Levesquechristiansen9938
Sjögren syndrome (SS) is a systemic autoimmune disease typically characterized by inflammatory involvement of the exocrine glands1 The association of SS with an increased risk of cardiovascular disease (CVD) including manifestations such as stroke and myocardial infarction has been demonstrated by numerous previous studies1.
To assess the efficacy of secukinumab on axial and peripheral enthesitis in patients with ankylosing spondylitis (AS) using pooled data from randomized controlled phase III studies.
In this posthoc analysis, data were pooled from patients originally randomized to secukinumab 150 mg, 300 mg, or placebo (PBO) from phase III MEASURE 1-4 studies (ClinicalTrials.gov NCT01358175, NCT01649375, NCT02008916, and NCT02159053). Maastricht AS Enthesitis Score (MASES) was used for assessments of enthesitis through Week 52. Efficacy outcomes were mean change in MASES score and complete resolution (MASES = 0) of enthesitis in patients with baseline MASES > 0.
A total of 693 (71.5%) patients had enthesitis at baseline in secukinumab 300 mg, 150 mg, and PBO groups (58 [76.3%], 355 [70.4%], and 280 [72%], respectively) out of 969 patients pooled in this analysis. At Week 16, mean changes from baseline for overall MASES and enthesitis at axial MASES sites, respectively, were as follows -2.9 (
< 0.01) and -2.9 (
< 0.01) for secukinumab 300 mg; -2.4 (
< 0.015) and -2.3 (
< 0.05) for secukinumab 150 mg; and -1.9 and -1.8 for PBO, with improvements seen through Week 52. More than one-third of secukinumab-treated patients (300 mg 36.2%; 150 mg 40.8%) achieved complete resolution of enthesitis at Week 16.
Secukinumab improved enthesitis at overall MASES and axial sites in patients with AS.
Secukinumab improved enthesitis at overall MASES and axial sites in patients with AS.Gout is the most common inflammatory arthritis1, historically poorly managed, and is arguably the only one of the inflammatory arthritides that is curable with appropriate urate-lowering therapy (ULT)2 Whereas febuxostat has been shown to be a more effective ULT3, allopurinol has been the cornerstone of treatment for decades; however, allopurinol is problematic in the elderly, those with renal impairment, and those who carry the HLA-B*5801 antigen who are primarily of Asian origin.A recent paper by Triantafyllias, et al described that optical spectral transmission (OST) scores, obtained by the HandScan, were significantly higher in male compared to female patients with rheumatoid arthritis (RA) and controls, and an association between OST score and age, BMI, and hand surface area was found.1.
To identify (1) which composite measure is the most stringent target of remission; and (2) which disease component target proves the most difficult to achieve in the different states of minimal disease activity (MDA), Composite Psoriatic Disease Activity Index (CPDAI), Disease Activity Index for Psoriatic Arthritis (DAPSA), and clinical DAPSA (cDAPSA) in patients with psoriatic arthritis (PsA).
There were 258 patients with PsA recruited. Disease remission was evaluated comparing 4 different composite measures and using remission cutoffs as previously proposed (very low disease activity [VLDA], CPDAI ≤ 2, DAPSA ≤ 4, cDAPSA ≤ 4).
Patients met VLDA criteria (MDA 7/7) in 9.0% of visits, DAPSA remission in 19.8%, cDAPSA remission in 23.4% and CPDAI remission in 30.2%. Of 258 patients, MDA criteria (≥ 5/7) were fulfilled in 46.5%. Of those in MDA, VLDA criteria were reached in 25.0%. Patients met the pain visual analog scale (VAS) target in 57.5% of visits when they were in MDA, 43.3% when in low disease actist stringent remission target; however, measurements of axial involvement, which contributed to the elevated pain VAS score in patients not achieving VLDA, were included as a domain in CPDAI only.We have read with great interest the letter of Verhoeven, et al,1 referring to our recent publication on the diagnostic value of optical spectral transmission (OST) in rheumatoid arthritis (RA).2 In our work we had described for the first time, to our knowledge, that OST values could be influenced not only by disease-associated factors (i.e., inflammatory activity) but also by patient-associated characteristics, such as sex, BMI, and age.2.The group from the College of American Pathologists1 have carried out an extensive survey of the approaches to antinuclear antibody testing by different laboratories, predominantly in the USA. click here They reviewed the techniques used and possible reasons for the variations in results.At the 2020 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), the International Dermatology Outcome Measures (IDEOM) Initiative Psoriasis (PsO) Working Group presented an update on its work to agree on meaningful, valid, and feasible outcome measures for PsO randomized controlled trials and longitudinal observational studies. The Treatment Satisfaction Working Group presented the development of a treatment satisfaction instrument to be utilized in PsO clinical trials. The Musculoskeletal Symptoms Working Group presented an overview of their work conducted to date to define how to best measure musculoskeletal symptoms in PsO clinical studies, and discussed next steps during an open-panel discussion, which included PsO and psoriatic arthritis experts.We thank Dr. Russell for raising the issue of reporting the false positivity rate of antinuclear antibody (ANA) indirect immunofluorescent assay (IFA) testing.1 It is difficult, however, for a laboratory to state a false positive rate, per se, as the determination of "falseness" is dependent on clinical evaluation that is typically not available to most laboratories.Pustular psoriasis (PsO) is an uncommon variant of PsO that may present in a generalized or localized fashion with or without musculoskeletal or systemic inflammatory involvement. Generalized pustular PsO (GPP) presents as a widespread acute or subacute pustular eruption that may be familial and is often associated with severe flares and systemic inflammation. The palmoplantar pustulosis variant is localized to palms and soles, whereas acrodermatitis continua of Hallopeau is localized to the nail apparatus. Patients with pustular PsO may have overlapping plaque PsO and may develop psoriatic arthritis (PsA). Pustulosis is also a feature of both synovitis, acne, pustulosis, hyperostosis, osteomyelitis (SAPHO) syndrome and chronic nonbacterial osteomyelitis. At the 2020 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting, members were given an overview of the cutaneous features of pustular PsO, SAPHO, and recent insights into the genetics of GPP, leading to new targeted drug therapies and the development of validated endpoints.