Clinical Edge Journal Scan

It is known that there are health-related consequences of migraine, as well as migraine-related comorbidities. Three recent studies examined the relationship between migraine and stroke, with nuanced results, suggesting that migraine does not necessarily increase stroke risk for all populations and may even be associated with a decreased risk for stroke for some patients. But it is clear that migraine is associated with an increased stroke risk for some specific populations, including during pregnancy.

Migraine is also known to have a negative impact on quality of life, affecting many different areas of well-being, including relationships, work productivity, and emotional health. Results from a recent study published in Cephalgia provided evidence that migraine can also increase the risk for occupational burnout.¹

Yet, there’s some good news for migraine patients who have a genetic predisposition for migraine. Results of a recent study published in the Journal of Clinical Medicine showed that hereditary predisposition to migraine does not necessarily correlate with development of chronic migraine.²

An observational study, with results published in Cephalgia in November 2024, included 646 patients aged 18-54 years who were hospitalized with their first stroke.³ It showed no significant association between cerebral small-vessel disease and migraine with aura among the study population. Interestingly, migraine with aura is generally more closely linked with stroke risk than migraine without aura, so the results do not align with previously held beliefs about migraine and stroke risk.⁴

A larger study examined the relationship between migraine and cardiovascular risk scores.⁴ This cohort study included 140,915 Dutch adults with a mean age of 44 years. Results, published in JAMA Network Open in October 2024, revealed that the odds of having prevalent or incident migraine decreased with increasing cardiovascular risk score categories, especially for women. The authors suggested that having migraine could be associated with a healthier cardiovascular system and suggested several potential mechanisms for this inverse relationship, including alterations in the activity of calcitonin gene–related peptide activity, changes in nitric oxide effects, or cortical spreading depression in response to atherosclerosis.

Although the results of these studies, which were focused on young patients, are interesting and could provide a sense of relief for patients with migraine, the authors of the JAMA Network Open article acknowledged that these results should not be extrapolated to other populations.⁴ Specifically, they noted that it has been established in other studies that older patients with migraine have an increased cardiovascular risk.

The relationship between migraine and stroke risk is important for pregnant women. Results of a large analysis including 19,825,525 pregnant patients, with data obtained from 2016 to 2020, were published in November 2024 in the Journal of Women’s Health.⁵ The analysis revealed that a history of migraine substantially increases the risk for hemorrhagic or ischemic stroke during pregnancy. They reported that “acute ischemic stroke was most strongly associated with migraine with aura (odds ratio [OR], 23.26; 95% confidence interval [CI], 18.46-29.31), followed by migraine without aura (OR, 8.15; 95% CI, 4.79-13.88).” The authors advised that stroke risk should be addressed in pregnant women who have migraine or who have a migraine history, especially if they have migraine with aura.

It is well known that migraine risk has a hereditary component, but hereditary factors might not play a role in the time of onset of migraines. In a retrospective clinical genetic case-control study that included over 15,000 participants, researchers identified migraine polygenic risk scores using genome-wide association studies.² The results were published in October 2024 in the Journal of Clinical Medicine. The study authors noted “a higher genetic risk was associated with earlier onset and increased risk for migraine well into adulthood, but not with chronification.” These results support the benefits of a diligent pursuit of effective migraine treatment, even for patients who might feel hopeless about achieving migraine control due to their own family history of migraine. As migraine therapies have evolved over the past decades, patients who had parents or other older family members with migraine may have a pessimistic outlook on the potential for effective treatment. However, newer therapies are far more effective than migraine treatments of the past, and patients should be informed and given encouragement that they can have a better prognosis and better migraine control than past generations.

The value of effective treatment cannot be underestimated. A study, with results published in Cephalgia in October 2024, included data from a subset of participants from the Negev Migraine Cohort, including 675 migraine patients and 232 control participants without migraine.¹ The authors reported that migraine patients reported “significantly higher levels of occupational burnout, with a mean burnout score of 3.46 vs a mean of 2.82 among controls.” They also noted that migraine patients worked longer hours, with 40 hours of work weekly vs 36 for controls. The authors suggested accommodations for migraine patients, such as working from home or flexible scheduling. Although this could be beneficial, achieving migraine relief would be even better for patients, who could eventually be able to enjoy having a 36-hour work week rather than a 40-hour work week. Admittedly, this potential outcome is an overly literal interpretation of the research results, but it emphasizes the potential value of having “more time” in patients’ lives as a result of effective migraine relief.

References

1. Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — a cohort study. Cephalalgia. October 18, 2024. Source 

2. Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. J Clin Med. October 29, 2024. Source 

3. Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: a case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

4. Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. October 22, 2024. Source 

5. Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source 

It is known that there are health-related consequences of migraine, as well as migraine-related comorbidities. Three recent studies examined the relationship between migraine and stroke, with nuanced results, suggesting that migraine does not necessarily increase stroke risk for all populations and may even be associated with a decreased risk for stroke for some patients. But it is clear that migraine is associated with an increased stroke risk for some specific populations, including during pregnancy.

Migraine is also known to have a negative impact on quality of life, affecting many different areas of well-being, including relationships, work productivity, and emotional health. Results from a recent study published in Cephalgia provided evidence that migraine can also increase the risk for occupational burnout.¹

Yet, there’s some good news for migraine patients who have a genetic predisposition for migraine. Results of a recent study published in the Journal of Clinical Medicine showed that hereditary predisposition to migraine does not necessarily correlate with development of chronic migraine.²

An observational study, with results published in Cephalgia in November 2024, included 646 patients aged 18-54 years who were hospitalized with their first stroke.³ It showed no significant association between cerebral small-vessel disease and migraine with aura among the study population. Interestingly, migraine with aura is generally more closely linked with stroke risk than migraine without aura, so the results do not align with previously held beliefs about migraine and stroke risk.⁴

A larger study examined the relationship between migraine and cardiovascular risk scores.⁴ This cohort study included 140,915 Dutch adults with a mean age of 44 years. Results, published in JAMA Network Open in October 2024, revealed that the odds of having prevalent or incident migraine decreased with increasing cardiovascular risk score categories, especially for women. The authors suggested that having migraine could be associated with a healthier cardiovascular system and suggested several potential mechanisms for this inverse relationship, including alterations in the activity of calcitonin gene–related peptide activity, changes in nitric oxide effects, or cortical spreading depression in response to atherosclerosis.

Although the results of these studies, which were focused on young patients, are interesting and could provide a sense of relief for patients with migraine, the authors of the JAMA Network Open article acknowledged that these results should not be extrapolated to other populations.⁴ Specifically, they noted that it has been established in other studies that older patients with migraine have an increased cardiovascular risk.

The relationship between migraine and stroke risk is important for pregnant women. Results of a large analysis including 19,825,525 pregnant patients, with data obtained from 2016 to 2020, were published in November 2024 in the Journal of Women’s Health.⁵ The analysis revealed that a history of migraine substantially increases the risk for hemorrhagic or ischemic stroke during pregnancy. They reported that “acute ischemic stroke was most strongly associated with migraine with aura (odds ratio [OR], 23.26; 95% confidence interval [CI], 18.46-29.31), followed by migraine without aura (OR, 8.15; 95% CI, 4.79-13.88).” The authors advised that stroke risk should be addressed in pregnant women who have migraine or who have a migraine history, especially if they have migraine with aura.

It is well known that migraine risk has a hereditary component, but hereditary factors might not play a role in the time of onset of migraines. In a retrospective clinical genetic case-control study that included over 15,000 participants, researchers identified migraine polygenic risk scores using genome-wide association studies.² The results were published in October 2024 in the Journal of Clinical Medicine. The study authors noted “a higher genetic risk was associated with earlier onset and increased risk for migraine well into adulthood, but not with chronification.” These results support the benefits of a diligent pursuit of effective migraine treatment, even for patients who might feel hopeless about achieving migraine control due to their own family history of migraine. As migraine therapies have evolved over the past decades, patients who had parents or other older family members with migraine may have a pessimistic outlook on the potential for effective treatment. However, newer therapies are far more effective than migraine treatments of the past, and patients should be informed and given encouragement that they can have a better prognosis and better migraine control than past generations.

The value of effective treatment cannot be underestimated. A study, with results published in Cephalgia in October 2024, included data from a subset of participants from the Negev Migraine Cohort, including 675 migraine patients and 232 control participants without migraine.¹ The authors reported that migraine patients reported “significantly higher levels of occupational burnout, with a mean burnout score of 3.46 vs a mean of 2.82 among controls.” They also noted that migraine patients worked longer hours, with 40 hours of work weekly vs 36 for controls. The authors suggested accommodations for migraine patients, such as working from home or flexible scheduling. Although this could be beneficial, achieving migraine relief would be even better for patients, who could eventually be able to enjoy having a 36-hour work week rather than a 40-hour work week. Admittedly, this potential outcome is an overly literal interpretation of the research results, but it emphasizes the potential value of having “more time” in patients’ lives as a result of effective migraine relief.

References

1. Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — a cohort study. Cephalalgia. October 18, 2024. Source 

2. Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. J Clin Med. October 29, 2024. Source 

3. Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: a case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

4. Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. October 22, 2024. Source 

5. Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source 

It is known that there are health-related consequences of migraine, as well as migraine-related comorbidities. Three recent studies examined the relationship between migraine and stroke, with nuanced results, suggesting that migraine does not necessarily increase stroke risk for all populations and may even be associated with a decreased risk for stroke for some patients. But it is clear that migraine is associated with an increased stroke risk for some specific populations, including during pregnancy.

Migraine is also known to have a negative impact on quality of life, affecting many different areas of well-being, including relationships, work productivity, and emotional health. Results from a recent study published in Cephalgia provided evidence that migraine can also increase the risk for occupational burnout.¹

Yet, there’s some good news for migraine patients who have a genetic predisposition for migraine. Results of a recent study published in the Journal of Clinical Medicine showed that hereditary predisposition to migraine does not necessarily correlate with development of chronic migraine.²

An observational study, with results published in Cephalgia in November 2024, included 646 patients aged 18-54 years who were hospitalized with their first stroke.³ It showed no significant association between cerebral small-vessel disease and migraine with aura among the study population. Interestingly, migraine with aura is generally more closely linked with stroke risk than migraine without aura, so the results do not align with previously held beliefs about migraine and stroke risk.⁴

A larger study examined the relationship between migraine and cardiovascular risk scores.⁴ This cohort study included 140,915 Dutch adults with a mean age of 44 years. Results, published in JAMA Network Open in October 2024, revealed that the odds of having prevalent or incident migraine decreased with increasing cardiovascular risk score categories, especially for women. The authors suggested that having migraine could be associated with a healthier cardiovascular system and suggested several potential mechanisms for this inverse relationship, including alterations in the activity of calcitonin gene–related peptide activity, changes in nitric oxide effects, or cortical spreading depression in response to atherosclerosis.

Although the results of these studies, which were focused on young patients, are interesting and could provide a sense of relief for patients with migraine, the authors of the JAMA Network Open article acknowledged that these results should not be extrapolated to other populations.⁴ Specifically, they noted that it has been established in other studies that older patients with migraine have an increased cardiovascular risk.

The relationship between migraine and stroke risk is important for pregnant women. Results of a large analysis including 19,825,525 pregnant patients, with data obtained from 2016 to 2020, were published in November 2024 in the Journal of Women’s Health.⁵ The analysis revealed that a history of migraine substantially increases the risk for hemorrhagic or ischemic stroke during pregnancy. They reported that “acute ischemic stroke was most strongly associated with migraine with aura (odds ratio [OR], 23.26; 95% confidence interval [CI], 18.46-29.31), followed by migraine without aura (OR, 8.15; 95% CI, 4.79-13.88).” The authors advised that stroke risk should be addressed in pregnant women who have migraine or who have a migraine history, especially if they have migraine with aura.

It is well known that migraine risk has a hereditary component, but hereditary factors might not play a role in the time of onset of migraines. In a retrospective clinical genetic case-control study that included over 15,000 participants, researchers identified migraine polygenic risk scores using genome-wide association studies.² The results were published in October 2024 in the Journal of Clinical Medicine. The study authors noted “a higher genetic risk was associated with earlier onset and increased risk for migraine well into adulthood, but not with chronification.” These results support the benefits of a diligent pursuit of effective migraine treatment, even for patients who might feel hopeless about achieving migraine control due to their own family history of migraine. As migraine therapies have evolved over the past decades, patients who had parents or other older family members with migraine may have a pessimistic outlook on the potential for effective treatment. However, newer therapies are far more effective than migraine treatments of the past, and patients should be informed and given encouragement that they can have a better prognosis and better migraine control than past generations.

The value of effective treatment cannot be underestimated. A study, with results published in Cephalgia in October 2024, included data from a subset of participants from the Negev Migraine Cohort, including 675 migraine patients and 232 control participants without migraine.¹ The authors reported that migraine patients reported “significantly higher levels of occupational burnout, with a mean burnout score of 3.46 vs a mean of 2.82 among controls.” They also noted that migraine patients worked longer hours, with 40 hours of work weekly vs 36 for controls. The authors suggested accommodations for migraine patients, such as working from home or flexible scheduling. Although this could be beneficial, achieving migraine relief would be even better for patients, who could eventually be able to enjoy having a 36-hour work week rather than a 40-hour work week. Admittedly, this potential outcome is an overly literal interpretation of the research results, but it emphasizes the potential value of having “more time” in patients’ lives as a result of effective migraine relief.

References

1. Peles I, Sharvit S, Zlotnik Y, et al. Migraine and work — beyond absenteeism: Migraine severity and occupational burnout — a cohort study. Cephalalgia. October 18, 2024. Source 

2. Chase BA, Frigerio R, Rubin S, et al. An integrative migraine polygenic risk score is associated with age at onset but not with chronification. J Clin Med. October 29, 2024. Source 

3. Cloet F, Gueyraud G, Lerebours F, Munio M, Larrue V, Gollion C. Stroke due to small-vessel disease and migraine: a case-control study of a young adult with ischemic stroke population. Cephalalgia. 2024;44:1-8. Source 

4. Al-Hassany L, MaassenVanDenBrink A, Kurth T. Cardiovascular risk scores and migraine status. JAMA Netw Open. October 22, 2024. Source 

5. Reddy M, Vazquez S, Nolan B, et al. Migraine and its association with stroke in pregnancy: A national examination. J Womens Health. 2024;33:1476-1481. Source 

Recently published clinical research in psoriatic arthritis (PsA) has continued to focus on the transition from psoriasis to PsA, comorbidities, and effects of treatments. Garcia-Salinas and colleagues reported results of a large study that investigated 1419 patients with joint pain who were carefully clinically evaluated with imaging (ultrasonography and MRI) and laboratory tests. They found that among patients with arthralgia, 8.4% were at risk of developing PsA (ie, had a personal or family history of psoriasis), with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis, synovitis detected by power Doppler ultrasound, enthesopathy on ultrasonography, and a low tender joint count. Thus, more than one quarter of patients with psoriasis and joint pain developed PsA in 1 year. Patients with psoriasis and joint pain, especially those with findings on imaging, should be referred to rheumatologists and carefully followed up for early diagnosis of PsA and therefore better outcomes.

Chronic kidney disease (CKD) is a known comorbidity in psoriatic disease but is less well characterised. In a prospective observational cohort study that included 1336 patients with PsA, Kharouf and colleagues reported that 123 (9.2%) had CKD. They demonstrated that diabetes, kidney stones, joint damage, high uric acid levels, and daily use of nonsteroidal anti-inflammatory drugs were associated with development of CKD, whereas methotrexate use had a renoprotective effect. Thus, patients with severe PsA and comorbidities such as diabetes are at higher risk for CKD. Better management of PsA using disease-modifying antirheumatic drugs may reduce the risk. Replication of these findings, especially in terms of the renoprotective effect of methotrexate, is required.

Patients with PsA who do not respond to treatment with tumour necrosis factor (TNF) inhibitors are generally less likely to respond to subsequent therapy. Evaluating newer modes of action in this treatment-resistant PsA population is important. COSMOS was a phase 3b trial that included 285 patients with PsA who had inadequate response or intolerance to TNF inhibitors and were randomly assigned to receive 100 mg guselkumab (a monoclonal antibody targeting interleukin-23; n = 189) or placebo (n = 96). In a post hoc analysis, Gossec and colleagues showed that at week 24, a greater proportion of patients receiving guselkumab vs placebo achieved minimal disease activity (MDA) (14.8% vs 3.1%). Most of the patients who achieved MDA at week 24 maintained the response at week 48. Thus, guselkumab treatment led to sustained MDA over 1 year in patients with PsA who had inadequate response or intolerance to TNF inhibitors.

Achieving MDA was also evaluated in another novel drug for PsA. Deucravacitinib is an oral TYK2 inhibitor that is approved for the treatment of psoriasis and is currently being evaluated in phase 3 PsA trials. In a post hoc analysis of a phase 2 trial that included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo, Kavanaugh and colleagues found that after 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007). Achieving MDA reflects a state of low disease activity or remission; therefore, these results are very encouraging. Results from phase 3 trials and a formal comparison with other drugs will inform rheumatologists about the place of deucravacitinib in the management of PsA.

Recently published clinical research in psoriatic arthritis (PsA) has continued to focus on the transition from psoriasis to PsA, comorbidities, and effects of treatments. Garcia-Salinas and colleagues reported results of a large study that investigated 1419 patients with joint pain who were carefully clinically evaluated with imaging (ultrasonography and MRI) and laboratory tests. They found that among patients with arthralgia, 8.4% were at risk of developing PsA (ie, had a personal or family history of psoriasis), with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis, synovitis detected by power Doppler ultrasound, enthesopathy on ultrasonography, and a low tender joint count. Thus, more than one quarter of patients with psoriasis and joint pain developed PsA in 1 year. Patients with psoriasis and joint pain, especially those with findings on imaging, should be referred to rheumatologists and carefully followed up for early diagnosis of PsA and therefore better outcomes.

Chronic kidney disease (CKD) is a known comorbidity in psoriatic disease but is less well characterised. In a prospective observational cohort study that included 1336 patients with PsA, Kharouf and colleagues reported that 123 (9.2%) had CKD. They demonstrated that diabetes, kidney stones, joint damage, high uric acid levels, and daily use of nonsteroidal anti-inflammatory drugs were associated with development of CKD, whereas methotrexate use had a renoprotective effect. Thus, patients with severe PsA and comorbidities such as diabetes are at higher risk for CKD. Better management of PsA using disease-modifying antirheumatic drugs may reduce the risk. Replication of these findings, especially in terms of the renoprotective effect of methotrexate, is required.

Patients with PsA who do not respond to treatment with tumour necrosis factor (TNF) inhibitors are generally less likely to respond to subsequent therapy. Evaluating newer modes of action in this treatment-resistant PsA population is important. COSMOS was a phase 3b trial that included 285 patients with PsA who had inadequate response or intolerance to TNF inhibitors and were randomly assigned to receive 100 mg guselkumab (a monoclonal antibody targeting interleukin-23; n = 189) or placebo (n = 96). In a post hoc analysis, Gossec and colleagues showed that at week 24, a greater proportion of patients receiving guselkumab vs placebo achieved minimal disease activity (MDA) (14.8% vs 3.1%). Most of the patients who achieved MDA at week 24 maintained the response at week 48. Thus, guselkumab treatment led to sustained MDA over 1 year in patients with PsA who had inadequate response or intolerance to TNF inhibitors.

Achieving MDA was also evaluated in another novel drug for PsA. Deucravacitinib is an oral TYK2 inhibitor that is approved for the treatment of psoriasis and is currently being evaluated in phase 3 PsA trials. In a post hoc analysis of a phase 2 trial that included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo, Kavanaugh and colleagues found that after 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007). Achieving MDA reflects a state of low disease activity or remission; therefore, these results are very encouraging. Results from phase 3 trials and a formal comparison with other drugs will inform rheumatologists about the place of deucravacitinib in the management of PsA.

Recently published clinical research in psoriatic arthritis (PsA) has continued to focus on the transition from psoriasis to PsA, comorbidities, and effects of treatments. Garcia-Salinas and colleagues reported results of a large study that investigated 1419 patients with joint pain who were carefully clinically evaluated with imaging (ultrasonography and MRI) and laboratory tests. They found that among patients with arthralgia, 8.4% were at risk of developing PsA (ie, had a personal or family history of psoriasis), with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis, synovitis detected by power Doppler ultrasound, enthesopathy on ultrasonography, and a low tender joint count. Thus, more than one quarter of patients with psoriasis and joint pain developed PsA in 1 year. Patients with psoriasis and joint pain, especially those with findings on imaging, should be referred to rheumatologists and carefully followed up for early diagnosis of PsA and therefore better outcomes.

Chronic kidney disease (CKD) is a known comorbidity in psoriatic disease but is less well characterised. In a prospective observational cohort study that included 1336 patients with PsA, Kharouf and colleagues reported that 123 (9.2%) had CKD. They demonstrated that diabetes, kidney stones, joint damage, high uric acid levels, and daily use of nonsteroidal anti-inflammatory drugs were associated with development of CKD, whereas methotrexate use had a renoprotective effect. Thus, patients with severe PsA and comorbidities such as diabetes are at higher risk for CKD. Better management of PsA using disease-modifying antirheumatic drugs may reduce the risk. Replication of these findings, especially in terms of the renoprotective effect of methotrexate, is required.

Patients with PsA who do not respond to treatment with tumour necrosis factor (TNF) inhibitors are generally less likely to respond to subsequent therapy. Evaluating newer modes of action in this treatment-resistant PsA population is important. COSMOS was a phase 3b trial that included 285 patients with PsA who had inadequate response or intolerance to TNF inhibitors and were randomly assigned to receive 100 mg guselkumab (a monoclonal antibody targeting interleukin-23; n = 189) or placebo (n = 96). In a post hoc analysis, Gossec and colleagues showed that at week 24, a greater proportion of patients receiving guselkumab vs placebo achieved minimal disease activity (MDA) (14.8% vs 3.1%). Most of the patients who achieved MDA at week 24 maintained the response at week 48. Thus, guselkumab treatment led to sustained MDA over 1 year in patients with PsA who had inadequate response or intolerance to TNF inhibitors.

Achieving MDA was also evaluated in another novel drug for PsA. Deucravacitinib is an oral TYK2 inhibitor that is approved for the treatment of psoriasis and is currently being evaluated in phase 3 PsA trials. In a post hoc analysis of a phase 2 trial that included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo, Kavanaugh and colleagues found that after 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007). Achieving MDA reflects a state of low disease activity or remission; therefore, these results are very encouraging. Results from phase 3 trials and a formal comparison with other drugs will inform rheumatologists about the place of deucravacitinib in the management of PsA.

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Guselkumab significantly reduced inflammatory and collagen biomarker levels, correlating with improvements in joint and overall disease activity over 2 years in biologic-naive patients with psoriatic arthritis (PsA).

Major finding: Over 2 years, reductions in C-reactive protein, interleukin-6, matrix metalloproteinase (MMP)–degradation type 1 collagen (C1M), and MMP-degradation type VI collagen (C6M) levels correlated with improved Disease Activity in Psoriatic Arthritis (correlation coefficient [r], 0.26-0.30; P < .05). Additionally, reductions in C1M, MMP-degradation type III collagen, MMP-degradation type IV collagen, and C6M levels correlated with improved Psoriatic Arthritis Disease Activity Scores (r, 0.27-0.31; P < .05).

Study details: This post hoc analysis of the phase 3 DISCOVER-2 trial included 739 biologic-naive patients with active PsA who were randomly assigned to receive guselkumab (100 mg every 4 or 8 weeks) or placebo with a crossover to 100 mg guselkumab every 4 weeks at week 24.

Disclosures: This DISCOVER-2 study was funded by Janssen Research & Development, LLC. Four authors reported being employees of Janssen and owning stock or stock options in Johnson & Johnson. Others declared having ties with various sources.

Source: Siebert S, Schett G, Raychaudhuri SP, et al. Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: Results from a phase III randomized controlled trial. Ther Adv Musculoskelet Dis. 2024;16:1-20. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: Among patients with psoriatic arthritis (PsA), men and those with elevated baseline C-reactive protein (CRP) levels showed an improved response to biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), whereas older patients and those with severe baseline disease activity showed a worse response.

Major finding: Among patients with PsA, men (odds ratio [OR], 2.188; 95% CI, 1.912-2.503) and those with elevated baseline CRP levels (OR, 1.537; 95% CI, 1.111-2.125) showed an improved response to b/tsDMARDs. Conversely, older patients (OR, 0.982; 95% CI, 0.975-0.99) and those with increased baseline Disease Activity in Psoriatic Arthritis (OR, 0.789; 95% CI, 0.663-0.938), Health Assessment Questionnaire (OR, 0.483; 95% CI, 0.336-0.696), and joint count (OR, 0.97; 95% CI, 0.945-0.996) scores showed a significantly worse b/tsDMARD response.

Study details: This systematic review and meta-analysis of 37 studies included 17,042 patients with PsA.

Disclosures: Open access funding was provided by the University of Zurich. This study did not receive any funding. The authors declared no conflicts of interest. 

Source: Künzler T, Bamert M, Sprott H. Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis—A systematic review and meta-analysis. Clin Rheumatol. Published online October 28, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The severity of psoriasis was associated with enthesitis in patients with psoriatic arthritis (PsA) and psoriasis, particularly in older patients and those with a longer history of psoriasis.

Major finding: The severity of psoriasis, as assessed using the Psoriasis Area and Severity Index, was significantly associated with enthesitis (correlation coefficient [ρ], 0.285; P = .013). The association remained significant after adjusting for age (ρ, 0.274; P = .043) and the duration of PsA (ρ, 0.302; P = .027).

Study details: This observational study included 76 adults diagnosed with PsA and psoriasis, comprising 42 men and 34 women.

Disclosures: This study was conducted within the project "Psoriatic arthritis—epidemiology and risk factors of progression" of the Ministry of Health, Education and Sports, Republic of Croatia. No conflicts of interest were reported in this study.

Source: Grazio S, Šitum M, Grubišić F, et al. Association of enthesitis with severity of psoriasis in psoriatic arthritis: An observational study. Rheumatol Int. Published online October 15, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The presence of depressive symptoms within the first 2 years after diagnosis in patients with psoriatic arthritis (PsA) was associated with a decreased likelihood of achieving remission.

Major finding: Overall, 18% patients with PsA had possible depression. During 2 years of follow-up, depression was associated with decreased odds of achieving remission (adjusted odds ratio, 0.24; 95% CI, 0.08-0.71). The presence of depression was also associated with an increased tender joint count, worse general health, and increased pain.

Study details: This study included data from the Dutch Southwest Early Psoriatic Arthritis Cohort study, a prospective cohort study that included 367 patients with PsA, and the Rotterdam Early Arthritis Cohort trial, which included 400 patients with rheumatoid arthritis.

Disclosures: This study was supported by unrestricted grants from ZonMW, Pfizer, and Abbvie B.V. The authors declared no conflicts of interest. 

Source: Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). Published online November 6, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: The significant predictors of developing psoriatic arthritis (PsA) in patients with arthralgia include a family history of psoriasis, synovitis, enthesopathy, and a low tender joint count.

Major finding: Among patients with arthralgia, 8.4% were at a risk of developing PsA, with 29% of these patients progressing to PsA within 1 year. Significant predictors of progression included a family history of psoriasis (odds ratio [OR], 32; 95% CI, 1.2-1026), synovitis detected by Power Doppler ultrasound (OR, 31; 95% CI, 1.1-967), enthesopathy findings on ultrasound (OR, 75; 95% CI, 13-710), and a low tender joint count (OR, 0.2; 95% CI, 0.05-0.6).

Study details: This prospective longitudinal study included 1419 patients with arthralgia who were older than 18 years of age.

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

Source: Garcia-Salinas R, Magri S, Mareco J, et al. Arthralgia with risk of progression to psoriatic arthritis: Role of clinical assessments and ultrasound as prognostic factors. Rheumatology (Oxford). Published online October 15, 2024. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: Diabetes, kidney stones, joint damage, high uric acid levels, and the daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) were associated with the development of chronic kidney disease (CKD) in patients with psoriatic arthritis (PsA), whereas methotrexate use had a renoprotective effect.

Major finding: The development of CKD in patients with PsA was independently associated with diabetes mellitus (adjusted hazard ratio [aHR], 2.58; P < .001), kidney stones (aHR, 2.14; P = .01), radiographic damaged joint count (aHR, 1.02; P = .02), higher uric acid levels (aHR, 1.21; P < .001; per 50-unit increase), and the daily use of NSAIDs (aHR, 1.77; P = .02). Methotrexate use had a renoprotective effect (aHR, 0.51; P = .01). 

Study details: This prospective observational cohort study included 1336 patients with PsA, of whom 123 (9.2%) had CKD.

Disclosures: The Gladman-Krembil Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation. The authors did not declare any conflicts of interest. 

Source: Kharouf F, Gao S, Al-Matar S, Cook RJ, Chandran V, Gladman DD. Chronic kidney disease in patients with psoriatic arthritis: A cohort study. RMD Open. 2024;10:e004636. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), elevated baseline ultrasound scores for synovitis, peritenonitis, and enthesitis were associated with increased reductions in the Disease Activity Index for PsA (DAPSA) score. 

Major finding: At 3 to 6 months, an increased reduction in the DAPSA score was associated with elevated baseline sonographic scores for synovitis (adjusted β [βadj], −3.89; P = .02), peritenonitis (βadj, −3.93; P = .01), and structural enthesitis (βadj, −2.91; P = .045). An elevated baseline total inflammatory score independently predicted an increased reduction in the DAPSA score, regardless of the total damage score (βadj, −5.23; P = .007).

Study details: This prospective cohort study included 135 treatment periods involving 107 patients with PsA who were starting or switching to a new disease-modifying anti-rheumatic drug and had active peripheral manifestations.

Disclosures: Jessica Gutierrez declared receiving a fellowship grant from AbbVie. Lihi Eder declared being Canada Research Chair (Tier 2) in Inflammatory Rheumatic Diseases. Two authors declared having ties with various sources. 

Source: Gutierrez J, Thib S, Koppikar S, Cook RJ, Eder L. Association between musculoskeletal sonographic features and response to treatment in patients with psoriatic arthritis. RMD Open. 2024;10:e003995. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source

Key clinical point: In patients with psoriatic arthritis (PsA), deucravacitinib (6 mg or 12 mg once daily) vs placebo for 16 weeks led to a higher minimal disease activity (MDA) response and a greater proportion of patients achieving MDA in each component.

Major finding: After 16 weeks, a significantly higher proportion of patients treated with deucravacitinib vs placebo achieved MDA (6 mg: 22.9% vs 7.6%; P = .01 and 12 mg: 23.9% vs 7.6%; P = .007) and individual components of MDA, including the tender joint count, pain, and the Health Assessment Questionnaire–Disability Index (all P < .05).

Study details: This post hoc analysis of a phase 2 trial included 203 adults with PsA who did not respond to or were intolerant to one or more prior therapies and were randomly assigned to receive 6 mg or 12 mg deucravacitinib or placebo.

Disclosures: This clinical trial was sponsored by Bristol Myers Squibb (BMS). Four authors declared being current or former employees or shareholders of BMS. Other authors declared having ties with various sources, including BMS.

Source: Kavanaugh A, Coates LC, Mease PJ, et al. Deucravacitinib, a selective, TYK2 inhibitor, in psoriatic arthritis: Achievement of minimal disease activity components in a phase 2 trial. Rheumatology (Oxford). Published online October 18, 2024. Source