Publications

Heiting et al. investigated whether the initiation of IL-17 blockade with secukinumab improves bone turnover, bone mineral density, and microarchitecture in axSpA patients. Despite symptomatic benefits of therapy with secukinumab, with improvements in pain and function, there were few biochemical, densitometric, or microarchitectural changes in skeletal health over two years of treatment with secukinumab. Larger, longer-term controlled studies using sensitive metrics such as HR-pQCT to follow bone quality are needed to improve our understanding of bone health in axSpA and the relation to disease activity and therapy.

In more than 1500 patients from 13 European countries, Pons et al. demonstrated that secukinumab retention rates after four years were approximately 50% in both axSpA and PsA patients. Pons et al. aimed to assess retention rates and proportions of patients achieving remission and LDA, according to disease activity measures and patient-reported outcomes at 24 and 48 months, in axSpA and PsA patients initiating secukinumab. In this large real-world study, Pons et al., for the first time, report 48-month retention rates as well as rates of remission and LDA. Importantly, b/tsDMARD naïve patients demonstrated higher retention, remission and LDA rates than patients with prior b/tsDMARDs exposure, particularly in axSpA.  

Palsson et al. aimed to estimate the prevalence and predictors of ever achieving remission and sustained remission (SR) in PsA patients initiating b/tsDMARDs therapy in Sweden, using three different remission criteria (DAPSA28, DAS28CRP and EGA). Palsson et al. found that despite increased availability and a wider selection of b/tsDMARDs with different modes of action, a considerable proportion of PsA patients receiving such treatments never achieve remission and approximately half never achieve SR. Fewer swollen joints at baseline predicted a greater likelihood of SR according to all assessed remission definitions, while male sex predicted the likelihood of SR according to DAPSA28 and EGA.

Silvagni et al. aimed to comparatively assess the risk of cardiovascular events (CVE) in RA patients treated with JAKis or TNFis and to explore the interactions with patient profiles [including age, baseline cardio-cerebrovascular (CV) risk, and frailty, which is a state of decreased physiological reserve, assessed using a validated frailty index for Administrative Heathcare Databases (AHD)]. This AHD-based study highlighted no significantly increased risk of CVEs or MACEs for JAKis with respect to TNFis. The CV risk remains mainly driven by the patient profiles. The frailty, in parallel with baseline CV risk, emerged as an important determinant of CVEs, MACEs, and thromboembolic events (TEs). Frailty and baseline CV risk are key predictors of CVEs, MACEs, and TEs, and should be considered in both clinical assessment and trial design for RA patients on ts/b-DMARDs.

Poddubnyy et al. identified no apparent increase in the risk of developing extramusculoskeletal manifestations (EMMs) in patients with PsA, r-axSpA, and nr-axSpA receiving 15mg UPA in the SELECT trials. Majority of patients did not report a history of EMMs at baseline, regardless of disease indication or study treatment.