Date: Monday, November 14, 2016
Session Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster II: Psoriatic Arthritis
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: To describe characteristics & potential risk factors(including treatment exposure) for all-cause mortality & malignancies (excluding NMSC) in psoriasis (PsO) patients (pts) with psoriatic arthritis (PsA) from PSOLAR.
Methods: PSOLAR is an international, disease-based, observational study in which pts eligible for or receiving conventional systemic & biologic agents for PsO are followed prospectively. Characteristics & adverse events for pts who reported PsA, including a subset with PsA confirmed by a joint-specialist are summarized. For characteristics & incidence rates, the cohorts were defined as & attribution was based on treatment exposure prior to/during registry in the following order(regardless of sequence & duration):(1)ustekinumab(UST) (2)other sponsor biologic(primarily infliximab[IFX])(3)non-sponsor biologic(primarily adalimumab/etanercept [ADA/ETN]),&(4)non-biologic therapies(NB)(including immunomodulators(IMM)[eg.MTX], phototherapy&topical therapy). Exposure to any therapy higher in the order precluded inclusion in the lower cohorts. Multivariate analyses using Cox hazard regression(without attribution bias)were used to identify factors associated with time to first malignancy&mortality[compared to no biologic use]&for IMM [compared to no IMM use].
Results: As of Aug 23, 2015, PSOLAR is fully enrolled with 12090 pts(48870 total pt-yrs [PY] of follow-up). Overall, 4315 pts reported having PsA:1551 UST, 754 IFX, 1650 ADA/ETN, 360 NB;of these, 1719 had confirmed PsA(689 UST, 346 IFX, 566 ADA/ETN,118 NB). Baseline demographics & medical history were generally balanced across cohorts; however, in overall PsA subgroup, more pts in NB cohort were
Conclusion: Unadjusted rates of all-cause mortality & malignancies for biologics were generally comparable among both PsA subsets with the exception of generally numerically higher rates in pts in NB cohort. The common risk factors associated with mortality for the overall & confirmed PsA subsets were age & smoking; age alone was the common risk factor associated with malignancy. Biologics & IMM use were not associated with increased risk of mortality or malignancy.
To cite this abstract in AMA style:Mease PJ, Gottlieb A, Menter A, Ritchlin CT, Kalia S, Kerdel F, Kafka S, Chakravarty S, Langholff W, Fakharzadeh S, Goyal K, Scher JU. Updated Results for All-Cause Mortality and Malignancies in Psoriasis Patients with Psoriatic Arthritis in the Psoriasis Longitudinal Assessment and Registry Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/updated-results-for-all-cause-mortality-and-malignancies-in-psoriasis-patients-with-psoriatic-arthritis-in-the-psoriasis-longitudinal-assessment-and-registry-study/. Accessed March 23, 2023.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/updated-results-for-all-cause-mortality-and-malignancies-in-psoriasis-patients-with-psoriatic-arthritis-in-the-psoriasis-longitudinal-assessment-and-registry-study/