Psoriatic Arthritis

THURSDAY, May 18, 2023 (HealthDay News) -- For patients with moderately to severely active psoriatic arthritis, the tyrosine kinase 2/Janus kinase 1 inhibitor brepocitinib is effective for reducing symptoms, according to a study published online May 17 in Arthritis &amp; Rheumatology.Philip Mease, M.D., from the University of Washington in Seattle, and colleagues conducted a placebo-controlled trial involving participants with moderately to severely active psoriatic arthritis. Two hundred eighteen participants were randomly assigned to brepocitinib 10 mg once daily (QD), 30 mg QD, 60 mg QD, or placebo, advancing to brepocitinib 30 or 60 mg QD at week 16.The researchers found that brepocitinib 30 and 60 mg QD groups had significantly greater American College of Rheumatology (ACR)20 response rates at week 16 versus placebo (66.7 and 74.6 percent, respectively, versus 43.3 percent) and had significantly higher ACR50/70, 75 percent and 90 percent improvement in Psoriasis Area and Severity Index, and Minimal Disease Activity response rates. Through week 52, response rates were maintained or improved. Adverse events were mostly mild/moderate; in 12 participants, serious adverse events occurred, including infections in six participants in the brepocitinib 30- and 60-mg QD groups. There were no major adverse cardiovascular events or deaths reported."These data demonstrate striking efficacy and confirm the relevance of multiple signaling pathways dependent on the kinases targeted by brepocitinib in psoriatic arthritis," Mease said in a statement. "The safety is also reassuring for brepocitinib in this study."Several authors disclosed financial ties to pharmaceutical companies, including Pfizer, which manufactures brepocitinib and funded the study.

Significantly greater ACR20 response rates seen at week 16 for 30 and 60 mg QD versus placebo; response maintained or improved at 52 weeks

Brepocitinib Beneficial for Moderate-to-Severe Psoriatic Arthritis

Risankizumab provides long-term benefits in patients with psoriatic arthritis (PsA) who have not achieved adequate response to previous therapies, according to a study recently published in
 
 Rheumatology
 
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 Andrew Östör, M.D., from Monash University in Melbourne, Australia, and colleagues evaluated the 52-week efficacy and safety of risankizumab in patients with active PsA who had previous inadequate response/intolerance to one or two biologic therapies or one or more conventional, synthetic disease-modifying antirheumatic drugs. Patients were randomly assigned to risankizumab or placebo at weeks 0, 4, and 16, with all patients receiving risankizumab every 12 weeks from weeks 28 to 208.




 The researchers found that at week 24, 51.3 percent of risankizumab-treated patients (224 patients) achieved ≥20 percent improvement in American College of Rheumatology criteria (ACR20) versus 26.5 percent of placebo-treated patients (220 individuals). ACR20 was achieved at week 52 by 58.5 percent of patients on continuous risankizumab versus 55.7 percent of patients who switched from placebo to risankizumab at week 24. Other efficacy measures showed similar trends. Through week 52, rates of serious treatment-emergent adverse events (TEAEs) and TEAEs leading to discontinuation remained stable, with no deaths reported.




 "Notably, efficacy was maintained with administration of risankizumab every 12 weeks, while similar interleukin-23 inhibitors are administered every eight weeks," the authors write.




 Several authors disclosed financial ties to pharmaceutical companies, including AbbVie, which manufactures risankizumab and funded the study.




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Long-term benefits seen in patients with inadequate response/intolerance to biologic or conventional disease-modifying antirheumatic drugs

Risankizumab Safe, Effective at 52 Weeks for Psoriatic Arthritis

The U.S. Food and Drug Administration has expanded the approval of Skyrizi (risankizumab-rzaa) to treatment of adults with active psoriatic arthritis, the manufacturer announced Friday.




 The dosing regimen of Skyrizi for psoriatic arthritis is consistent with the regimen for moderate-to-severe plaque psoriasis, which is a single 150-mg subcutaneous injection four times a year following two starter doses at weeks 0 and 4. Skyrizi can be administered alone or in combination with disease-modifying antirheumatic drugs (DMARDs).




 The approval was based on data from the KEEPsAKE-1 and KEEPsAKE-2 phase 3 studies, which enrolled patients with active psoriatic arthritis, some of whom had responded inadequately or were intolerant to biologic therapy or nonbiologic DMARDs. In a press release announcing the approval, the manufacturer said 57.3 and 51.3 percent of patients receiving Skyrizi in the KEEPsAKE-1 and KEEPsAKE-2 trials, respectively, achieved the primary end point of ACR20 response at week 24 compared with 33.5 and 26.5 percent of patients receiving placebo. Skyrizi also showed improvement compared with placebo in dactylitis and enthesitis as well as improvements in skin lesions of psoriasis as measured by the Psoriasis Area Severity Index 90 at week 24 in patients with coexistent plaque psoriasis.




 The most common side effects of Skyrizi include upper respiratory infections, fatigue, fungal skin infections, headache, and injection site reactions. Skyrizi may also increase the risk for infections. Health care providers should check patients for infections and tuberculosis before initiating treatment.




 Approval was granted to AbbVie.




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Approval based on two Phase 3 trials showing more than 50 percent of patients receiving Skyrizi achieved ACR20 response at 24 weeks

Skyrizi Approved for Psoriatic Arthritis

In Episode 30 of Derms and Conditions, host James Q. Del Rosso, DO speaks with Joseph Merola, MD, MMSc, a board certified rheumatologist and dermatologist. They discuss the diagnosis and management of cutaneous lupus and key diagnostic tips for psoriatic arthritis.

In Episode 30 of Derms and Conditions, host James Q. Del Rosso, DO speaks with Joseph Merola, MD, MMSc, a board certified rheumatologist and dermatologist who is an Associate Professor of Dermatology at Harvard Medical School. Dr. Merola and Dr. Del Rosso first discuss the diagnosis and management of cutaneous lupus with a special focus on drug-induced lupus. Next, Dr. Del Rosso asks Dr. Merola about dermatomyositis including tips on diagnosis and which laboratory tests are best to order. Finally, Dr. Merola ends the episode with a focus on psoriatic arthritis, including key diagnostic tips to help differentiate it from other arthritic disorders. FINANCIAL DISCLOSURES: James Q. Del Rosso, DO CONSULTANT/ADVISOR Abbvie, Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), BioFrontera, BioPharmX, Bristol-Myers-Squibb, Cassiopea, Dermata, Dermavant, Encore, EPI Health, Evommune, Ferndale, Galderma, Incyte, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), MC2, Novan, Pfizer, Regeneron, Sanofi-Genzyme, SolGel, Sonoma (IntraDerm), Sun Pharma, Trevi, UCB, Verrica, Vyne (Foamix; Menlo) SPEAKER BUREAU Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), EPI Health, Ferndale, Galderma, Genentech, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), Pfizer, Regeneron, Sanofi-Genzyme, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo) RESEARCH INVESTIGATOR Aclaris, Almirall, Amgen, Anaptys Bio, Arcutis, Athenex, Bausch Health (Ortho Dermatology), BioPharmX, Biorasi, Botanix, Brickell, Cara Therapeutics, Cassiopea, Dermavant, EPI Health, Ferndale, Galderma, Incyte, Leo Pharma, Lilly (Dermira), Novan, Pfizer, Ralexar, Regeneron, SolGel, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo). Joseph F. Merola, MD, MMSc Consultant/Investigator and/or Research funding&mdash;Amgen, BMS, Avotres, AbbVie, Dermavant, Eli Lilly, Novartis, Janssen, UCB, Sanofi, Regeneron, Biogen, Pfizer, Leo Pharma.

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