April 2024

Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: Results of a Phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1)

J Am Acad Dermatol 2015;73:37-49. doi: 10.1016/j.jaad.2015.03.049

Here, investigators reported that efficacy measures for skin and scalp were significantly greater for apremilast than for placebo in patients with PsO at baseline. Previously, clinical study data has highlighted that the use of apremilast leads to a reduction in the expression within the epidermis of numerous inflammatory cytokines relevant to PsO. As a result, ESTEEM 1 evaluated the efficacy/safety of apremilast at 30 mg BID for moderate to severe PsO.

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Bimekizumab versus adalimumab in plaque psoriasis

N Engl J Med 2021; 385:130–41. doi: 10.1056/NEJMoa2102388

Bimekizumab was noninferior and superior to adalimumab with respect to PASI 90 response and IGA score at Week 16. Bimekizumab is a promising IL-17A/F inhibitor that has shown clinical improvement in PsO patients compared to placebo and other IL inhibitors. Warren et al. compared the safety and efficacy of bimekizumab with adalimumab in a 56-week double-blind trial.

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Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: Efficacy and safety results from the 52-week, randomized, double-blinded, placebo-controlled Phase 3 POETYK PSO-1 trial

J Am Acad Dermatol 2023;88:29–39. doi: 10.1016/j.jaad.2022.07.002

Deucravacitinib has shown efficacy in the treatment of both skin and joint disease. As a result, researchers sought to compare the efficacy and safety of deucravacitinib versus placebo and apremilast in adults with moderate to severe plaque PsO.

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February 2024

Modulation of IL-23 Signalling with Guselkumab in Biologic-Naïve Patients Versus TNF Inhibitor-Inadequate Responders with Active Psoriatic Arthritis

Arthritis Rheumatol 2024 doi 10.1002/art.42803 Epub ahead of print

Guselkumab treatment exhibited generally comparable and significant pharmacodynamic effects on IL-23/Th17–associated cytokines across participants with PsA who are biologic-naïve or have TNFi-IR. In coming to this conclusion, investigators assessed and compared immunologic differences and associations with clinical response to guselkumab in participants with active PsA who were biologic-naïve or TNFi-IR.

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July 2023

Pain and Inflammation as Mediators of Tofacitinib Treatment Effect on Fatigue in Patients with Ankylosing Spondylitis: A Mediation Analysis

Rheumatol Ther 2023;10(4):1073–1087 doi 10.1007/s40744-023-00570-0

Kristensen, et al. used mediation modelling to show that tofacitinib indirectly improved fatigue symptoms via back pain and morning stiffness. This study was carried out using FACIT-F- and BASDAI Q1-based models to determine the relationship between these variables.

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January 2023

Safety and Efficacy of Bimekizumab in Patients With Active Psoriatic Arthritis: Three-Year Results From a Phase IIb Randomized Controlled Trial and Its Open-Label Extension Study

Arthritis Rheumatol. 2022 doi: 10.1002/art.42280

This study highlighted that the safety of bimekizumab in patients with PsA over 3 years of treatment was consistent with the previous 48-week results, as well as other recently published studies of IL-17 inhibitors in PsA patients.

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October 2022

Comparative Effectiveness of Guselkumab in Psoriatic Arthritis: Updates to A Systematic Literature Review and Network Meta-analysis

Rheumatology (Oxford). 2022 doi: 10.1093/rheumatology/keac500

Guselkumab (GUS) demonstrates better skin efficacy than most other targeted PsA therapies, including upadacitinib. The objective of this NMA update was to expand the network to include all targeted therapies in PsA on arthritis, skin efficacy and safety, and to include data on GUS patients with an IR to TNFinibs.

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July 2022

June 2022

Persistence and Effectiveness of the IL-12/23 Pathway Inhibitor Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: 1-year Results From the Real-world PsABio Study

Ann Rheum Dis 2022 doi: 10.1136/annrheumdis-2021-221640

Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.

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May 2022

Drug survival of biologics and novel immunomodulators for rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, and psoriasis – A nationwide cohort study from the DANBIO and DERMBIO registries

Semin Arthritis Rheum. 2022 doi: 10.1016/j.semarthrit.2022.151979

The authors reviewed drug survival of therapies across common inflammatory skin and joint conditions from national registries.  The findings highlighted that despite the overlapping pathogenesis of these conditions there was little similarity in drug survival. This reinforces the need for an individualised treatment approach consistent with the underlying disease, patient profile and treatment history.

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