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CPT updates for 2024 include new RSV vaccines, Spanish translation
The American Medical Association recently released the Current Procedural Terminology (CPT) 2024 Code Set. The update included 349 editorial changes, including 230 additions, 49 deletions, and 70 revisions. With more than 11,100 codes in use, the CPT system continues “to grow and evolve with the rapid pace of innovation in medical science and health technology,” AMA said.
The AMA said the CPT update includes five new codes created to report product-specific RSV products (90380, 90381, 90683, 90679, and 90678) for better tracking, reporting and analysis that supports data-driven planning and allocation, AMA said.
There’s been a flurry of new U.S. vaccines and drugs to address RSV. The Food and Drug Administration in May granted the first U.S. approval of an RSV vaccine to Arexy, manufactured by GSK. The FDA cleared it for prevention of lower respiratory tract disease caused by RSV in adults age 60 years and older.
In June, Pfizer won FDA approval of Abrysvo, another vaccine meant to protect adults older than 60 years from RSV. The following month, the FDA approved nirsevimab (Beyfortus, AstraZeneca/Sanofi), for the prevention of RSV in neonates and infants entering their first RSV season, and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. (This is not a vaccine, but a monoclonal antibody used for prevention. There has been confusion on this issue in part because monoclonal antibodies are often used for treatment rather than prevention.)
The FDA also has approved Abrysvo for use in pregnant individuals.
In addition, new CPT codes aim to streamline COVID-19 immunizations reporting. A new code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient. New provisional codes (91318-91322) will identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19.
These provisional codes will be effective for use when the monovalent vaccine products from Moderna and Pfizer receive FDA approval, AMA said.
More codes explained in Spanish
The 2024 update includes more code descriptions in Spanish. Many hospitals, health plans, and medical offices already incorporate CPT descriptors in English-language medical documents, insurance forms, price sheets, and patient portals. This expansion is intended to help patients who may not read English well or at all.
“Providing approximately 41 million Spanish-speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care,” Lori Prestesater, AMA’s senior vice president of health solutions, said in a statement.
In addition, the 2024 update includes clarifications sought by the Centers for Medicare & Medicaid Services about the reporting of evaluation and management (E/M) services. The revisions include:
- Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and format alignment with other E/M codes.
- Definition of the “substantive portion” of a split/shared E/M visit in which a physician and a nonphysician practitioner work jointly to furnish all the work related to the visit.
- Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes. 99234-99236 when the patient stay crosses over two calendar dates.
A version of this article appeared on Medscape.com.
The American Medical Association recently released the Current Procedural Terminology (CPT) 2024 Code Set. The update included 349 editorial changes, including 230 additions, 49 deletions, and 70 revisions. With more than 11,100 codes in use, the CPT system continues “to grow and evolve with the rapid pace of innovation in medical science and health technology,” AMA said.
The AMA said the CPT update includes five new codes created to report product-specific RSV products (90380, 90381, 90683, 90679, and 90678) for better tracking, reporting and analysis that supports data-driven planning and allocation, AMA said.
There’s been a flurry of new U.S. vaccines and drugs to address RSV. The Food and Drug Administration in May granted the first U.S. approval of an RSV vaccine to Arexy, manufactured by GSK. The FDA cleared it for prevention of lower respiratory tract disease caused by RSV in adults age 60 years and older.
In June, Pfizer won FDA approval of Abrysvo, another vaccine meant to protect adults older than 60 years from RSV. The following month, the FDA approved nirsevimab (Beyfortus, AstraZeneca/Sanofi), for the prevention of RSV in neonates and infants entering their first RSV season, and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. (This is not a vaccine, but a monoclonal antibody used for prevention. There has been confusion on this issue in part because monoclonal antibodies are often used for treatment rather than prevention.)
The FDA also has approved Abrysvo for use in pregnant individuals.
In addition, new CPT codes aim to streamline COVID-19 immunizations reporting. A new code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient. New provisional codes (91318-91322) will identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19.
These provisional codes will be effective for use when the monovalent vaccine products from Moderna and Pfizer receive FDA approval, AMA said.
More codes explained in Spanish
The 2024 update includes more code descriptions in Spanish. Many hospitals, health plans, and medical offices already incorporate CPT descriptors in English-language medical documents, insurance forms, price sheets, and patient portals. This expansion is intended to help patients who may not read English well or at all.
“Providing approximately 41 million Spanish-speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care,” Lori Prestesater, AMA’s senior vice president of health solutions, said in a statement.
In addition, the 2024 update includes clarifications sought by the Centers for Medicare & Medicaid Services about the reporting of evaluation and management (E/M) services. The revisions include:
- Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and format alignment with other E/M codes.
- Definition of the “substantive portion” of a split/shared E/M visit in which a physician and a nonphysician practitioner work jointly to furnish all the work related to the visit.
- Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes. 99234-99236 when the patient stay crosses over two calendar dates.
A version of this article appeared on Medscape.com.
The American Medical Association recently released the Current Procedural Terminology (CPT) 2024 Code Set. The update included 349 editorial changes, including 230 additions, 49 deletions, and 70 revisions. With more than 11,100 codes in use, the CPT system continues “to grow and evolve with the rapid pace of innovation in medical science and health technology,” AMA said.
The AMA said the CPT update includes five new codes created to report product-specific RSV products (90380, 90381, 90683, 90679, and 90678) for better tracking, reporting and analysis that supports data-driven planning and allocation, AMA said.
There’s been a flurry of new U.S. vaccines and drugs to address RSV. The Food and Drug Administration in May granted the first U.S. approval of an RSV vaccine to Arexy, manufactured by GSK. The FDA cleared it for prevention of lower respiratory tract disease caused by RSV in adults age 60 years and older.
In June, Pfizer won FDA approval of Abrysvo, another vaccine meant to protect adults older than 60 years from RSV. The following month, the FDA approved nirsevimab (Beyfortus, AstraZeneca/Sanofi), for the prevention of RSV in neonates and infants entering their first RSV season, and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. (This is not a vaccine, but a monoclonal antibody used for prevention. There has been confusion on this issue in part because monoclonal antibodies are often used for treatment rather than prevention.)
The FDA also has approved Abrysvo for use in pregnant individuals.
In addition, new CPT codes aim to streamline COVID-19 immunizations reporting. A new code (90480) was approved for reporting the administration of any COVID-19 vaccine for any patient. New provisional codes (91318-91322) will identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19.
These provisional codes will be effective for use when the monovalent vaccine products from Moderna and Pfizer receive FDA approval, AMA said.
More codes explained in Spanish
The 2024 update includes more code descriptions in Spanish. Many hospitals, health plans, and medical offices already incorporate CPT descriptors in English-language medical documents, insurance forms, price sheets, and patient portals. This expansion is intended to help patients who may not read English well or at all.
“Providing approximately 41 million Spanish-speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care,” Lori Prestesater, AMA’s senior vice president of health solutions, said in a statement.
In addition, the 2024 update includes clarifications sought by the Centers for Medicare & Medicaid Services about the reporting of evaluation and management (E/M) services. The revisions include:
- Removal of time ranges from office or other outpatient visit codes (99202-99205, 99212-99215) and format alignment with other E/M codes.
- Definition of the “substantive portion” of a split/shared E/M visit in which a physician and a nonphysician practitioner work jointly to furnish all the work related to the visit.
- Instructions for reporting hospital inpatient or observation care services and admission and discharge services for the use of codes. 99234-99236 when the patient stay crosses over two calendar dates.
A version of this article appeared on Medscape.com.
Progressive pulmonary fibrosis: treatment and support
MILAN – Numerous unresolved questions surround progressive pulmonary fibrosis (PPF) treatment, according to Elisabeth Bendstrup, MD, PhD, a researcher and clinical professor in the department of clinical medicine – department of respiratory diseases and allergy, Aarhus (Denmark) University, Denmark. These questions regard the optimal timing for treatment initiation, the role of available medications, either as monotherapy or in combination, and nonpharmacologic support options.
What’s in the toolbox?
Pulmonologists who manage PPF have a range of treatment options at their disposal. This includes careful patient observation, with treatment initiation based on clinical necessity. The therapeutic arsenal comprises immunomodulatory treatments, antifibrotic agents, palliative and supportive care, and, for a minority of patients, lung transplantation.
“Once a patient is diagnosed with PPF, it is important to remember that the diagnostic criteria from the guidelines are not exactly the same of those accepted for the reimbursement of antifibrotic treatments in different countries,” Dr. Bendstrup said, suggesting that nonclinical considerations could also potentially influence the treatment choice. She spoke at the annual congress of the European Respiratory Society.
Michael Kreuter, MD, director of the Lung Center at the University Hospital in Mainz, Germany, provided insight into the introduction of antifibrotic drugs for the treatment of PPF. Drawing from nearly a decade ago when the first antifibrotic medication was approved for idiopathic pulmonary fibrosis (IPF), Dr. Kreuter noted its effectiveness in slowing disease progression, although it does not reverse it. Subsequently, the discovery that non-IPF diseases, such as rheumatoid arthritis, exhibited IPF-like behavior led to the exploration of the use of the same drugs for similar conditions, even if not IPF.
“That’s how antifibrotic treatments came into place. Now we have more trials and data to be discussed in the future,” Dr. Kreuter added. He highlighted that antifibrotic drugs are effective for several diseases. Most of those diseases are treated with different anti-inflammatory drugs, which makes it difficult to decide when to start antifibrotic therapy and how to eventually combine it with different pharmacologic approaches.
A pivotal starting point
a question only partially addressed by existing guidelines. Dr. Bendstrup advocated for a comprehensive baseline evaluation. Factors to be considered include symptom burden, the severity of lung decline, radiologic characteristics, signs of alveolar inflammation, progression risk factors, quality of life, patient preferences, and medical history. “All these should be best discussed in a multidisciplinary team, including pulmonologists, nurses, experts in palliative care, occupational physicians, and more,” she said.
Current guidelines recommend nintedanib for PPF treatment for patients who have failed standard management for fibrotic interstitial lung disease (ILD) other than IPF. However, the definition of “standard management” remains a topic of debate, and it is acknowledged that evidence-based guidance for a standard of care varies among patients. Dr. Bendstrup pointed out the limited guidance clinicians receive from these guidelines. “As clinicians, we are not left with very much help from here.”
Choosing the right approach
Dr. Bendstrup delved into the factors influencing the choice between antifibrotic and anti-inflammatory therapies. This decision hinges on whether the patient presents with a predominantly inflammatory or a fibrotic progressive phenotype. Certain clinical characteristics contribute to the decision. Factors such as younger age, female gender, and the presence of connective tissue disease lean toward an inflammatory phenotype. Radiologic patterns, such as organized pneumonia, hypersensitivity pneumonia, or usual interstitial pneumonia–like patterns also provide valuable clues. Additionally, genetics plays a role, with shorter telomeres indicating a more fibrotic phenotype and an increased risk of immunomodulatory treatment side effects in non-IPF ILDs.
Bendstrup referred to a recent position paper on treatment recommendations and many other studies that support the use of different treatments for patients with PPF. The authors highlighted limited evidence for immunomodulation in fibrotic ILD, though such treatment is generally used except for ILD associated with systemic sclerosis. Moreover, the guidelines conditionally recommend nintedanib and call for further research on pirfenidone in PPF.
“We need intelligent, well-designed trials looking at subgroups of patients at higher risk, maybe based on molecular identification. We also need to have good biomarkers to better classify our patients based on disease behavior and treatment response. There’s a lot of discussion of biomarkers for progression, much less – if any – on biomarkers for the response to treatment. And we need them as well,” Dr. Bendstrup said in an interview.
The role of supportive care
Effective PPF treatment extends beyond pharmacologic interventions. It encompasses symptom management, patient education on vaccination and smoking cessation, and fostering social support networks. Psychological support, supplemental oxygen therapy, and pulmonary rehabilitation are integral components of care.
Elisabeth Robertson, a PPF patient representative from the United Kingdom, emphasized the importance of palliative care, not just in end-of-life scenarios but throughout the patient’s journey. Palliative care encompasses symptom alleviation, enabling patients to stay at home when possible, addressing mental health, and preparing for the end of life. Such holistic care can significantly enhance the patient’s quality of life.
The cochair of the session, Marlies S. Wijsenbeek, MD, PhD, pulmonary physician and head of the ILD Centre at the Erasmus University Medical Centre, Rotterdam, the Netherlands, underscored that palliative care begins at diagnosis and involves managing symptom burdens. “Supportive care also includes nurses, as they are precious for the patients while answering their questions and can help save time for the doctors,” she said in an interview.
In the discussion on treatment decisions, experts agreed on the pivotal role of patients in decision-making. However, Dr. Kreuter highlighted two critical factors that influence successful patient-doctor interactions: the cultural backgrounds of patients and their relatives, and the attitudes of health care providers.
Dr. Bendstrup has received honoraria or consultation fees from Boehringer Ingelheim, Roche, Astra Zeneca, Chiesi, and Daiichi Sankyo. Ms. Robertson disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.
MILAN – Numerous unresolved questions surround progressive pulmonary fibrosis (PPF) treatment, according to Elisabeth Bendstrup, MD, PhD, a researcher and clinical professor in the department of clinical medicine – department of respiratory diseases and allergy, Aarhus (Denmark) University, Denmark. These questions regard the optimal timing for treatment initiation, the role of available medications, either as monotherapy or in combination, and nonpharmacologic support options.
What’s in the toolbox?
Pulmonologists who manage PPF have a range of treatment options at their disposal. This includes careful patient observation, with treatment initiation based on clinical necessity. The therapeutic arsenal comprises immunomodulatory treatments, antifibrotic agents, palliative and supportive care, and, for a minority of patients, lung transplantation.
“Once a patient is diagnosed with PPF, it is important to remember that the diagnostic criteria from the guidelines are not exactly the same of those accepted for the reimbursement of antifibrotic treatments in different countries,” Dr. Bendstrup said, suggesting that nonclinical considerations could also potentially influence the treatment choice. She spoke at the annual congress of the European Respiratory Society.
Michael Kreuter, MD, director of the Lung Center at the University Hospital in Mainz, Germany, provided insight into the introduction of antifibrotic drugs for the treatment of PPF. Drawing from nearly a decade ago when the first antifibrotic medication was approved for idiopathic pulmonary fibrosis (IPF), Dr. Kreuter noted its effectiveness in slowing disease progression, although it does not reverse it. Subsequently, the discovery that non-IPF diseases, such as rheumatoid arthritis, exhibited IPF-like behavior led to the exploration of the use of the same drugs for similar conditions, even if not IPF.
“That’s how antifibrotic treatments came into place. Now we have more trials and data to be discussed in the future,” Dr. Kreuter added. He highlighted that antifibrotic drugs are effective for several diseases. Most of those diseases are treated with different anti-inflammatory drugs, which makes it difficult to decide when to start antifibrotic therapy and how to eventually combine it with different pharmacologic approaches.
A pivotal starting point
a question only partially addressed by existing guidelines. Dr. Bendstrup advocated for a comprehensive baseline evaluation. Factors to be considered include symptom burden, the severity of lung decline, radiologic characteristics, signs of alveolar inflammation, progression risk factors, quality of life, patient preferences, and medical history. “All these should be best discussed in a multidisciplinary team, including pulmonologists, nurses, experts in palliative care, occupational physicians, and more,” she said.
Current guidelines recommend nintedanib for PPF treatment for patients who have failed standard management for fibrotic interstitial lung disease (ILD) other than IPF. However, the definition of “standard management” remains a topic of debate, and it is acknowledged that evidence-based guidance for a standard of care varies among patients. Dr. Bendstrup pointed out the limited guidance clinicians receive from these guidelines. “As clinicians, we are not left with very much help from here.”
Choosing the right approach
Dr. Bendstrup delved into the factors influencing the choice between antifibrotic and anti-inflammatory therapies. This decision hinges on whether the patient presents with a predominantly inflammatory or a fibrotic progressive phenotype. Certain clinical characteristics contribute to the decision. Factors such as younger age, female gender, and the presence of connective tissue disease lean toward an inflammatory phenotype. Radiologic patterns, such as organized pneumonia, hypersensitivity pneumonia, or usual interstitial pneumonia–like patterns also provide valuable clues. Additionally, genetics plays a role, with shorter telomeres indicating a more fibrotic phenotype and an increased risk of immunomodulatory treatment side effects in non-IPF ILDs.
Bendstrup referred to a recent position paper on treatment recommendations and many other studies that support the use of different treatments for patients with PPF. The authors highlighted limited evidence for immunomodulation in fibrotic ILD, though such treatment is generally used except for ILD associated with systemic sclerosis. Moreover, the guidelines conditionally recommend nintedanib and call for further research on pirfenidone in PPF.
“We need intelligent, well-designed trials looking at subgroups of patients at higher risk, maybe based on molecular identification. We also need to have good biomarkers to better classify our patients based on disease behavior and treatment response. There’s a lot of discussion of biomarkers for progression, much less – if any – on biomarkers for the response to treatment. And we need them as well,” Dr. Bendstrup said in an interview.
The role of supportive care
Effective PPF treatment extends beyond pharmacologic interventions. It encompasses symptom management, patient education on vaccination and smoking cessation, and fostering social support networks. Psychological support, supplemental oxygen therapy, and pulmonary rehabilitation are integral components of care.
Elisabeth Robertson, a PPF patient representative from the United Kingdom, emphasized the importance of palliative care, not just in end-of-life scenarios but throughout the patient’s journey. Palliative care encompasses symptom alleviation, enabling patients to stay at home when possible, addressing mental health, and preparing for the end of life. Such holistic care can significantly enhance the patient’s quality of life.
The cochair of the session, Marlies S. Wijsenbeek, MD, PhD, pulmonary physician and head of the ILD Centre at the Erasmus University Medical Centre, Rotterdam, the Netherlands, underscored that palliative care begins at diagnosis and involves managing symptom burdens. “Supportive care also includes nurses, as they are precious for the patients while answering their questions and can help save time for the doctors,” she said in an interview.
In the discussion on treatment decisions, experts agreed on the pivotal role of patients in decision-making. However, Dr. Kreuter highlighted two critical factors that influence successful patient-doctor interactions: the cultural backgrounds of patients and their relatives, and the attitudes of health care providers.
Dr. Bendstrup has received honoraria or consultation fees from Boehringer Ingelheim, Roche, Astra Zeneca, Chiesi, and Daiichi Sankyo. Ms. Robertson disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.
MILAN – Numerous unresolved questions surround progressive pulmonary fibrosis (PPF) treatment, according to Elisabeth Bendstrup, MD, PhD, a researcher and clinical professor in the department of clinical medicine – department of respiratory diseases and allergy, Aarhus (Denmark) University, Denmark. These questions regard the optimal timing for treatment initiation, the role of available medications, either as monotherapy or in combination, and nonpharmacologic support options.
What’s in the toolbox?
Pulmonologists who manage PPF have a range of treatment options at their disposal. This includes careful patient observation, with treatment initiation based on clinical necessity. The therapeutic arsenal comprises immunomodulatory treatments, antifibrotic agents, palliative and supportive care, and, for a minority of patients, lung transplantation.
“Once a patient is diagnosed with PPF, it is important to remember that the diagnostic criteria from the guidelines are not exactly the same of those accepted for the reimbursement of antifibrotic treatments in different countries,” Dr. Bendstrup said, suggesting that nonclinical considerations could also potentially influence the treatment choice. She spoke at the annual congress of the European Respiratory Society.
Michael Kreuter, MD, director of the Lung Center at the University Hospital in Mainz, Germany, provided insight into the introduction of antifibrotic drugs for the treatment of PPF. Drawing from nearly a decade ago when the first antifibrotic medication was approved for idiopathic pulmonary fibrosis (IPF), Dr. Kreuter noted its effectiveness in slowing disease progression, although it does not reverse it. Subsequently, the discovery that non-IPF diseases, such as rheumatoid arthritis, exhibited IPF-like behavior led to the exploration of the use of the same drugs for similar conditions, even if not IPF.
“That’s how antifibrotic treatments came into place. Now we have more trials and data to be discussed in the future,” Dr. Kreuter added. He highlighted that antifibrotic drugs are effective for several diseases. Most of those diseases are treated with different anti-inflammatory drugs, which makes it difficult to decide when to start antifibrotic therapy and how to eventually combine it with different pharmacologic approaches.
A pivotal starting point
a question only partially addressed by existing guidelines. Dr. Bendstrup advocated for a comprehensive baseline evaluation. Factors to be considered include symptom burden, the severity of lung decline, radiologic characteristics, signs of alveolar inflammation, progression risk factors, quality of life, patient preferences, and medical history. “All these should be best discussed in a multidisciplinary team, including pulmonologists, nurses, experts in palliative care, occupational physicians, and more,” she said.
Current guidelines recommend nintedanib for PPF treatment for patients who have failed standard management for fibrotic interstitial lung disease (ILD) other than IPF. However, the definition of “standard management” remains a topic of debate, and it is acknowledged that evidence-based guidance for a standard of care varies among patients. Dr. Bendstrup pointed out the limited guidance clinicians receive from these guidelines. “As clinicians, we are not left with very much help from here.”
Choosing the right approach
Dr. Bendstrup delved into the factors influencing the choice between antifibrotic and anti-inflammatory therapies. This decision hinges on whether the patient presents with a predominantly inflammatory or a fibrotic progressive phenotype. Certain clinical characteristics contribute to the decision. Factors such as younger age, female gender, and the presence of connective tissue disease lean toward an inflammatory phenotype. Radiologic patterns, such as organized pneumonia, hypersensitivity pneumonia, or usual interstitial pneumonia–like patterns also provide valuable clues. Additionally, genetics plays a role, with shorter telomeres indicating a more fibrotic phenotype and an increased risk of immunomodulatory treatment side effects in non-IPF ILDs.
Bendstrup referred to a recent position paper on treatment recommendations and many other studies that support the use of different treatments for patients with PPF. The authors highlighted limited evidence for immunomodulation in fibrotic ILD, though such treatment is generally used except for ILD associated with systemic sclerosis. Moreover, the guidelines conditionally recommend nintedanib and call for further research on pirfenidone in PPF.
“We need intelligent, well-designed trials looking at subgroups of patients at higher risk, maybe based on molecular identification. We also need to have good biomarkers to better classify our patients based on disease behavior and treatment response. There’s a lot of discussion of biomarkers for progression, much less – if any – on biomarkers for the response to treatment. And we need them as well,” Dr. Bendstrup said in an interview.
The role of supportive care
Effective PPF treatment extends beyond pharmacologic interventions. It encompasses symptom management, patient education on vaccination and smoking cessation, and fostering social support networks. Psychological support, supplemental oxygen therapy, and pulmonary rehabilitation are integral components of care.
Elisabeth Robertson, a PPF patient representative from the United Kingdom, emphasized the importance of palliative care, not just in end-of-life scenarios but throughout the patient’s journey. Palliative care encompasses symptom alleviation, enabling patients to stay at home when possible, addressing mental health, and preparing for the end of life. Such holistic care can significantly enhance the patient’s quality of life.
The cochair of the session, Marlies S. Wijsenbeek, MD, PhD, pulmonary physician and head of the ILD Centre at the Erasmus University Medical Centre, Rotterdam, the Netherlands, underscored that palliative care begins at diagnosis and involves managing symptom burdens. “Supportive care also includes nurses, as they are precious for the patients while answering their questions and can help save time for the doctors,” she said in an interview.
In the discussion on treatment decisions, experts agreed on the pivotal role of patients in decision-making. However, Dr. Kreuter highlighted two critical factors that influence successful patient-doctor interactions: the cultural backgrounds of patients and their relatives, and the attitudes of health care providers.
Dr. Bendstrup has received honoraria or consultation fees from Boehringer Ingelheim, Roche, Astra Zeneca, Chiesi, and Daiichi Sankyo. Ms. Robertson disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.
AT ERS 2023
Uveitis more frequent in axSpA than in PsA
Key clinical point: Uveitis is far more prevalent in patients with axial spondylarthritis (axSpA) than in those with psoriatic arthritis (PsA). A family history of SpA, axial disease at diagnosis, and disease duration were important factors associated with the occurrence of uveitis in PsA.
Major finding: Uveitis was more frequent in patients with axSpA vs PsA (11.7% vs 2.7%), with a median uveitis recurrence rate of 0.205 episodes per year and 0.285 episodes per year for axSpA and PsA, respectively. Family history of SpA (odds ratio [OR] 6.35; P = .023), axial disease at diagnosis (OR 5.61; P = .038), and disease duration (OR 1.12; P = .004) were associated with the occurrence of uveitis in PsA.
Study details: Findings are from a retrospective study including 264 patients with axSpA and 369 patients with PsA.
Disclosures: This study did not receive any specific funding except open access funding by HEAL-Link Greece. The authors declared no conflicts of interest.
Source: Kougkas N et al. Higher frequency but similar recurrence rate of uveitis episodes in axial spondylarthritis compared to psoriatic arthritis. A multicentre retrospective study. Rheumatol Int. 2023;43:2081-2088 (Aug 23). doi: 10.1007/s00296-023-05424-0
Key clinical point: Uveitis is far more prevalent in patients with axial spondylarthritis (axSpA) than in those with psoriatic arthritis (PsA). A family history of SpA, axial disease at diagnosis, and disease duration were important factors associated with the occurrence of uveitis in PsA.
Major finding: Uveitis was more frequent in patients with axSpA vs PsA (11.7% vs 2.7%), with a median uveitis recurrence rate of 0.205 episodes per year and 0.285 episodes per year for axSpA and PsA, respectively. Family history of SpA (odds ratio [OR] 6.35; P = .023), axial disease at diagnosis (OR 5.61; P = .038), and disease duration (OR 1.12; P = .004) were associated with the occurrence of uveitis in PsA.
Study details: Findings are from a retrospective study including 264 patients with axSpA and 369 patients with PsA.
Disclosures: This study did not receive any specific funding except open access funding by HEAL-Link Greece. The authors declared no conflicts of interest.
Source: Kougkas N et al. Higher frequency but similar recurrence rate of uveitis episodes in axial spondylarthritis compared to psoriatic arthritis. A multicentre retrospective study. Rheumatol Int. 2023;43:2081-2088 (Aug 23). doi: 10.1007/s00296-023-05424-0
Key clinical point: Uveitis is far more prevalent in patients with axial spondylarthritis (axSpA) than in those with psoriatic arthritis (PsA). A family history of SpA, axial disease at diagnosis, and disease duration were important factors associated with the occurrence of uveitis in PsA.
Major finding: Uveitis was more frequent in patients with axSpA vs PsA (11.7% vs 2.7%), with a median uveitis recurrence rate of 0.205 episodes per year and 0.285 episodes per year for axSpA and PsA, respectively. Family history of SpA (odds ratio [OR] 6.35; P = .023), axial disease at diagnosis (OR 5.61; P = .038), and disease duration (OR 1.12; P = .004) were associated with the occurrence of uveitis in PsA.
Study details: Findings are from a retrospective study including 264 patients with axSpA and 369 patients with PsA.
Disclosures: This study did not receive any specific funding except open access funding by HEAL-Link Greece. The authors declared no conflicts of interest.
Source: Kougkas N et al. Higher frequency but similar recurrence rate of uveitis episodes in axial spondylarthritis compared to psoriatic arthritis. A multicentre retrospective study. Rheumatol Int. 2023;43:2081-2088 (Aug 23). doi: 10.1007/s00296-023-05424-0
Tofacitinib can be considered as a treatment option for PsA with enthesitis
Key clinical point: Compared with placebo, tofacitinib demonstrated greater improvement in enthesitis in patients with psoriatic arthritis (PsA), irrespective of enthesitis location and severity.
Major finding: Tofacitinib vs placebo led to greater changes in the Leeds Enthesitis Index (LEI) and Spondyloarthritis Research Consortium of Canada Enthesitis Index scores up to month 3, irrespective of baseline enthesitis locations and severities, with all improvements with tofacitinib being maintained and continued through month 6. Among patients with baseline LEI >0 whose enthesitis had resolved at month 1, relapse at month 3 was experienced by 26.3% and 15.6% vs 30.8% of patients treated with 5 mg tofacitinib and 10 mg tofacitinib vs placebo, respectively.
Study details: This post hoc analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) and included 710 patients with PsA who received tofacitinib for 6 months or placebo for 3 months.
Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer Inc. Five authors declared receiving grants, research support, or consulting fees from or having ties with various sources, including Pfizer.
Source: Mease PJ et al. Efficacy of tofacitinib on enthesitis in patients with active psoriatic arthritis: Analysis of pooled data from two phase 3 studies. Arthritis Res Ther. 2023;25:153 (Aug 22). doi: 10.1186/s13075-023-03108-5
Key clinical point: Compared with placebo, tofacitinib demonstrated greater improvement in enthesitis in patients with psoriatic arthritis (PsA), irrespective of enthesitis location and severity.
Major finding: Tofacitinib vs placebo led to greater changes in the Leeds Enthesitis Index (LEI) and Spondyloarthritis Research Consortium of Canada Enthesitis Index scores up to month 3, irrespective of baseline enthesitis locations and severities, with all improvements with tofacitinib being maintained and continued through month 6. Among patients with baseline LEI >0 whose enthesitis had resolved at month 1, relapse at month 3 was experienced by 26.3% and 15.6% vs 30.8% of patients treated with 5 mg tofacitinib and 10 mg tofacitinib vs placebo, respectively.
Study details: This post hoc analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) and included 710 patients with PsA who received tofacitinib for 6 months or placebo for 3 months.
Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer Inc. Five authors declared receiving grants, research support, or consulting fees from or having ties with various sources, including Pfizer.
Source: Mease PJ et al. Efficacy of tofacitinib on enthesitis in patients with active psoriatic arthritis: Analysis of pooled data from two phase 3 studies. Arthritis Res Ther. 2023;25:153 (Aug 22). doi: 10.1186/s13075-023-03108-5
Key clinical point: Compared with placebo, tofacitinib demonstrated greater improvement in enthesitis in patients with psoriatic arthritis (PsA), irrespective of enthesitis location and severity.
Major finding: Tofacitinib vs placebo led to greater changes in the Leeds Enthesitis Index (LEI) and Spondyloarthritis Research Consortium of Canada Enthesitis Index scores up to month 3, irrespective of baseline enthesitis locations and severities, with all improvements with tofacitinib being maintained and continued through month 6. Among patients with baseline LEI >0 whose enthesitis had resolved at month 1, relapse at month 3 was experienced by 26.3% and 15.6% vs 30.8% of patients treated with 5 mg tofacitinib and 10 mg tofacitinib vs placebo, respectively.
Study details: This post hoc analysis of pooled data from 2 phase 3 studies (OPAL Broaden and OPAL Beyond) and included 710 patients with PsA who received tofacitinib for 6 months or placebo for 3 months.
Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees and shareholders of Pfizer Inc. Five authors declared receiving grants, research support, or consulting fees from or having ties with various sources, including Pfizer.
Source: Mease PJ et al. Efficacy of tofacitinib on enthesitis in patients with active psoriatic arthritis: Analysis of pooled data from two phase 3 studies. Arthritis Res Ther. 2023;25:153 (Aug 22). doi: 10.1186/s13075-023-03108-5
Secukinumab offers sustained improvement in synovitis and enthesitis in active PsA
Key clinical point: Patients with active psoriatic arthritis (PsA) who initiated secukinumab treatment had stable improvements in synovitis and sustained clinical improvements in enthesitis up to week 52.
Major finding: At week 12, secukinumab vs placebo led to significant improvements in power Doppler ultrasound (PDUS)-assessed synovitis (Global EULAR-OMERACT Synovitis Score: −9 vs −6; one-sided P = .004) and PDUS-assessed enthesitis (Spondyloarthritis Research Consortium of Canada enthesitis index score: −2.2 vs −1.6; one-sided P = .03), with the improvements being sustained up to week 52.
Study details: This 52-week, phase 3 ULTIMATE study included 166 patients with active PsA, who were naive to biologics and intolerant to conventional synthetic disease-modifying anti-rheumatic drugs and were randomly assigned to receive secukinumab or placebo.
Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Three authors declared being employees or stockholders of Novartis. Several authors declared ties with various sources, including Novartis. Three authors declared no conflicts of interest.
Source: D’Agostino MA et al. Effects of secukinumab on synovitis and enthesitis in patients with psoriatic arthritis: 52-week clinical and ultrasound results from the randomised, double-blind ULTIMATE trial with open label extension. Semin Arthritis Rheum. 2023;63:152259 (Aug 19). doi: 10.1016/j.semarthrit.2023.152259
Key clinical point: Patients with active psoriatic arthritis (PsA) who initiated secukinumab treatment had stable improvements in synovitis and sustained clinical improvements in enthesitis up to week 52.
Major finding: At week 12, secukinumab vs placebo led to significant improvements in power Doppler ultrasound (PDUS)-assessed synovitis (Global EULAR-OMERACT Synovitis Score: −9 vs −6; one-sided P = .004) and PDUS-assessed enthesitis (Spondyloarthritis Research Consortium of Canada enthesitis index score: −2.2 vs −1.6; one-sided P = .03), with the improvements being sustained up to week 52.
Study details: This 52-week, phase 3 ULTIMATE study included 166 patients with active PsA, who were naive to biologics and intolerant to conventional synthetic disease-modifying anti-rheumatic drugs and were randomly assigned to receive secukinumab or placebo.
Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Three authors declared being employees or stockholders of Novartis. Several authors declared ties with various sources, including Novartis. Three authors declared no conflicts of interest.
Source: D’Agostino MA et al. Effects of secukinumab on synovitis and enthesitis in patients with psoriatic arthritis: 52-week clinical and ultrasound results from the randomised, double-blind ULTIMATE trial with open label extension. Semin Arthritis Rheum. 2023;63:152259 (Aug 19). doi: 10.1016/j.semarthrit.2023.152259
Key clinical point: Patients with active psoriatic arthritis (PsA) who initiated secukinumab treatment had stable improvements in synovitis and sustained clinical improvements in enthesitis up to week 52.
Major finding: At week 12, secukinumab vs placebo led to significant improvements in power Doppler ultrasound (PDUS)-assessed synovitis (Global EULAR-OMERACT Synovitis Score: −9 vs −6; one-sided P = .004) and PDUS-assessed enthesitis (Spondyloarthritis Research Consortium of Canada enthesitis index score: −2.2 vs −1.6; one-sided P = .03), with the improvements being sustained up to week 52.
Study details: This 52-week, phase 3 ULTIMATE study included 166 patients with active PsA, who were naive to biologics and intolerant to conventional synthetic disease-modifying anti-rheumatic drugs and were randomly assigned to receive secukinumab or placebo.
Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Three authors declared being employees or stockholders of Novartis. Several authors declared ties with various sources, including Novartis. Three authors declared no conflicts of interest.
Source: D’Agostino MA et al. Effects of secukinumab on synovitis and enthesitis in patients with psoriatic arthritis: 52-week clinical and ultrasound results from the randomised, double-blind ULTIMATE trial with open label extension. Semin Arthritis Rheum. 2023;63:152259 (Aug 19). doi: 10.1016/j.semarthrit.2023.152259
Real-world study confirms high retention rates and favorable safety of secukinumab in active PsA
Key clinical point: Secukinumab demonstrated sustained efficacy, high retention rates, and a consistent safety profile in patients with active psoriatic arthritis (PsA) who were followed for ≥ 2 years.
Major finding: The treatment retention rate with secukinumab was 78.2% in PsA. The mean swollen joint counts (enrolment vs 2 years: 4.5 vs 3.6) and tender joint counts (enrolment vs 2 years: 12.8 vs 9.2) remained stable over 2 years of treatment. Serious adverse events occurred in 13.6% of patients, but no deaths related to treatment-emergent adverse events were reported.
Study details: Findings are from an interim analysis of the ongoing SERENA study including patients with active PsA (n = 81) or radiographic axial spondyloarthritis (n = 108) who had received secukinumab for ≥16 weeks prior to enrolment.
Disclosures: This study was supported by Novartis Pharma AG. Two authors declared being employees of Novartis Pharmaceuticals U.K. Ltd. Three authors declared ties with various sources, including Novartis.
Source: Gaffney K et al. Real-world evidence for secukinumab in UK patients with psoriatic arthritis or radiographic axial spondyloarthritis: Interim 2-year analysis from SERENA. Rheumatol Adv Pract. 2023;7(3):rkad055 (Aug 21). doi: 10.1093/rap/rkad055
Key clinical point: Secukinumab demonstrated sustained efficacy, high retention rates, and a consistent safety profile in patients with active psoriatic arthritis (PsA) who were followed for ≥ 2 years.
Major finding: The treatment retention rate with secukinumab was 78.2% in PsA. The mean swollen joint counts (enrolment vs 2 years: 4.5 vs 3.6) and tender joint counts (enrolment vs 2 years: 12.8 vs 9.2) remained stable over 2 years of treatment. Serious adverse events occurred in 13.6% of patients, but no deaths related to treatment-emergent adverse events were reported.
Study details: Findings are from an interim analysis of the ongoing SERENA study including patients with active PsA (n = 81) or radiographic axial spondyloarthritis (n = 108) who had received secukinumab for ≥16 weeks prior to enrolment.
Disclosures: This study was supported by Novartis Pharma AG. Two authors declared being employees of Novartis Pharmaceuticals U.K. Ltd. Three authors declared ties with various sources, including Novartis.
Source: Gaffney K et al. Real-world evidence for secukinumab in UK patients with psoriatic arthritis or radiographic axial spondyloarthritis: Interim 2-year analysis from SERENA. Rheumatol Adv Pract. 2023;7(3):rkad055 (Aug 21). doi: 10.1093/rap/rkad055
Key clinical point: Secukinumab demonstrated sustained efficacy, high retention rates, and a consistent safety profile in patients with active psoriatic arthritis (PsA) who were followed for ≥ 2 years.
Major finding: The treatment retention rate with secukinumab was 78.2% in PsA. The mean swollen joint counts (enrolment vs 2 years: 4.5 vs 3.6) and tender joint counts (enrolment vs 2 years: 12.8 vs 9.2) remained stable over 2 years of treatment. Serious adverse events occurred in 13.6% of patients, but no deaths related to treatment-emergent adverse events were reported.
Study details: Findings are from an interim analysis of the ongoing SERENA study including patients with active PsA (n = 81) or radiographic axial spondyloarthritis (n = 108) who had received secukinumab for ≥16 weeks prior to enrolment.
Disclosures: This study was supported by Novartis Pharma AG. Two authors declared being employees of Novartis Pharmaceuticals U.K. Ltd. Three authors declared ties with various sources, including Novartis.
Source: Gaffney K et al. Real-world evidence for secukinumab in UK patients with psoriatic arthritis or radiographic axial spondyloarthritis: Interim 2-year analysis from SERENA. Rheumatol Adv Pract. 2023;7(3):rkad055 (Aug 21). doi: 10.1093/rap/rkad055
Persistence and multidomain effectiveness of guselkumab in active PsA
Key clinical point: In a real-world population of patients with treatment-resistant, long-standing active psoriatic arthritis (PsA), nearly 80% persisted with guselkumab treatment for 6 months and showed improvements in peripheral joint and skin symptoms of PsA.
Major finding: Overall, 78.9% of patients who initiated guselkumab had persistent use at the 6-month follow-up. The mean scores for clinical Disease Activity in PsA (mean change [Δ] −5.4), overall joint+skin activity (Δ −19.0), patient-reported pain (Δ −9.1), and percentage of skin with psoriasis (Δ −5.1%) improved significantly in patients receiving guselkumab for 6 months (all P < .001).
Study details: This study evaluated 114 patients with active PsA from the CorEvitas PsA/Spondyloarthritis Registry who initiated guselkumab.
Disclosures: This study was sponsored by CorEvitas, LLC, and the analysis was funded by Janssen Scientific Affairs, LLC. Six authors declared employment with CorEvitas, LLC, or Janssen Scientific Affairs, LLC, or owned stock or stock options in Johnson & Johnson or others. Several authors declared ties with various sources, including Janssen and CorEvitas.
Source: Mease PJ et al. Six-month persistence and multi-domain effectiveness of guselkumab in adults with psoriatic arthritis: Real-world data from the CorEvitas psoriatic arthritis/spondyloarthritis registry. Rheumatol Ther. 2023 (Aug 19). doi: 10.1007/s40744-023-00582-w
Key clinical point: In a real-world population of patients with treatment-resistant, long-standing active psoriatic arthritis (PsA), nearly 80% persisted with guselkumab treatment for 6 months and showed improvements in peripheral joint and skin symptoms of PsA.
Major finding: Overall, 78.9% of patients who initiated guselkumab had persistent use at the 6-month follow-up. The mean scores for clinical Disease Activity in PsA (mean change [Δ] −5.4), overall joint+skin activity (Δ −19.0), patient-reported pain (Δ −9.1), and percentage of skin with psoriasis (Δ −5.1%) improved significantly in patients receiving guselkumab for 6 months (all P < .001).
Study details: This study evaluated 114 patients with active PsA from the CorEvitas PsA/Spondyloarthritis Registry who initiated guselkumab.
Disclosures: This study was sponsored by CorEvitas, LLC, and the analysis was funded by Janssen Scientific Affairs, LLC. Six authors declared employment with CorEvitas, LLC, or Janssen Scientific Affairs, LLC, or owned stock or stock options in Johnson & Johnson or others. Several authors declared ties with various sources, including Janssen and CorEvitas.
Source: Mease PJ et al. Six-month persistence and multi-domain effectiveness of guselkumab in adults with psoriatic arthritis: Real-world data from the CorEvitas psoriatic arthritis/spondyloarthritis registry. Rheumatol Ther. 2023 (Aug 19). doi: 10.1007/s40744-023-00582-w
Key clinical point: In a real-world population of patients with treatment-resistant, long-standing active psoriatic arthritis (PsA), nearly 80% persisted with guselkumab treatment for 6 months and showed improvements in peripheral joint and skin symptoms of PsA.
Major finding: Overall, 78.9% of patients who initiated guselkumab had persistent use at the 6-month follow-up. The mean scores for clinical Disease Activity in PsA (mean change [Δ] −5.4), overall joint+skin activity (Δ −19.0), patient-reported pain (Δ −9.1), and percentage of skin with psoriasis (Δ −5.1%) improved significantly in patients receiving guselkumab for 6 months (all P < .001).
Study details: This study evaluated 114 patients with active PsA from the CorEvitas PsA/Spondyloarthritis Registry who initiated guselkumab.
Disclosures: This study was sponsored by CorEvitas, LLC, and the analysis was funded by Janssen Scientific Affairs, LLC. Six authors declared employment with CorEvitas, LLC, or Janssen Scientific Affairs, LLC, or owned stock or stock options in Johnson & Johnson or others. Several authors declared ties with various sources, including Janssen and CorEvitas.
Source: Mease PJ et al. Six-month persistence and multi-domain effectiveness of guselkumab in adults with psoriatic arthritis: Real-world data from the CorEvitas psoriatic arthritis/spondyloarthritis registry. Rheumatol Ther. 2023 (Aug 19). doi: 10.1007/s40744-023-00582-w
Ixekizumab improves axial symptoms in PsA
Key clinical point: Ixekizumab was more effective than placebo in improving axial symptoms, such as back pain and morning stiffness, in patients with active psoriatic arthritis (PsA) presenting with axial manifestations.
Major finding: At weeks 16 and 24, ixekizumab vs placebo led to greater improvements in axial manifestations, such as back pain and morning stiffness (P < .001), as indicated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, with a significantly higher proportion of patients achieving a 50% improvement in BASDAI scores (P < .001). All improvements with ixekizumab were sustained through week 52.
Study details: This post hoc analysis of pooled data from two phase 3 studies included biologic-naive and tumor necrosis factor inhibitor-experienced patients with active PsA and axial manifestations (n = 313) who were randomly assigned to receive either ixekizumab or placebo.
Disclosures: The studies described in this post hoc analysis were sponsored by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. Several authors declared having ties with various sources, including Eli Lilly and Company.
Source: Deodhar A et al. The effect of ixekizumab on axial manifestations in patients with psoriatic arthritis from two phase III clinical trials: SPIRIT-P1 and SPIRIT-P2. Ther Adv Musculoskelet Dis. 2023 (Aug 24). doi: 10.1177/1759720X231189005
Key clinical point: Ixekizumab was more effective than placebo in improving axial symptoms, such as back pain and morning stiffness, in patients with active psoriatic arthritis (PsA) presenting with axial manifestations.
Major finding: At weeks 16 and 24, ixekizumab vs placebo led to greater improvements in axial manifestations, such as back pain and morning stiffness (P < .001), as indicated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, with a significantly higher proportion of patients achieving a 50% improvement in BASDAI scores (P < .001). All improvements with ixekizumab were sustained through week 52.
Study details: This post hoc analysis of pooled data from two phase 3 studies included biologic-naive and tumor necrosis factor inhibitor-experienced patients with active PsA and axial manifestations (n = 313) who were randomly assigned to receive either ixekizumab or placebo.
Disclosures: The studies described in this post hoc analysis were sponsored by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. Several authors declared having ties with various sources, including Eli Lilly and Company.
Source: Deodhar A et al. The effect of ixekizumab on axial manifestations in patients with psoriatic arthritis from two phase III clinical trials: SPIRIT-P1 and SPIRIT-P2. Ther Adv Musculoskelet Dis. 2023 (Aug 24). doi: 10.1177/1759720X231189005
Key clinical point: Ixekizumab was more effective than placebo in improving axial symptoms, such as back pain and morning stiffness, in patients with active psoriatic arthritis (PsA) presenting with axial manifestations.
Major finding: At weeks 16 and 24, ixekizumab vs placebo led to greater improvements in axial manifestations, such as back pain and morning stiffness (P < .001), as indicated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, with a significantly higher proportion of patients achieving a 50% improvement in BASDAI scores (P < .001). All improvements with ixekizumab were sustained through week 52.
Study details: This post hoc analysis of pooled data from two phase 3 studies included biologic-naive and tumor necrosis factor inhibitor-experienced patients with active PsA and axial manifestations (n = 313) who were randomly assigned to receive either ixekizumab or placebo.
Disclosures: The studies described in this post hoc analysis were sponsored by Eli Lilly and Company. Four authors declared being employees and shareholders of Eli Lilly and Company. Several authors declared having ties with various sources, including Eli Lilly and Company.
Source: Deodhar A et al. The effect of ixekizumab on axial manifestations in patients with psoriatic arthritis from two phase III clinical trials: SPIRIT-P1 and SPIRIT-P2. Ther Adv Musculoskelet Dis. 2023 (Aug 24). doi: 10.1177/1759720X231189005
Acitretin use poses no additional risk for PsA compared with DMARD in patients with psoriasis
Key clinical point: The risk for psoriatic arthritis (PsA) was not higher among patients with psoriasis treated with acitretin vs disease-modifying antirheumatic drugs (DMARD), irrespective of the use of non-steroidal anti-inflammatory drugs (NSAID).
Major finding: The 5-year cumulative incidence rate for PsA was lower in the acitretin vs DMARD cohort (7.52% vs 9.93%; P = .005), with the incidence rates of PsA being markedly lower in the subgroup of patients receiving NSAID in the acitretin vs DMARD cohort (14.31% vs 23.83%; P = .008). Acitretin therapy showed no association with PsA development (hazard ratio 0.84; 95% CI 0.66-1.07).
Study details: Findings are from a retrospective cohort study including patients with psoriasis and without PsA who received either acitretin (n = 1948) or DMARD (n = 1948) for ≥ 30 days within a year.
Disclosures: This study was supported in part by the Taichung Veterans General Hospital. The authors declared no conflicts of interest.
Source: Lin TL et al. Psoriatic arthritis risk in psoriasis patients prescribed acitretin versus disease-modifying antirheumatic drugs: A nationwide cohort study. Rheumatology (Oxford). 2023 (Sep 1). doi: 10.1093/rheumatology/kead446
Key clinical point: The risk for psoriatic arthritis (PsA) was not higher among patients with psoriasis treated with acitretin vs disease-modifying antirheumatic drugs (DMARD), irrespective of the use of non-steroidal anti-inflammatory drugs (NSAID).
Major finding: The 5-year cumulative incidence rate for PsA was lower in the acitretin vs DMARD cohort (7.52% vs 9.93%; P = .005), with the incidence rates of PsA being markedly lower in the subgroup of patients receiving NSAID in the acitretin vs DMARD cohort (14.31% vs 23.83%; P = .008). Acitretin therapy showed no association with PsA development (hazard ratio 0.84; 95% CI 0.66-1.07).
Study details: Findings are from a retrospective cohort study including patients with psoriasis and without PsA who received either acitretin (n = 1948) or DMARD (n = 1948) for ≥ 30 days within a year.
Disclosures: This study was supported in part by the Taichung Veterans General Hospital. The authors declared no conflicts of interest.
Source: Lin TL et al. Psoriatic arthritis risk in psoriasis patients prescribed acitretin versus disease-modifying antirheumatic drugs: A nationwide cohort study. Rheumatology (Oxford). 2023 (Sep 1). doi: 10.1093/rheumatology/kead446
Key clinical point: The risk for psoriatic arthritis (PsA) was not higher among patients with psoriasis treated with acitretin vs disease-modifying antirheumatic drugs (DMARD), irrespective of the use of non-steroidal anti-inflammatory drugs (NSAID).
Major finding: The 5-year cumulative incidence rate for PsA was lower in the acitretin vs DMARD cohort (7.52% vs 9.93%; P = .005), with the incidence rates of PsA being markedly lower in the subgroup of patients receiving NSAID in the acitretin vs DMARD cohort (14.31% vs 23.83%; P = .008). Acitretin therapy showed no association with PsA development (hazard ratio 0.84; 95% CI 0.66-1.07).
Study details: Findings are from a retrospective cohort study including patients with psoriasis and without PsA who received either acitretin (n = 1948) or DMARD (n = 1948) for ≥ 30 days within a year.
Disclosures: This study was supported in part by the Taichung Veterans General Hospital. The authors declared no conflicts of interest.
Source: Lin TL et al. Psoriatic arthritis risk in psoriasis patients prescribed acitretin versus disease-modifying antirheumatic drugs: A nationwide cohort study. Rheumatology (Oxford). 2023 (Sep 1). doi: 10.1093/rheumatology/kead446
Failure of first-line IL-17A inhibitor should not deter treatment with second-line IL-17A
Key clinical point: Patients with psoriatic arthritis (PsA) showed similar adherence to secukinumab and ixekizumab as first-line or second-line interleukin (IL)-17A inhibitors, which indicates that the failure of a first-line IL-17A inhibitor therapy should not deter treatment with a second-line IL-17A inhibitors.
Major finding: Similar adherence to treatment was observed between first-line and second-line IL-17A inhibitor switchers and between second-line secukinumab and second-line ixekizumab switchers. Withdrawal reasons were similar for both first-line and second-line switchers when considering adverse events (14% for both); however, withdrawal due to failure of therapy was higher for the first-line vs second-line switchers (34% vs 18%).
Study details: Findings are from a population-based cohort study including patients with PsA who underwent prior treatment with ≥ 1 tumor necrosis factor inhibitor and switched to either first-line (n = 534) or second-line (n = 102) IL-17A inhibitors (ixekizumab or secukinumab).
Disclosures: This study was funded by the Oak Foundation. Five authors declared having ties with various sources, and three authors declared no conflicts of interest.
Source: Hansen RL et al. Adherence to therapy of ixekizumab and secukinumab in psoriatic arthritis patients using first- or second-line IL-17A inhibitor treatment: A Danish population-based cohort study. Rheumatology (Oxford). 2023 (Aug 30). doi: 10.1093/rheumatology/kead434
Key clinical point: Patients with psoriatic arthritis (PsA) showed similar adherence to secukinumab and ixekizumab as first-line or second-line interleukin (IL)-17A inhibitors, which indicates that the failure of a first-line IL-17A inhibitor therapy should not deter treatment with a second-line IL-17A inhibitors.
Major finding: Similar adherence to treatment was observed between first-line and second-line IL-17A inhibitor switchers and between second-line secukinumab and second-line ixekizumab switchers. Withdrawal reasons were similar for both first-line and second-line switchers when considering adverse events (14% for both); however, withdrawal due to failure of therapy was higher for the first-line vs second-line switchers (34% vs 18%).
Study details: Findings are from a population-based cohort study including patients with PsA who underwent prior treatment with ≥ 1 tumor necrosis factor inhibitor and switched to either first-line (n = 534) or second-line (n = 102) IL-17A inhibitors (ixekizumab or secukinumab).
Disclosures: This study was funded by the Oak Foundation. Five authors declared having ties with various sources, and three authors declared no conflicts of interest.
Source: Hansen RL et al. Adherence to therapy of ixekizumab and secukinumab in psoriatic arthritis patients using first- or second-line IL-17A inhibitor treatment: A Danish population-based cohort study. Rheumatology (Oxford). 2023 (Aug 30). doi: 10.1093/rheumatology/kead434
Key clinical point: Patients with psoriatic arthritis (PsA) showed similar adherence to secukinumab and ixekizumab as first-line or second-line interleukin (IL)-17A inhibitors, which indicates that the failure of a first-line IL-17A inhibitor therapy should not deter treatment with a second-line IL-17A inhibitors.
Major finding: Similar adherence to treatment was observed between first-line and second-line IL-17A inhibitor switchers and between second-line secukinumab and second-line ixekizumab switchers. Withdrawal reasons were similar for both first-line and second-line switchers when considering adverse events (14% for both); however, withdrawal due to failure of therapy was higher for the first-line vs second-line switchers (34% vs 18%).
Study details: Findings are from a population-based cohort study including patients with PsA who underwent prior treatment with ≥ 1 tumor necrosis factor inhibitor and switched to either first-line (n = 534) or second-line (n = 102) IL-17A inhibitors (ixekizumab or secukinumab).
Disclosures: This study was funded by the Oak Foundation. Five authors declared having ties with various sources, and three authors declared no conflicts of interest.
Source: Hansen RL et al. Adherence to therapy of ixekizumab and secukinumab in psoriatic arthritis patients using first- or second-line IL-17A inhibitor treatment: A Danish population-based cohort study. Rheumatology (Oxford). 2023 (Aug 30). doi: 10.1093/rheumatology/kead434