The authors provide a treatment schema summarizing their recommendations for all the different domains of PsA and related conditions.

The presenter emphasized strong skin responses with bimekizumab, and said that the agent had a favorable safety profile in line with previous observations.

Li et al then evaluated specific mental disorders separately, finding an increased risk for organic disorders, obsessive–compulsive disorder, schizophrenia, and mood disorders, as well as childhood neurodevelopmental conditions including autism and attention deficit hyperactivity disorder, in those born to mothers with versus without autoimmune diseases.

Further studies should analyze the immunopathology of such conditions.

“Not being able to examine someone’s joints or listen to their lungs or take a close look at their skin really impacted the level of care that we were able to provide” during the early part of the pandemic “when in-person care really wasn’t a safe option or something that was being offered widely,” he adds.

Findings from the second part of the LILAC trial suggest that BIIB059, a monoclonal antibody targeting blood dendritic cell antigen 2, improves skin outcomes for patients with active cutaneous lupus erythematosus.

“However, patients who have active diseases are difficult to manage remotely for prolonged periods due to the potential for flares and progression of their conditions without monitoring.”

Commenting on this, Coates said that skin disease components did not flare any quicker than swollen joint count, and it was more common to see a flare in pain and tender joint count joint, part of which could be attributed to the nocebo effect.

The authors describe the majority (77.8%) of treatment-emergent adverse events (TEAEs), of which infections and skin disorders were the most common, as “mild in severity,” with no serious TEAEs or deaths reported.

However, this risk association is specific to adults; children with anti-TIF1 γ or anti-NXP2 are at risk for severe skin disease including calcinosis, but not cancer.

Findings from the phase II ASSET trial suggest that patients with diffuse cutaneous systemic sclerosis who are treated with abatacept do not experience significantly greater improvements in skin disease than those given placebo.

Why PsA patients have elevated CVD risk “The reasons are complex,” notes Eder, adding that “it is a combination of traditional risk factors” as well as “the fact that [PsA patients] have systemic inflammation in their skin and in their joints.”

Participants experienced significant improvements in skin and joint symptoms, as well as quality of life, after attending the combined clinic.

The objective of this study was to investigate the clinical presentation of joint and active skin symptom involvement and the associated impact on physician- and patient-reported outcomes, and healthcare resource burden in patients with psoriatic arthritis [ read more ]. de Vlam K et al. Rheumatol Ther 2018. doi: 10.1007/s40744-018-0120-8

Tuberculin skin testing (TST) or interferon gamma release assays (IGRAs) are both acceptable mechanisms for screening for LTBI. 

She emphasizes that ixekizumab is “very good for skin disease,” and is therefore “a really good option for patients where skin is a big problem to them.”