Effectiveness of Sequential Lines of Biologic and Targeted Small Molecule Drugs in Psoriatic Arthritis: A Systematic Review

Rheumatology (Oxford). 2024 Jan 18:keae006 doi: 10.1093/rheumatology/keae006 Epub ahead of print

The authors found that there is a reduction in effectiveness of lines of bDMARDs after first-line in PsA, with inadequate data to determine response to tsDMARDs.

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January 2024

Nationwide study involving 14 778 new users of targeted therapies with PsA found treatment persistence to be lower for women than men for TNFi and IL17i but not for IL-12/23i, IL-23i or JAK inhibition.

The Risk Factors for Uveitis Among Psoriatic Arthritis Patients: A Population-based Cohort Study

Clin Rheumatol. 2023;43(3):1053–1061 doi: 10.1007/s10067-023-06834-y

Retrospective matched cohort study concludes that PsA is associated with increased risk of uveitis, with past uveitis and treatment with etanercept being independently associated with a higher risk of uveitis. Patients who developed uveitis were mainly treated with topical glucocorticoids.

This Phase 3 RCT by D’Agostino, et al. assessed the long-term effect of secukinumab to placebo at tissue level on synovitis and enthesitis, and across all PsA manifestations. They found consistent improvements in clinically and ultrasound-assessed synovitis and enthesitis.

December 2023

Psoriatic arthritis clusters, obtained by machine learning (ML) analysis of pooled data from the FUTURE, MEASURE, and MAXIMISE trials, indicate phenotypical heterogeneity of patients with PsA and axial manifestations and overlapping features across the spondyloarthritis spectrum. Here, Baraliakos, et al. sort to identify distinct clinical clusters, based on patient demographics and baseline clinical indicators, from the secukinumab clinical development programme.

Rates of MACE and VTE events in patients with RA or PsA treated are consistent across 15 mg and 30 mg doses of upadacitinib, and comparable with active comparators adalimumab and MTX. Several risk factors were also identified for MACE and VTE events in patients with RA.

In this study, Eder, et al. performed a systematic literature review and meta-analysis of RCTs to assess information on participants’ characteristics and rates of American College of Rheumatology response and minimal disease activity by sex. The authors found that the biological sex of patients with PsA influences their response to advanced therapies, but the effect varies by drug class.

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Rates of malignancy were similar between upadacitinib, adalimumab, and MTX. They were also consistent across RA, PsA, AS and nr-axSpA. A dose-dependent increased rate of NMSC was observed with upadacitinib in RA. For RA and PsA, being older (≥65 years) and male was associated with
an increased risk of malignancy excluding NMSC.

November 2023

As part of the GBD 2021, the authors provide updated estimates for the global burden of musculoskeletal disorders, excluding RA, osteoarthritis, low back pain, neck pain, and gout. In 2020, the total years lived with disability globally was estimated to be 42.7 million, which was a 122% increase from 1990. Over the same time period, mortality increased by 199%. The study forecasts an increase in cases by 2050 in all regions, with the exception of Central Europe.

Real-world data from the PsABio study indicated that females with PsA had more severe disease than males before the initiation of treatment. While both genders experienced treatment related improvements, fewer females than males were able to achieve a favourable disease state within 12 months. Treatment discontinuation and switching were also higher in females than males, due to lower efficacy and adverse events.