Severe obesity among preschool-age children from low-income families is on the rise in the United States, according to a new analysis of federal data.

An estimated 2% of children ages 2 to 4 years old had severe obesity in 2020, up from 1.8% in 2016, according to the report that appeared Dec. 18 in Pediatrics, a journal published by the American Academy of Pediatrics. 

The increase is “small but significant,” a group of experts not involved in the research wrote in a companion commentary published alongside the research.

The new data put an end to hopes that childhood obesity was on the retreat following a small decrease in rates from 2010 to 2016. Instead, the researchers noted that the new childhood obesity figures reflect those of the general population. In the United States, about 20% of children and teens are obese, and about 42% of adults are obese, according to the CDC.

This latest study looked for severe obesity, which was defined as being well above the 95th percentile for the combined height-weight measure known as body mass index. The figures are important because rates of severe obesity among young children can foreshadow health problems that may occur on a scale to warrant concerns among public health officials, policymakers, and health care professionals.

Compared with children who have moderate obesity, children with severe obesity “are at a greater risk of various health complications, including cardiovascular disease, metabolic syndrome, type 2 diabetes, fatty liver disease, and premature death,” the study authors wrote.

The largest increases from 2016 to 2020 in severe obesity were observed among 4-year-olds and among Hispanic children. When looking at state-level data, Alaska was the only state to report a decline in severe obesity among young children from 2016 to 2020.

The new estimates were drawn from data on children enrolled in the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

“WIC is a federal assistance program that provides healthy foods, nutrition education, health care referrals, and other services to millions of low-income pregnant and postpartum women, as well as infants and children up to age 5, who are at nutritional risk,” the researchers noted.

The new figures indicate 16.6 million children ages 2 to 4 years old have severe obesity. Having severe obesity at these early ages is “nearly irreversible,” the authors of the commentary article noted, adding that little research exists that indicates how to effectively treat obesity before age 6.

“The study underscores the need for ongoing monitoring ... post pandemic of children’s health status,” a news release from the American Academy of Pediatrics stated. “It also further supports the need for children and families from households with lower incomes across the nation to have access to early clinical detection, such as health care screenings and referrals to effective family-based interventions to support healthy growth.”
 

A version of this article first appeared on WebMD.com.

Severe obesity among preschool-age children from low-income families is on the rise in the United States, according to a new analysis of federal data.

An estimated 2% of children ages 2 to 4 years old had severe obesity in 2020, up from 1.8% in 2016, according to the report that appeared Dec. 18 in Pediatrics, a journal published by the American Academy of Pediatrics. 

The increase is “small but significant,” a group of experts not involved in the research wrote in a companion commentary published alongside the research.

The new data put an end to hopes that childhood obesity was on the retreat following a small decrease in rates from 2010 to 2016. Instead, the researchers noted that the new childhood obesity figures reflect those of the general population. In the United States, about 20% of children and teens are obese, and about 42% of adults are obese, according to the CDC.

This latest study looked for severe obesity, which was defined as being well above the 95th percentile for the combined height-weight measure known as body mass index. The figures are important because rates of severe obesity among young children can foreshadow health problems that may occur on a scale to warrant concerns among public health officials, policymakers, and health care professionals.

Compared with children who have moderate obesity, children with severe obesity “are at a greater risk of various health complications, including cardiovascular disease, metabolic syndrome, type 2 diabetes, fatty liver disease, and premature death,” the study authors wrote.

The largest increases from 2016 to 2020 in severe obesity were observed among 4-year-olds and among Hispanic children. When looking at state-level data, Alaska was the only state to report a decline in severe obesity among young children from 2016 to 2020.

The new estimates were drawn from data on children enrolled in the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

“WIC is a federal assistance program that provides healthy foods, nutrition education, health care referrals, and other services to millions of low-income pregnant and postpartum women, as well as infants and children up to age 5, who are at nutritional risk,” the researchers noted.

The new figures indicate 16.6 million children ages 2 to 4 years old have severe obesity. Having severe obesity at these early ages is “nearly irreversible,” the authors of the commentary article noted, adding that little research exists that indicates how to effectively treat obesity before age 6.

“The study underscores the need for ongoing monitoring ... post pandemic of children’s health status,” a news release from the American Academy of Pediatrics stated. “It also further supports the need for children and families from households with lower incomes across the nation to have access to early clinical detection, such as health care screenings and referrals to effective family-based interventions to support healthy growth.”
 

A version of this article first appeared on WebMD.com.

Severe obesity among preschool-age children from low-income families is on the rise in the United States, according to a new analysis of federal data.

An estimated 2% of children ages 2 to 4 years old had severe obesity in 2020, up from 1.8% in 2016, according to the report that appeared Dec. 18 in Pediatrics, a journal published by the American Academy of Pediatrics. 

The increase is “small but significant,” a group of experts not involved in the research wrote in a companion commentary published alongside the research.

The new data put an end to hopes that childhood obesity was on the retreat following a small decrease in rates from 2010 to 2016. Instead, the researchers noted that the new childhood obesity figures reflect those of the general population. In the United States, about 20% of children and teens are obese, and about 42% of adults are obese, according to the CDC.

This latest study looked for severe obesity, which was defined as being well above the 95th percentile for the combined height-weight measure known as body mass index. The figures are important because rates of severe obesity among young children can foreshadow health problems that may occur on a scale to warrant concerns among public health officials, policymakers, and health care professionals.

Compared with children who have moderate obesity, children with severe obesity “are at a greater risk of various health complications, including cardiovascular disease, metabolic syndrome, type 2 diabetes, fatty liver disease, and premature death,” the study authors wrote.

The largest increases from 2016 to 2020 in severe obesity were observed among 4-year-olds and among Hispanic children. When looking at state-level data, Alaska was the only state to report a decline in severe obesity among young children from 2016 to 2020.

The new estimates were drawn from data on children enrolled in the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

“WIC is a federal assistance program that provides healthy foods, nutrition education, health care referrals, and other services to millions of low-income pregnant and postpartum women, as well as infants and children up to age 5, who are at nutritional risk,” the researchers noted.

The new figures indicate 16.6 million children ages 2 to 4 years old have severe obesity. Having severe obesity at these early ages is “nearly irreversible,” the authors of the commentary article noted, adding that little research exists that indicates how to effectively treat obesity before age 6.

“The study underscores the need for ongoing monitoring ... post pandemic of children’s health status,” a news release from the American Academy of Pediatrics stated. “It also further supports the need for children and families from households with lower incomes across the nation to have access to early clinical detection, such as health care screenings and referrals to effective family-based interventions to support healthy growth.”
 

A version of this article first appeared on WebMD.com.

TOPLINE:

Both blood eosinophil-directed treatment (BET) and standard care treatment (ST) similarly reduced treatment failure following acute exacerbations in chronic obstructive pulmonary disease (COPD).

METHODOLOGY:

• The researchers randomized 152 adults with a mean age of 70 years to BET or a placebo (if eosinophil counts were less than 2%) or to standard care treatment regardless of baseline eosinophil counts; the final population available for analysis included 47 patients in the blood eosinophil group and 46 in the primary care group, with 73 and 71 exacerbations, respectively.
• Participants were assessed at baseline and at day 14, day 30, and day 90 after exacerbation; the primary outcome was the rate of treatment failure at 30 days post exacerbation, defined as any need for retreatment with antibiotics or steroids, hospitalization, or death; secondary outcomes included health-related quality of life, forced expiratory volume in 1 second, and visual analogue score respiratory symptoms.
• Participants were recruited from 14 general practices between November 6, 2017, and April 30, 2020; the study was terminated on April 30, 2023, because of the COVID-19 pandemic.

TAKEAWAY:

• BET was noninferior to ST in a noninferiority analysis.
• At 30 days post exacerbation, 14 treatment failures had occurred in the BET group and 23 in the ST group; the relative risk was 0.60 (P = .070).
• The frequency of adverse events was similar between the groups; the most common adverse events were glycosuria and hospital admission for COPD exacerbation (2% in the BET group and 1% in the ST group for both event types), and no deaths occurred during the study period.
• Subgroup analysis showed the greatest benefit in both groups was to patients with higher eosinophil counts who received prednisolone.

IN PRACTICE: 

“There was improvement of lung function, quality of life, and symptoms in exacerbations with low eosinophil count independent of whether placebo or prednisolone was prescribed,” the authors wrote in their discussion.

SOURCE:

The lead author on the study was Sanjay Ramakrishnan, MBBS, University of Oxford, United Kingdom. The study was published online in Lancet Respiratory Medicine .

LIMITATIONS:

A key limitation was an error in the randomization code that prevented the trial’s completion as a superiority study; other limitations included the relatively low number of exacerbations associated with low eosinophil counts and reduction in the recommended length of treatment with prednisolone during the study period.

DISCLOSURES:

The study was supported by the National Institute for Health and Care Research. Dr. Ramakrishnan disclosed personal salary support from the National Institute for Health and Care Research, an unrestricted research grant from AstraZeneca to his institution, and speaker fees and conference travel support from AstraZeneca, all unrelated to the current study.

A version of this article first appeared on Medscape.com.

TOPLINE:

Both blood eosinophil-directed treatment (BET) and standard care treatment (ST) similarly reduced treatment failure following acute exacerbations in chronic obstructive pulmonary disease (COPD).

METHODOLOGY:

• The researchers randomized 152 adults with a mean age of 70 years to BET or a placebo (if eosinophil counts were less than 2%) or to standard care treatment regardless of baseline eosinophil counts; the final population available for analysis included 47 patients in the blood eosinophil group and 46 in the primary care group, with 73 and 71 exacerbations, respectively.
• Participants were assessed at baseline and at day 14, day 30, and day 90 after exacerbation; the primary outcome was the rate of treatment failure at 30 days post exacerbation, defined as any need for retreatment with antibiotics or steroids, hospitalization, or death; secondary outcomes included health-related quality of life, forced expiratory volume in 1 second, and visual analogue score respiratory symptoms.
• Participants were recruited from 14 general practices between November 6, 2017, and April 30, 2020; the study was terminated on April 30, 2023, because of the COVID-19 pandemic.

TAKEAWAY:

• BET was noninferior to ST in a noninferiority analysis.
• At 30 days post exacerbation, 14 treatment failures had occurred in the BET group and 23 in the ST group; the relative risk was 0.60 (P = .070).
• The frequency of adverse events was similar between the groups; the most common adverse events were glycosuria and hospital admission for COPD exacerbation (2% in the BET group and 1% in the ST group for both event types), and no deaths occurred during the study period.
• Subgroup analysis showed the greatest benefit in both groups was to patients with higher eosinophil counts who received prednisolone.

IN PRACTICE: 

“There was improvement of lung function, quality of life, and symptoms in exacerbations with low eosinophil count independent of whether placebo or prednisolone was prescribed,” the authors wrote in their discussion.

SOURCE:

The lead author on the study was Sanjay Ramakrishnan, MBBS, University of Oxford, United Kingdom. The study was published online in Lancet Respiratory Medicine .

LIMITATIONS:

A key limitation was an error in the randomization code that prevented the trial’s completion as a superiority study; other limitations included the relatively low number of exacerbations associated with low eosinophil counts and reduction in the recommended length of treatment with prednisolone during the study period.

DISCLOSURES:

The study was supported by the National Institute for Health and Care Research. Dr. Ramakrishnan disclosed personal salary support from the National Institute for Health and Care Research, an unrestricted research grant from AstraZeneca to his institution, and speaker fees and conference travel support from AstraZeneca, all unrelated to the current study.

A version of this article first appeared on Medscape.com.

TOPLINE:

Both blood eosinophil-directed treatment (BET) and standard care treatment (ST) similarly reduced treatment failure following acute exacerbations in chronic obstructive pulmonary disease (COPD).

METHODOLOGY:

• The researchers randomized 152 adults with a mean age of 70 years to BET or a placebo (if eosinophil counts were less than 2%) or to standard care treatment regardless of baseline eosinophil counts; the final population available for analysis included 47 patients in the blood eosinophil group and 46 in the primary care group, with 73 and 71 exacerbations, respectively.
• Participants were assessed at baseline and at day 14, day 30, and day 90 after exacerbation; the primary outcome was the rate of treatment failure at 30 days post exacerbation, defined as any need for retreatment with antibiotics or steroids, hospitalization, or death; secondary outcomes included health-related quality of life, forced expiratory volume in 1 second, and visual analogue score respiratory symptoms.
• Participants were recruited from 14 general practices between November 6, 2017, and April 30, 2020; the study was terminated on April 30, 2023, because of the COVID-19 pandemic.

TAKEAWAY:

• BET was noninferior to ST in a noninferiority analysis.
• At 30 days post exacerbation, 14 treatment failures had occurred in the BET group and 23 in the ST group; the relative risk was 0.60 (P = .070).
• The frequency of adverse events was similar between the groups; the most common adverse events were glycosuria and hospital admission for COPD exacerbation (2% in the BET group and 1% in the ST group for both event types), and no deaths occurred during the study period.
• Subgroup analysis showed the greatest benefit in both groups was to patients with higher eosinophil counts who received prednisolone.

IN PRACTICE: 

“There was improvement of lung function, quality of life, and symptoms in exacerbations with low eosinophil count independent of whether placebo or prednisolone was prescribed,” the authors wrote in their discussion.

SOURCE:

The lead author on the study was Sanjay Ramakrishnan, MBBS, University of Oxford, United Kingdom. The study was published online in Lancet Respiratory Medicine .

LIMITATIONS:

A key limitation was an error in the randomization code that prevented the trial’s completion as a superiority study; other limitations included the relatively low number of exacerbations associated with low eosinophil counts and reduction in the recommended length of treatment with prednisolone during the study period.

DISCLOSURES:

The study was supported by the National Institute for Health and Care Research. Dr. Ramakrishnan disclosed personal salary support from the National Institute for Health and Care Research, an unrestricted research grant from AstraZeneca to his institution, and speaker fees and conference travel support from AstraZeneca, all unrelated to the current study.

A version of this article first appeared on Medscape.com.

CHICAGO — Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m² to <25 kg/m² (42%) and 25 to <30 kg/m² (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

CHICAGO — Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m² to <25 kg/m² (42%) and 25 to <30 kg/m² (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

CHICAGO — Among women interested in aesthetic treatments, Hispanic/Latinx women are more concerned about submental fat and under-eye hollowing, which differed from the top concerns in White women, according to the results of a study that involved a survey of almost 4000 women.

To date, the aesthetic needs of Hispanic/Latinx patients, the second largest ethnic group in the United States, have been poorly understood. “Most [aesthetic] marketing materials are gauged toward Caucasian patients,” Sabrina Fabi, MD, a dermatologist and dermatologic cosmetic surgeon in San Diego, California, said at the annual meeting of the American Society for Dermatologic Surgery (ASDS), where she presented the study results.

In addition, Dr. Fabi noted that current studies of facial and body aesthetics are limited in terms of representation. “When we look at studies, they are more Fitzpatrick type IIs and IIIs,” she said. Addressing this gap, she and her colleagues conducted the large multicenter study to learn more about cosmetic concerns unique to Hispanic/Latinx women, across different ethnic groups, and how they may differ by age.

In the study, an online survey was administered to aesthetically-inclined adults across different demographic groups in the United States. Specifically, respondents were surveyed regarding 41 facial and 31 body characteristics, identifying those they found bothersome. Maximum difference scaling was used to generate their most and least bothersome characteristics in each respective category.

Of the 3974 women surveyed, 748 self-identified as Hispanic/Latinx and female. Most participants (86%) were born in the United States and were interested in aesthetic treatments (93%). The majority of patients identified as Generation X (42-57 years, 40.0%), followed by older Millennials (31-41 years, 33.0%), Generation Z/young Millennials (under 30 years, 16.7%), and Baby Boomers and older (over 57 years, 10.3%). Participants most commonly reported Fitzpatrick skin types III (24%) and IV (56%), and BMIs of 18.5 kg/m² to <25 kg/m² (42%) and 25 to <30 kg/m² (27%).

Among Hispanic/Latinx women, the top facial concerns were related to submental fat (36%) and under-eye hollowing (35%). This is in contrast to White counterparts, who tended to find wrinkles more bothersome, according to Dr. Fabi. Among Hispanic/Latinx women, the top body concerns were related to stubborn fat involving the stomach (50%), sides (44%), and bra or the back area (40%).

Despite the shared concern of stubborn body fat across age groups, facial concerns shifted from skin quality (50%) and under-eye issues (43%) in the younger generations to upper facial lines (52%) and jowls/sagging skin (57%) in the older generations.

Dr. Fabi stated that approximately 30% of the population she sees is Hispanic/Latinx, and the results of this study substantiate what she sees in her practice. “This magnifies the things we need to be talking to them more about specifically.” The findings from this survey may aid in the customization of treatment plans to better serve this population, she said.

The study was sponsored by Allergan Aesthetics, which participated in the trial design, research, analysis, data collection, interpretation of data, and the review and approval of the publication. Dr. Fabi and three other authors are speakers, consultants, and investigators for Allergan. Other authors are on the advisory board, or are employees of Abbvie, Allergan’s parent company, and may own stock.

In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

In the last 3 months I’ve had an odd uptick in calls for foot-drop. Some of them said they’d seen other neurologists and were hoping I could help them, others that they wanted to see a specialist in foot-drop. Most called in, a few even showed up at the office wanting to be seen that day.

Now, I have nothing against seeing patients with foot-drop. It’s a relatively common issue in my field. But I’ve never claimed to be a “specialist” in foot-drop. I don’t even do my own EMG/NCVs anymore, except for the occasional carpal tunnel syndrome case.

So where were all these people coming from?

All of them had previously seen good neurologists, had the correct work-up, diagnoses, and treatment, but just hadn’t had the outcome they wanted. Now they were showing up at my little office, telling my staff that I was their last hope.

All of them had the common thread that they weren’t sent by my regular referral base. Instead, they found me on “the Internet.” Of course, none remembered where. This isn’t easy, as there are hundreds of physician listing and review sites out there. But, because of the number of calls, and the abuse that my staff and I were getting when people found out I wasn’t some magical foot-drop guru, I decided to try to find out.

After a few days of searching in my spare time, I finally had it. A site called MediFind lists me as being “advanced” in treating foot-drop, to the extent that it’s at the top of my “Areas of Expertise.” The site also says I handle “Autosomal Dominant Partial Epilepsy with Auditory Features” (no, I don’t. Try the epilepsy centers in town), “Familial Neurocardiogenic Syncope” (no), and narcolepsy (definitely not, try a sleep specialist).

I have no affiliation with MediFind. In fact, I’d never heard of them until I began tracking down this issue. How they came to have such incorrect information about me I don’t know, perhaps pulled from insurance billing data, or patient reviews, or a Magic 8 Ball.

But the foot-drop issue had, oddly, become a problem. My staff was having to tell people who called in with it that I wanted to see their previous neurology records so I didn’t waste their time. People being told I wasn’t some Ivory Tower foot-dropologist often became abusive and nasty, something I won’t tolerate (5 years ago this was rarely a problem, now it’s frighteningly common). People who made it as far as seeing me (a few when this began) were livid when I looked through their records and said I had nothing to offer that their previous neurologist(s) hadn’t done. I was accused of false advertising, misrepresenting myself, etc, even though I had nothing to do with why MediFind put that up.

So I wrote to MediFind, using the email info on their page. I told them I didn’t specialize in foot-drop, and didn’t even handle several of the other conditions on their page. I asked them to take those things out, or (preferably) simply delete my listing from their site.

I got an automated reply thanking me for writing to them and saying their team would look into it. That was almost a month ago. I haven’t heard back, and the listing is, as of this writing, still up.

Like the “once in, never out” issue with a wrong diagnosis in the EMR, erroneous professional information on the Internet probably isn’t going to go away. The computer algorithms that create such listings have no interest in correcting their errors, and so the frustration for these patients, my staff, and myself, is going to continue for a while. It’s a waste of time for them and us.

And, as this point, I doubt there’s much I can do about it.
 

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Joint space narrowing, and bone proliferation were the most frequently observed radiological alterations in patients having psoriatic arthritis (PsA), with male sex, older age, higher disease activity, and initial polyarticular involvement being significant predictors of bone damage.

Major finding: At a mean follow-up period of ~12.9 years, patients presented with a significantly greater burden of joint space narrowing and bone proliferation in the hands (both P = .001) and joint space narrowing in the feet (P = .047). Male sex (P = .030), older age (P < .05), high initial scores of the Disease Activity Index for PsA (P = .032), and symmetrical polyarticular involvement (P = .025) were significant predictors of bone damage.

Study details: This retrospective cohort study included 50 patients with PsA who were assessed for radiological changes in bone structure and were followed up for ~10 years.

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

Source: Ozdemir Isik O et al. Radiological progression and predictive factors in psoriatic arthritis: Insights from a decade-long retrospective cohort study. Clin Rheumatol. 2023 (Dec 3). doi: 10.1007/s10067-023-06839-7

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: Patients with psoriatic arthritis (PsA) who did not have fibromyalgia but presented with prolonged and persistent pain due to central sensitization (CS) reported a greater impact of disease, higher disease activity, and worsened physical and mental function.

Major finding: CS Inventory scores were positively associated with disease activity (Disease Activity in Psoriatic Arthritis: correlation coefficient [ρ] 0.587; P < .0001) and the impact of disease (PsA Impact of Disease 12 items: ρ 0.670; P < .0001) but were negatively associated with the quality of life (Short Form Survey 36 items [SF-36]-physical component summary: ρ −0.405; and SF-36-mental component summary: ρ −0.483; both P < .0001).

Study details: Findings are from a cross-sectional analysis including 157 patients who had PsA without coexisting fibromyalgia, 45.2% of whom had CS Inventory scores ≥40.

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

Source: Salaffi F et al. Central sensitization in psoriatic arthritis: Relationship with composite measures of disease activity, functional disability and health-related quality of life. J Rheumatol. 2023 (Nov 15). doi: 10.3899/jrheum.2023-0177

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: The burden of inflammation-independent persistent refractory pain was substantially high in bio-naive patients with psoriatic arthritis (PsA) who received anti-tumor necrosis factor (TNF) therapy.

Major finding: At 12 months of anti-TNF therapy, 39% of patients reported unacceptable pain, the majority (63%) of which was non-inflammatory refractory pain. Higher pain intensity, higher disease activity, and worse health-related quality of life were associated with a higher risk for refractory pain at 12 months (all P < .05) whereas more swollen joints were associated with a lower risk for the same (P = .03).

Study details: This study included 351 bio-naive patients with PsA from the South Swedish Arthritis Treatment Group register who initiated anti-TNF therapy.

Disclosures: This study was funded by grants from Greta och Johan Kocks stiftelser, ALF Region Skåne, and others. Two authors declared receiving research support from or performing consultation tasks for various sources. The other authors declared no conflicts of interest.

Source: Roseman C et al. Persistent pain and its predictors after starting anti-tumour necrosis factor therapy in psoriatic arthritis: What is the role of inflammation control? Scand J Rheumatol. 2023 (Nov 30). doi: 10.1080/03009742.2023.2258644

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Patients with psoriatic arthritis (PsA) who had no evidence of active swelling or inflammation but reported persistent joint pain presented with higher levels of fatigue, depression, and anxiety along with increased sleep disturbances than those in remission.

Major finding: Higher levels of fatigue, depression, and anxiety, as well as increased sleep disturbances were observed in patients with PsA who had persistent joint pain vs those who achieved remission (all P ≤ .01). Patients with persistent pain vs those in remission also had lower global mental health scores, which indicated worsened mental health (45.2 vs 49.9, P = 0.02).

Study details: This study included 95 patients having PsA without swollen joints, of whom 25 patients had persistent joint pain.

Disclosures: This study was funded by the US National Institutes of Health and other sources. Three authors declared serving as consultants for or receiving clinical research support or funding from various sources. The other authors declared no conflicts of interest.

Source: Haberman RH et al. Psychosocial factors significantly contribute to joint pain persistence in psoriatic arthritis. J Rheumatol. 2023 (Dec 1). doi: 10.3899/jrheum.2023-0909

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: Female patients with psoriatic arthritis (PsA) who initiated treatment with first-line tumor necrosis factor inhibitors (TNFi) experienced less reduction in disease activity scores and showed higher discontinuation rates than male patients.

Major finding: At 6 months, women were 17% less likely than men to achieve low disease activity according to Disease Activity Score-28 C-reactive protein measurements (adjusted relative risk 0.83; 95% CI 0.81-0.85), and the risk for TNFi treatment discontinuation at 2 years was nearly 60% higher in women vs in men (adjusted hazard ratio 1.57; 95% CI 1.49-1.66).

Study details: Findings are from a retrospective study including 18,599 patients with PsA who received their first TNFi, of whom 7679 and 17,842 women were analyzed for treatment response and retention rates, respectively.

Disclosures: This study did not disclose any funding source. Several authors declared receiving honoraria, unrestricted grants, speaker’s fees, or consultancy fees from or having other ties with various sources.

Source: Hellamand P et al. Sex differences in the effectiveness of first-line tumor necrosis factor inhibitors in psoriatic arthritis; results from the EuroSpA Research Collaboration Network. Arthritis Rheumatol. 2023 (Nov 16). doi: 10.1002/art.42758

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524

Key clinical point: In patients with psoriatic arthritis (PsA), a 16-week treatment with either a tumor necrosis factor inhibitor (TNFi) or secukinumab improved both active and chronic ultrasound-confirmed enthesitis to a similar extent; however, a TNFi was more effective in reducing active entheseal lesions.

Major finding: The mean reduction in MAdrid Sonographic Enthesitis Index (MASEI) score that assesses both active and chronic entheseal disease was not significantly different with TNFi vs secukinumab treatment (3.42 vs 1.74; P = .097). However, TNFi was significantly more effective than secukinumab when only active entheseal lesions were considered (MASEIActive score 4.37 vs 2.26; P = .030).

Study details: Findings are from an open-label observational study including 80 patients with PsA who received either secukinumab (n = 24) or TNFi (n = 56), of whom 75 patients completed the treatment.

Disclosures: This study was supported by the UK Psoriasis and Psoriatic Arthritis Alliance and other sources. The authors reported receiving honoraria from Novartis.

Source: Elliott A et al. Effects of TNF-α inhibition versus secukinumab on active ultrasound-confirmed enthesitis in psoriatic arthritis. Ther Adv Musculoskelet Dis. 2023; 15:1759720X231179524. (Nov 16). doi: 10.1177/1759720X231179524