MD, of the Division of Gastroenterology, department of medicine, Duke University, Durham, N.C., and published in Hepatology.
 

Low-access areas

“Ultimately, no single telehealth strategy will be successful in all areas, and these will need to be tailored at the local and state level,” the authors wrote. “They will also depend on the persistence of policy changes enacted during the pandemic which made use and reimbursement for telehealth less restrictive.”

The researchers found that 69.5% of American counties had no gastrointestinal physicians. Moreover, 41.1% of counties were more than 100 miles away from a liver transplant (LT) center; 33.7% had no GI physicians and were more than 100 miles from a LT center. These categories represented populations of 48.8 million, 53.7 million, and 17.8 million. These counties had higher poverty rates, more unemployment, and lower educational attainment than did those that had GI physicians or were closer to LT centers. Distance from LT centers was associated with higher liver-related mortality (r = 0.24; P < .001) and density of GI providers (r = –0.12; P < .001).

Reduced access to specialty care for liver disease was also associated with decreased access to technology, including cell phones, smart phones, and internet service. Among counties in the highest death quartile and lowest access to care, 35.5% of households had no computer, 43.1% had no home internet, and only 19.2% of these had internet at broadband speeds.

“Use of platforms with lower internet speed requirements and that are compatible with mobile devices may help extend access, as could partnerships with local primary care and GI clinics,” they concluded. Further work should be done at the local and state levels to better understand the optimal strategies to reach their populations of need.
 

Missing ‘baseline ingredients’

Commenting on the study, Nancy Reau, MD, professor of medicine and chief of hepatology at Rush University Medical Center, Chicago, said that “anyone who takes care of vulnerable populations, whether elderly individuals or those who may be socioeconomically disadvantaged, realizes that we have to improve access to medical resources, and telehealth is certainly an attractive way of doing that.”

She added that a key message from the study is that attempts to improve access to disadvantaged populations, no matter how well-intentioned, are likely to provide the most benefit to those who have more resources than others. For example, not everyone has access to a smart phone or tablet: “Even if you have a tablet [or cell phone], you might have to go to the public library to get high speed internet, or you may not even have a public library. So, when something sounds like a great idea, such as expanding the academic footprint or access to integrative medicine through something like a virtual option, a lot of the individuals that you are targeting may not be able to engage,” said Dr. Reau.

For those working to expand access, it’s critical to get the perspective of underserved communities and remember that every patient is unique. Physicians may treat patients who are poor, or from disadvantaged areas, who nevertheless have successful telehealth visits. But that doesn’t mean everyone’s experience will be similar. “You can’t use those who have been successful in accessing telemedicine as an example for everyone else. Just because one person can do it doesn’t mean that everyone else can. Involving a practitioner or an advocate from the area that you’re trying to reach is imperative,” she explained.

The COVID-19 pandemic led to a big push for telehealth, and it may be tempting to believe that the transition to telehealth has been smooth. This study “demonstrates in a very granular way that a large number of Americans have no access to high-speed internet, or if they do, many don’t have access to the tools that would let them engage this way. You can’t make assumptions and use them to build a product,” continued Dr. Reau.

Innovative options are needed, such as working with primary care providers in rural or disadvantaged areas to setup pop-up hot spots where e-consultations could be performed. Working directly with broadband internet providers to set up access in specific locations for telehealth, or using products like Amazon Echo Show as a portal for telehealth, can also be tried. “Think about being innovative and recognize that these areas probably don’t have the baseline ingredients we thought they had,” suggested Dr. Reau.

The authors reported having no financial support. Dr. Reau has no relevant financial disclosures.

Key clinical point: A higher proportion of patients with psoriatic arthritis (PsA) receiving 15 mg upadacitinib achieved low disease activity (LDA) or remission after the first 6 months of treatment, with the difference being visible even after 1 year of treatment, compared to those who received a placebo.

Major finding: At week 24, a higher proportion of patients receiving 15 mg upadacitinib vs. placebo achieved Disease Activity in PsA LDA (range 35%-48% vs. 4%-16%; P < .05) and remission (range 7%-11% vs. 0%-3%; P < .05), with the responses sustained until 56 weeks.

Study details: This was a post hoc analysis of the SELECT-PsA 1 and SELECT-PsA 2 trials including 1386 adults with PsA and prior inadequate response/intolerance to ≥1 non-biologic or biologic disease-modifying antirheumatic drugs who were randomly assigned to receive upadacitinib (15 or 30 mg), adalimumab, or placebo.

Disclosures: This study was funded by AbbVie, Inc. Four authors declared being current or former employees or stockholders of AbbVie, and other authors reported ties with various sources.

Source: Mease P et al. Disease control with upadacitinib in patients with psoriatic arthritis: A post hoc analysis of the randomized, placebo-controlled SELECT-PsA 1 and 2 phase 3 trials. Rheumatol Ther. 2022 (May 23). Doi: 10.1007/s40744-022-00449-6

Key clinical point: A higher proportion of patients with psoriatic arthritis (PsA) receiving 15 mg upadacitinib achieved low disease activity (LDA) or remission after the first 6 months of treatment, with the difference being visible even after 1 year of treatment, compared to those who received a placebo.

Major finding: At week 24, a higher proportion of patients receiving 15 mg upadacitinib vs. placebo achieved Disease Activity in PsA LDA (range 35%-48% vs. 4%-16%; P < .05) and remission (range 7%-11% vs. 0%-3%; P < .05), with the responses sustained until 56 weeks.

Study details: This was a post hoc analysis of the SELECT-PsA 1 and SELECT-PsA 2 trials including 1386 adults with PsA and prior inadequate response/intolerance to ≥1 non-biologic or biologic disease-modifying antirheumatic drugs who were randomly assigned to receive upadacitinib (15 or 30 mg), adalimumab, or placebo.

Disclosures: This study was funded by AbbVie, Inc. Four authors declared being current or former employees or stockholders of AbbVie, and other authors reported ties with various sources.

Source: Mease P et al. Disease control with upadacitinib in patients with psoriatic arthritis: A post hoc analysis of the randomized, placebo-controlled SELECT-PsA 1 and 2 phase 3 trials. Rheumatol Ther. 2022 (May 23). Doi: 10.1007/s40744-022-00449-6

Key clinical point: A higher proportion of patients with psoriatic arthritis (PsA) receiving 15 mg upadacitinib achieved low disease activity (LDA) or remission after the first 6 months of treatment, with the difference being visible even after 1 year of treatment, compared to those who received a placebo.

Major finding: At week 24, a higher proportion of patients receiving 15 mg upadacitinib vs. placebo achieved Disease Activity in PsA LDA (range 35%-48% vs. 4%-16%; P < .05) and remission (range 7%-11% vs. 0%-3%; P < .05), with the responses sustained until 56 weeks.

Study details: This was a post hoc analysis of the SELECT-PsA 1 and SELECT-PsA 2 trials including 1386 adults with PsA and prior inadequate response/intolerance to ≥1 non-biologic or biologic disease-modifying antirheumatic drugs who were randomly assigned to receive upadacitinib (15 or 30 mg), adalimumab, or placebo.

Disclosures: This study was funded by AbbVie, Inc. Four authors declared being current or former employees or stockholders of AbbVie, and other authors reported ties with various sources.

Source: Mease P et al. Disease control with upadacitinib in patients with psoriatic arthritis: A post hoc analysis of the randomized, placebo-controlled SELECT-PsA 1 and 2 phase 3 trials. Rheumatol Ther. 2022 (May 23). Doi: 10.1007/s40744-022-00449-6