Influence of Sex on the Persistence of Different Classes of Targeted Therapies for Psoriatic Arthritis: A Cohort Study of 14 778 Patients from the French Health Insurance Database (SNDS)
RMD Open. 2023;9(4):e003570 doi: 10.1136/rmdopen-2023-003570
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.
Risk of Major Adverse Cardiovascular Events in Immune-Mediated Inflammatory Disorders on Biologics and Small Molecules: Network Meta-Analysis
Clin Gastroenterol Hepatol. 2023 Oct 9:S1542-3565(23)00767-X doi 10.1016/j.cgh.2023.09.033 Epub ahead of print
The results of this study show that anti-IL-12/23, JAK inhibitors, and anti-TNF-α were associated with slightly higher risk of MACE compared with placebo. The risk was no different between biologic treatments, and the magnitude of risk did not differ between IMID type.
Association Between Biological Immunotherapy for Psoriasis and Time to Incident Inflammatory Arthritis: A Retrospective Cohort Study
Lancet Rheumatol 2023;5:200–207 doi https://doi.org/10.1016/S2665-9913(23)00034-6
Retrospective cohort study found 15 501 PsO patients in the TriNetX database during January 2014–June 2022 that were prescribed bDMARDS, of which 6.3% developed inflammatory arthritis. 3.5% of all patients in the study specifically developed PsA.
Gender-specific Differences in Patients with Psoriatic Arthritis Receiving Ustekinumab or Tumour Necrosis Factor Inhibitor: Real-world Data
Rheumatology (Oxford). 2023 doi: 10.1093/rheumatology/kead089
These real-world data from PsABio on gender differences suggest that, at the start of biologic treatment, females have a worse clinical picture of PsA than males. In coming to these conclusions and others, this study sought to investigate effects of gender on disease characteristics and treatment impact in patients with PsA.
Risk of Hospitalization for Serious Infection After Initiation of Ustekinumab or Other Biologics in Patients with Psoriasis or Psoriatic Arthritis
Arthritis Care Res (Hoboken) 2022 doi: 10.1002/acr.24630
In this investigation it was concluded that other biologics and apremilast were associated with a 1.4- to 3-times higher risk of hospitalisation for serious infections in PsO/PsA patients when compared to ustekinumab. These findings should be considered in the safety profile of these therapies when selecting appropriate treatment regimens in patients with PsO/PsA.
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.
Risk of major adverse cardiovascular events in patients initiating biologics/apremilast for psoriatic arthritis: a nationwide cohort study
Pina Vegas and her colleagues sought to assess the relative risk of MACEs in patients with PsA initiating bDMARDs or apremilast. They found that overall, the data produced overall a positive picture regarding the incidence of MACE in treatment.
A review of JAK-STAT signalling in the pathogenesis of spondyloarthritis and the role of JAK inhibition
Rheumatology (Oxford). 2021. Epub ahead of print. doi: 10.1093/rheumatology/keab740.JAK inhibitors are likely to become an important part of the overall treatment paradigm for spondyloarthritis (SpA).Although not fully understood, the pathogenesis of SpA is complex and thought to involve both environmental and genetic factors that together elicit a chronic inflammatory response involving the innate and adaptive immune systems. Several different cytokines, TNF, IL-17A, IL-12/23 and IL-23, which are directly/indirectly affected by JAK molecules, are involved in the pathogenesis o...
Tocilizumab Discontinuation After Attaining Remission in Patients with Rheumatoid Arthritis who were Treated with Tocilizumab Alone or in Combination with Methotrexate: Results from a Prospective Randomised Controlled Study (the second year of the SURPRISE study)
Ann Rheum Dis 2018; 77:1268–1275 DOI: 10.1093/rheumatology/key121The second-year results from the SURPRISE study show that low disease activity (LDA) can be maintained after discontinuation of tocilizumab with continued methotrexate after remission is achieved. Discontinuation of biologic agents in patients who have achieved remission or low disease activity (LDA) is desirable from a risk–benefit point of view. Compared with TNF inhibitors, little is known regarding TCZ-free remission or LDA, but studies indicate that only a small proportion of patients remai...
Rheumatoid arthritis pathophysiology: update on emerging cytokine and cytokine-associated cell targets
Rheumatology doi:10.1093/rheumatology/ket414Despite biologic therapies greatly improving the treatment of rheumatoid arthritis, many patients do not respond to current treatments or do not maintain response to these treatments. This review covers the evidence for the newly discovered role of Th17 cells, IL-12 and IL-17 family of cytokines in the pathogenesis of RA as well as the development of new therapies targeting these cytokines. With current biologics targeting cytokines such as TNF, IL-1ß and IL-6, the discovery of the Th17 subset o...