RhAPPcast: ACR Psoriatic Arthritis RhAPPUp Part 3

Welcome back to RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP). In the final episode of our three-part series covering highlights from ACR Convergence 2024, host Amanda Mixon, PA-C, is joined once again by Daric Mueller, PA-C, to explore two more important abstracts shaping the future of psoriatic arthritis (PsA) care. This episode dives into new insights on treatment response and real-world outcomes that may help inform clinical decision-making.

First, Daric breaks down a post-hoc analysis from the SPIRIT-H2H trial, comparing ixekizumab vs adalimumab in PsA patients with nail disease. The data suggest that nail involvement at baseline may be associated with a more robust clinical response—particularly with IL-17 inhibitors—highlighting the importance of considering specific psoriatic domains like nail psoriasis when tailoring treatment. Amanda then discusses a pooled post-hoc analysis of three phase 3 trials of guselkumab, evaluating the impact of prior TNF inhibitor exposure and baseline disease activity on achieving minimally clinically important improvement (MCII). Findings show that patients with higher baseline disease severity required greater improvement to perceive a benefit, but still responded well to IL-23 inhibition, even after TNF failure.

This episode offers key takeaways for advanced practice providers, especially around optimizing PsA management using precision medicine approaches. From choosing the right therapy for patients with nail disease to understanding how past biologic exposure influences outcomes, Amanda and Derek offer real-world insights grounded in the latest data.

Be sure to catch Parts 1 and 2 of our ACR Wrap-Up for a full view of the PsA updates from ACR Convergence 2024. And don’t forget to follow RhAPP on LinkedIn, Instagram, Facebook, and X for more education, community, and clinical resources in rheumatology.

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