Poster abstracts 45
1
Probity Medical Research, Waterloo, Ontario, Canada, 2 Human Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Romania, 3 Eli Lilly and Company, Indianapolis, Indiana, USA, 4 Department of Dermatology, University Medical Centre Schleswig-Holstein, Campus Kiel, Germany
Introduction and Objectives: Ixekizumab( IXE), an interleukin- 17A antagonist, has shown superior efficacy in psoriasis compared to placebo, 1 etanercept, 1 and ustekinumab. 2 This post hoc analysis intended to evaluate absolute and relative Psoriasis Area and Severity Index( PASI) improvements with IXE treatment in a phase 3 trial( IXORAP). Methods: In IXORA-P, patients with moderate-to-severe psoriasis were randomized( 2:1:1) to receive any of the 3 dosing regimens of IXE 80 mg: every 2 weeks( Q2W; n = 611), every 4 weeks( Q4W; n = 310), or Q4W / Q2W step-up( n = 306), for 52 weeks. Randomization was stratified by country and weight( < 80 kg, ≥80 to < 100 kg, or ≥100 kg). The percentage of patients achieving a 75 %, 90 % or 100 % improvement from baseline in PASI( PASI 75, 90, and 100) was evaluated using logistic regression with dosing regimen, country, and baseline weight as factors. Fisher’ s exact test with nonresponder imputation was used to compare the response rates between treatment groups. Here, we present results at 12 weeks for Q2W( label dose) and Q4W groups; results from Q4W / Q2W group will be discussed separately. Results: Mean( standard deviation) PASI score at baseline was 20.3( 8.25). Response rates were significantly higher( p < 0.001) for Q2W group compared to Q4W group across all cut-off points for absolute PASI: absolute PASI ≤ 1, 2, 3, and 5 response rates at Week 12 were 61.4 %, 76.1 %, 84.5 %, and 89.4 %, respectively, for Q2W group, and 49.7 %, 64.5 %, 72.6 %, and 83.9 %, respectively, for Q4W group. At Week 12, PASI 75 response rates in Q2W and Q4W groups were 89.2 % and 83.2 %, respectively( p = 0.012). For Q2W and Q4W groups, PASI 90 response rates were 75.3 % and 63.2 %, respectively( p < 0.001), and PASI 100 response rates were 46.0 % and 32.6 %, respectively( p < 0.001). Conclusion: As reported in psoriasis registration trials, induction with IXE Q2W, the labeled dosing regimen, provides better clinical outcomes at Week 12. References: [ 1 ] Griffiths CE, Reich K, Lebwohl M, et al. Lancet 2015; 386:541-51. [ 2 ] Reich K, Pinter A, Lacour JP, et al. Br J Dermatol 2017; 177( 4): 1014-23.
P110 PREVALENCE AND SEX DIFFERENCES OF PSORIATIC ARTHRITIS IN PATIENTS WITH SEVERE PLAQUE
PSORIASIS. Nadezhda Batkaeva 1, Tatiana Korotaeva 2, Edgem Batkaev 1
1
Peoples’ Friendship University of Russia( RUDN University), 2 Research Institute of Rheumatology n. a. V. A. Nasonova
Background: Prevalence of psoriatic arthritis in patients with psoriasis has conflicting data in different population. But no study has been performed in Russian population of prevalence and sex differences of psoriatic arthritis in patients with severe plaque psoriasis. Objectives: to evaluate the prevalence PsA in patients( pts) with PsO in a dermatological hospital cohort. Methods: 890 pts( Male-516 / Female-374) with severy plaque PsO, mean age 50.4 ± 17.6 years, mean PsO duration 21.5 ± 14.7, mean PASI 49.4 ± 0.5 were included. 374 female were divided into groups by age. 113 young F. pts with age less than 49 years( mean age 36.1 ± 11.0 years), 261 old F. pts with age more than 50 years( mean age 63.7 ± 9.6 years). 516 male were divided into groups by age. 304 young M. pts with age less than 54 years( mean age 38.5 ± 11.3 years), 212 old M. pts with age more than 55 years( mean age 38.5 ± 11.3 years) were included. PsO and PsA pts were identify in hospital Database reporting and coding by International
Statistical Classification of Disease and Related Health Problems( ICD-10) between 2010- 2015 years. PSA was diagnosed after appointment with a rheumatologist and an X-ray examination. Diagnosis was carried out according to the criteria of CASPAR. M ± m, t-test, x2,(%) were calculated. All p < 0.05 were considered to indicate statistical significance. Results: 303 out of 890 pts( 34.0 %) had psoriatic arthritis( PsA). PsA pts were older then PsO pts without arthritis – 55.3 ± 13.7 years and 50.4 ± 17.6 years accordingly( p < 0.001). PsA was found significantly often in F. pts compare to M. pts – in 143 out of 374 pts( 38.2 %) and in 129 out of 516 pts( 25.0 %) accordingly( p < 0.05). PsA was found significantly often in F. pts over 50 years old( y. o.) compare to F. pts under 50 y. o. – in 134 out of 261 pts( 51.3 %) and in 9 out of 113 pts( 7.9 %) accordingly( p < 0.05). In old M. and young M. PsA was found in the same cases- in 58 out of 212 pts( 27.3 %) and in 71 out of 304 pts( 23.3 %) accordingly( p > 0.05). Conclusions: PsA was detected in more than a third of patients with severe plaque psoriasis. PSA was found predominantly often in F. pts over 50 years of age with severe plaque psoriasis. Future investigation in this field is needed to determine the causes of high risks PSA in this age group.
P111 SKIN LESION SEVERITY IN EARLY AXIAL AND PERIPHERAL PSORIATIC ARTHRITIS PATIENTS Elena Gubar, Elena Loginova, Svetlana Glukhova, Tatiana Korotaeva Nasonova Research Institute of Rheumatology, Moscow
Introduction: Comparative analysis of skin lesion severity in early PsA patients with and without axial involvement hadn’ t been sufficiently studied. Objective: to compare skin lesion severity of two early peripheral PsA patient populations – with and without axial involvement. Methods: 95 patients( pts)( M / F – 47 / 48) with early PsA according to CASPAR criteria were included; all pts had peripheral arthritis for ≤ 2 years; no inflammatory back pain( IBP) pts were specially selected. Mean age 36.5 ± 10.7 yrs, disease duration 12.2 ± 10.3 mo, disease activity indexes DAS = 4.0 ± 1.4, DAS28 = 4.2 ± 1.1, BASDAI = 4.5 ± 1.6. Skin lesion severity was evaluated in terms of body surface area( BSA) affected and Psoriasis Area Severity Index( PASI). When BSA was ≥3 %, PASI was calculated. PASI ≥11 indicates moderate and severe psoriasis. All pts were evaluated for the presence of inflammatory back pain( IBP) by ASAS criteria. IBP was observed in 63( 66.3 %) cases. Magnetic resonance imaging( MRI) of SIJs was performed in 79 pts, regardless of the presence of IBP, on Signa Ovation 0,35T. MRI results were evaluated by an independent reader. Bone marrow edema on MRI( STIR) was considered as active MRI sacroiliitis( MRI-SI). MRI-SI was detected in 28 of 79( 35.4 %) examined cases. The examination also included X-ray of sacroiliac joints( SIJs)( pelvic radiographs). Radiographic sacroiliitis( R-SI) was considered according to New York criteria( unilateral grade≥3 or bilateral grade≥2). R-SI was found in 29( 30.5 %) cases. Pts were split into two groups: those with axial involvement( axPsA), that is with IBP and / or MRI-SI and / or R-SI; and those without axial involvement( having only peripheral PsA [ pPsA ]). The axPsA group included 65( 68.4 %) cases, the pPsA one 30( 31.6 %) cases. Results: skin lesions’ severity was higher in the axPsA group than in the pPsA group: in axPsA pts BSA median was 3.0 [ 1.0 – 9.0 ] and in pPsA pts it was 1.0 [ 0.2 – 3.0 ]( р = 0.007); in the axPsA group PASI median was 15.6 [ 6.6 – 55.2 ] and in the pPsA group it was 6.0 [ 0.0 – 7.2 ]( р = 0.006). Conclusion: Axial involvement in early PsA patients is associated with skin lesions’ severity. These findings may have a positive impact on the selection of the best therapeutic strategy.
Acta Derm Venereol 2018