Zohra Faizy Ahmadzay

Objective: Identifying patient characteristics that predict treatment response in psoriatic arthritis (PsA) may help optimize treat-to-target strategies. We aimed to explore overall and sex-specific predictors of secukinumab (SEC) effectiveness in European patients with PsA treated in routine care. Methods: We analyzed data from 14 registries in the European Spondyloarthritis (EuroSpA) Research Collaboration. Patients aged ≥ 18 years at diagnosis, initiating SEC treatment from January 2015 to January 2021, were included. Multiple imputation was used for missing covariates at treatment start (baseline) and Disease Activity Index for Psoriatic Arthritis based on 28 joints (DAPSA28) at 6 months. Overall and sex-stratified analyses were performed by logistic and Cox regressions to identify baseline predictors of the following treatment outcomes: (1) DAPSA28 low disease activity (LDA; DAPSA28 ≤ 14) at 6 months, (2) DAPSA28 moderate response at 6 months, and (3) SEC discontinuation within 12 months. Results: In total, 2790 patients (43% male) were included. Median age was 43 years (IQR 34-52), and SEC was the first-line biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) in 665 patients (24%). Positive predictors for both DAPSA28 LDA and DAPSA28 moderate response were male sex, fewer previous b/tsDMARDs, C-reactive protein (CRP) > 10 mg/L, and lower Health Assessment Questionnaire (HAQ) score. Absence of psoriasis, higher patient fatigue, and tender joint counts predicted SEC discontinuation within 12 months. For some outcomes, sex-specific predictors were fewer previous b/tsDMARDs and CRP > 10 mg/L among male patients and lower patient fatigue score among female patients. Conclusion: We identified overall and sex-specific predictors of SEC effectiveness in European patients with PsA. Our findings may support personalized treatment decisions.

Objectives: To investigate associations between cardiometabolic comorbidities and clinical characteristics, prescription patterns and retention of first biologic/targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) in patients with psoriatic arthritis (PsA). Methods: Patients with PsA initiating a first b/tsDMARD treatment in 2015 or later were identified in eight European rheumatology registries. Patients with information on five cardiometabolic comorbidities (obesity, dyslipidaemia, diabetes, hypertension, ischaemic heart disease) at treatment start (baseline) were included. All analyses were conducted according to patients’ comorbidity burden (count: 0/1/≥2) and status (presence/absence of each comorbidity). Patient characteristics and prescription patterns were described. Twelve-month treatment retention rates were estimated and compared using Kaplan-Meier plots, log-rank tests and multivariable Cox regression analyses. Results: Among 5299 patients, 36% had at least one cardiometabolic comorbidity. Patients with comorbidity were older, had higher disease activity and more disability. Regardless of comorbidity, most patients were prescribed a tumour necrosis factor inhibitor (76%). The use of interleukin-17 inhibitors increased with comorbidity burden (0/1/≥2 comorbidities: 13%/18%/19%), whereas Janus kinase inhibitor use declined (2.3%/1.6%/0.8%). Retention rates were marginally lower with higher comorbidity burden (80%/76%/78%) (log-rank, p=0.036) and obesity (absent 79% vs present 77%) (log-rank, p=0.04). The risk of treatment withdrawal was only marginally higher in patients with higher comorbidity burden (one comorbidity: HR 1.19; 95% CI 1.02 to 1.40; ≥2 comorbidities: HR 1.18; 0.98 to 1.42). Conclusion: Patients with cardiometabolic comorbidities had higher disease activity at treatment initiation of the first b/tsDMARD. Prescription patterns varied with comorbidity burden. Cardiometabolic comorbidity burden, especially obesity, was associated with marginally lower treatment retention.

Actinic keratosis is a common, chronic, and potentially pre-cancerous skin disease that can negatively impact patients’ health-related quality of life. This systematic review aimed to identify and describe the questionnaires used to assess health-related quality of life in patients with actinic keratosis and summarize reported impacts. Four databases (EMBASE, PsycINFO, PubMed, and Cochrane Library) were searched up to February 2025. Two reviewers independently screened articles, and risk of bias was assessed using tools appropriate to study design. Of 639 records, 37 studies including 9,326 patients met inclusion criteria. Most studies were interventional (59%) and of moderate to high quality (64%). Health-related quality of life was assessed using 3 disease-specific, 3 dermatology-specific, and 2 generic questionnaires. The most frequently used instruments were the Actinic Keratosis Quality of Life (n = 13) and the Dermatology Life Quality Index (n = 16). All questionnaires detected health-related quality of life impairment, especially during treatment. Actinic Keratosis Quality of Life identified patient subgroups with greater health-related quality of life reduction, including females, younger individuals, patients with comorbidities, and those with a history of skin cancer. All health-related quality of life questionnaires captured impairment in patients with actinic keratosis. The Actinic Keratosis Quality of Life and Dermatology Life Quality Index questionnaires were widely used. Actinic Keratosis Quality of Life identified subpopulations with health-related quality of life impairment. Among studies reporting mean health-related quality of life scores, the Dermatology Life Quality Index ranged from 1.55 to 24 and the Actinic Keratosis Quality of Life from 4.22 to 17, reflecting very broad variability and underlying differences in actinic keratosis severity across study populations.

Objectives: Real-world evidence is needed to inform treatment strategies for patients with PsA and axial SpA (axSpA) who have non-musculoskeletal manifestations (NMMs), various risk factors and comorbidities. International collaboration is required to ensure statistical power and to enhance generalizability. The first step forward is identifying which data are currently being collected. Across 17 registries participating in the European Spondyloarthritis Research Collaboration (EuroSpA), we aimed to map recording practices for NMMs, comorbidities and safety outcomes in patients with PsA and axSpA. Methods: Through a survey with 4,420 questionnaire items, we explored the recording practices of 58 pre-defined conditions (i.e. NMMs, comorbidities and safety outcomes) covering 10 disease areas. In all registries we mapped for each condition whether it was recorded, the recording procedure and the potential to identify it through linkage to other national registries. Results: Conditions were generally recorded at entry into the registry and clinical follow-up visits using a pre-specified list or a coding system. Most registries recorded conditions within the following disease areas: NMMs (number of registries, n = 15–16), cardiovascular diseases (n = 10–14), gastrointestinal diseases (n = 12–13), infections (n = 10–13) and death (n = 14). Nordic countries had the potential for data linkage and generally had limited recording of conditions in their registry, while other countries had comprehensive recording practices. Conclusion: A wide range of conditions were consistently recorded across the registries. The recording practices of many conditions and disease areas were comparable across the registries. Our findings support the potential for future collaborative research.