1
|
Spini A, Pellegrini G, Ingrasciotta Y, L'Abbate L, Bellitto C, Carollo M, Leoni O, Zanforlini M, Ancona D, Stella P, Cavazzana A, Scapin A, Lopes S, Belleudi V, Ledda S, Carta P, Rossi P, Ejlli L, Sapigni E, Puccini A, Spila Alegiani S, Massari M, Guarneri C, Gisondi P, Trifirò G. Switching patterns of biological drugs in patients with psoriasis and psoriatic arthritis: insight from the VALORE database network. Expert Opin Biol Ther 2024; 24:399-409. [PMID: 38767132 DOI: 10.1080/14712598.2024.2357381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Switch patterns among different biologics and from originators to biosimilars (and vice versa) can be complex in patients with psoriasis (PsO) and psoriatic arthritis (PsA). OBJECTIVE The aim of this study was to describe switching patterns of biological drugs in PsO/PsA patients and to explore predictors of multiple switches and switch-back. RESEARCH DESIGN AND METHODS A large-scale retrospective cohort study was conducted using the Italian VALORE database. Bio-naïve users treated for PsO/PsA during 2010-2022 were included. Time to switch/swap and predictors of multiple switches and switch-back were analyzed. RESULTS Thirty-thousand seven hundred bio-naïve users were included. At 3 and 5 years of follow-up, patients with at least one switch/swap were 37.1% and 47.8%, respectively. The median time to first switch/swap was significantly shorter (p< 0.001) for TNF-α inhibitors (2,068 days) than anti-IL (2,780 days). At 1 year of follow-up patients starting with IL-23 switched/swapped biological therapy less frequently than those with anti-IL-12/23 and anti-IL-17 (4.9% vs. 8.7% and 9.4%, respectively). Patients starting with anti-IL-12/23 reported a significantly lower risk of multiple switches and switch-back (0.74, 95% CI, 0.67-0.83; 0.58, 95% CI, 0.44-0.77, respectively) than those with TNF-α inhibitors. CONCLUSIONS Patients with PsO/PsA starting with TNF-α inhibitors switch/swap more rapidly and frequently than those with anti-IL, which are also associated with a reduced risk of multiple switches during follow-up.
Collapse
Affiliation(s)
- Andrea Spini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giorgia Pellegrini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ylenia Ingrasciotta
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Luca L'Abbate
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Chiara Bellitto
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Massimo Carollo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Olivia Leoni
- Lombardy Regional Centre of Pharmacovigilance and Regional Epidemiologic Observatory, Milan, Italy
| | | | - Domenica Ancona
- Centro Regionale di Farmacovigilanza Regione Puglia, Bari, Italy
| | - Paolo Stella
- Centro Regionale di Farmacovigilanza Regione Puglia, Bari, Italy
| | | | | | - Sara Lopes
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Paolo Carta
- Regione Autonoma della Sardegna, Cagliari, Italy
| | - Paola Rossi
- Friuli-Venezia Giulia Regional Center of Pharmacovigilance, Trieste, Italy
| | - Lucian Ejlli
- Friuli-Venezia Giulia Regional Center of Pharmacovigilance, Trieste, Italy
| | - Ester Sapigni
- Emilia-Romagna Regional Center of Pharmacovigilance, Bologna, Italy
| | - Aurora Puccini
- Emilia-Romagna Regional Center of Pharmacovigilance, Bologna, Italy
| | - Stefania Spila Alegiani
- Pharmacoepidemiology and Pharmacovigilance Unit, National Centre for Drug Research and Evaluation, Italian National Institute of Health (ISS), Rome, Italy
| | - Marco Massari
- Pharmacoepidemiology and Pharmacovigilance Unit, National Centre for Drug Research and Evaluation, Italian National Institute of Health (ISS), Rome, Italy
| | | | - Paolo Gisondi
- Department of Medicine, University of Verona, Verona, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| |
Collapse
|
2
|
Ghirardi GM, Delrosso CA, Nerviani A, Boutet MA. Molecular portrait of chronic joint diseases: Defining endotypes toward personalized medicine. Joint Bone Spine 2024; 91:105692. [PMID: 38246575 DOI: 10.1016/j.jbspin.2024.105692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
Joint diseases affect hundreds of millions of people worldwide, and their prevalence is constantly increasing. To date, despite recent advances in the development of therapeutic options for most rheumatic conditions, a significant proportion of patients still lack efficient disease management, considerably impacting their quality of life. Through the spectrum of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA) as quintessential and common rheumatic diseases, this review first provides an overview of their epidemiological and clinical features before exploring how the better definition of clinical phenotypes has helped their clinical management. It then discusses the recent progress in understanding the diversity of endotypes underlying disease phenotypes. Finally, this review highlights the current challenges of implementing molecular endotypes towards the personalized management of RA, PsA and OA patients in the future.
Collapse
Affiliation(s)
- Giulia Maria Ghirardi
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | | | - Alessandra Nerviani
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK
| | - Marie-Astrid Boutet
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK; Nantes Université, Oniris, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000 Nantes, France.
| |
Collapse
|
3
|
Loo YP, Loo CH, Lim AL, Wong CK, Ali NBM, Khor YH, Tan WC. Prevalence and risk factors associated with psoriatic arthritis among patients with psoriasis. Int J Rheum Dis 2023; 26:1788-1798. [PMID: 37485806 DOI: 10.1111/1756-185x.14833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/14/2023] [Accepted: 06/28/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Psoriatic arthritis is a chronic, autoimmune inflammatory arthritis that occurs with psoriasis and has profound impact on patients' physical and psychological well-being. This study aims to determine the prevalence and risk factors associated with psoriatic arthritis among patients with psoriasis. METHODS A single-center, cross-sectional study was conducted over a 12-month period at the Dermatology Clinic, Hospital Pulau Pinang, Malaysia involving all consecutive psoriasis patients. CASPAR (ClASsification of Psoriatic ARthritis) criteria were used to diagnose psoriatic arthritis. RESULTS A total of 360 patients with psoriasis were recruited, of whom 107 (29.7%) had psoriatic arthritis. Psoriatic arthritis patients had equal gender distribution and the mean age of arthritis onset was 40.7 ± 12.8 years. Psoriasis preceded arthritis in 81.3% of patients (n = 87) with a mean latency interval of 10.5 years. Polyarthropathy was the predominant subtype affecting 46.8% (n = 50) of patients, followed by oligoarthropathy (22.4%, n = 24), axial joint disease (5.6%, n = 6), predominant distal interphalangeal joint disease (2.8%, n = 3), and mixed subtype (22.4%, n = 24). Enthesitis and dactylitis occurred in 12.1% (n = 13) and 20.6% (n = 22) of arthritis patients, respectively, and deformity was present in 37.4% (n = 40). Psoriatic arthritis was significantly associated with being an ever smoker (adjusted odds ratio [aOR] 0.41; 95% confidence interval [CI] 0.18-0.91, p = .029), genital psoriasis (aOR 2.25; 95% CI 1.17-4.33, p = .015), and increased erythrocyte sedimentation rate (ESR) (aOR 1.02; 95% CI 1.01-1.04, p = .005) and C-reactive protein [CRP] (aOR 1.04; 95% CI 1.00-1.08, p = .040). CONCLUSION Our study showed a high prevalence of psoriatic arthritis among the psoriasis cohort. Genital involvement, and increased ESR and CRP were associated with psoriatic arthritis among patients with psoriasis.
Collapse
Affiliation(s)
- Yin Pin Loo
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
- Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Kuala Lumpur, Malaysia
| | - Chai Har Loo
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
| | - Ai Lee Lim
- Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia
| | - Chee Keong Wong
- Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia
| | | | - Yek Huan Khor
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
| | - Wooi Chiang Tan
- Department of Dermatology, Hospital Pulau Pinang, Penang, Malaysia
| |
Collapse
|
4
|
Al Rayes H, Alazmi M, Attar S, Alderaan K, Alghamdi M, Alghanim N, Alhazmi A, Alkhadhrawi N, Almohideb M, Alzahrani Z, Bedaiwi M, Halabi H. Consensus-based recommendations on the diagnosis, referral and clinical management of patients with psoriatic arthritis. Rheumatol Int 2021; 42:391-401. [PMID: 34716785 DOI: 10.1007/s00296-021-05029-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022]
Abstract
Psoriatic arthritis (PsA) is a highly heterogeneous disease with complex manifestations. Limited understanding of the disease and non-availability of local guidelines pose challenges in the management of PsA in Saudi Arabia. Therefore, this expert consensus is aimed to provide recommendations on the management of patients with PsA, including referral pathway, definition of remission and treat-to-target (T2T) approach. A Delphi technique of consensus development was used involving an expert panel comprised of 10 rheumatologists, one dermatologist and one family physician. Based on the review of available published evidence and the opinions of clinical experts, key recommendations were developed. A consensus was achieved in defining the following: management guideline adaptable for Saudi Arabia, most useful screening tool, laboratory investigations, imaging tests and criteria for referring suspected PsA patients to a rheumatologist. In addition, an agreement was achieved in defining the T2T strategy and remission for the clinical management of PsA. Overall, these recommendations provide an evidence-based framework for the management of PsA patients in Saudi Arabia.
Collapse
Affiliation(s)
- Hanan Al Rayes
- Department of Medicine, Prince Sultan Military Medical City, Riyadh, 21577, Saudi Arabia.
| | - Mansour Alazmi
- Department of Rheumatology, Prince Mohammed Medical City, Al Jouf, Saudi Arabia
| | - Suzan Attar
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled Alderaan
- Department of Rheumatology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Mushabab Alghamdi
- Department of Rheumatology, University of Bisha, Bisha, Saudi Arabia
| | - Nayef Alghanim
- Department of Rheumatology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ahmed Alhazmi
- Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Nadeer Alkhadhrawi
- Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad Almohideb
- Department of Dermatology, King Saud Bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Zeyad Alzahrani
- Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohamed Bedaiwi
- Department of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hussein Halabi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| |
Collapse
|
5
|
Grinnell-Merrick LL, Lydon EJ, Mixon AM, Saalfeld W. Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature. Rheumatol Ther 2020; 7:667-684. [PMID: 32935330 PMCID: PMC7695767 DOI: 10.1007/s40744-020-00234-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/03/2020] [Indexed: 01/03/2023] Open
Abstract
Psoriatic arthritis (PsA) is a chronic immune-mediated disease characterized by psoriatic skin and nail changes, peripheral joint inflammation, enthesitis, dactylitis, and/or axial involvement, either alone or in combination with each other. The presence of axial involvement has been shown to be a marker of PsA severity; however, there is no widely accepted definition of axial involvement in PsA (axPsA) or consensus on how or when to screen and treat patients with suspected axPsA. Chronic back pain is a prominent feature of axPsA and is thought to have a relevant role in early identification of disease. Chronic back pain can be caused by inflammatory back pain (IBP) or mechanical back pain (MBP). However, MBP can complicate recognition of IBP and delay diagnosis of axPsA. While MBP can also be associated with chronic back pain of ≥ 3 months in duration that is typical of IBP, IBP is characterized by inflammation of the sacroiliac joint and lower spine that is differentiated from MBP by key characteristic features, including insidious onset at age < 40 years, improvement with exercise but not with rest, and nighttime pain. This review discusses the differences in identification and management of IBP and MBP in patients with PsA with axPsA. The summary of available evidence highlights the importance of appropriate and timely screening, difficulties and limitations of differential diagnoses and treatment, and unmet needs in axPsA.
Collapse
Affiliation(s)
| | | | - Amanda M Mixon
- Arthritis and Rheumatology Clinic of Northern Colorado, Fort Collins, CO, USA
| | | |
Collapse
|
6
|
Korotaeva TV, Novikova DS, Loginova EY. Cardiovascular risk in patients with psoriatic arthritis. TERAPEVT ARKH 2016; 88:102-106. [DOI: 10.17116/terarkh2016885102-106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
7
|
Ogdie A, Yu Y, Haynes K, Love TJ, Maliha S, Jiang Y, Troxel AB, Hennessy S, Kimmel SE, Margolis DJ, Choi H, Mehta NN, Gelfand JM. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis 2014; 74:326-32. [PMID: 25351522 DOI: 10.1136/annrheumdis-2014-205675] [Citation(s) in RCA: 322] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors. METHODS A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use. RESULTS Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73). CONCLUSIONS Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA.
Collapse
Affiliation(s)
- Alexis Ogdie
- Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - YiDing Yu
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kevin Haynes
- Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Yihui Jiang
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrea B Troxel
- Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sean Hennessy
- Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven E Kimmel
- Department of Medicine, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Center for Therapeutic Effectiveness Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David J Margolis
- Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hyon Choi
- Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Joel M Gelfand
- Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Center for Dermatoepidemiology and Translation, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|