<?xml version="1.0" encoding="utf-8"?>
<recommendedContent xmlns="http://api.mspoke.com">
    <recommendedItem id="20100101_19_404"
                     title="Tailor Etanercept to Symptoms in Psoriasis and Psoriatic Arthritis (CME/CE)"
                     score="0.01"
                     href="http://www.medpagetoday.com/Rheumatology/Arthritis/tb/18309?impressionId=1265792586891"
                     
      &lt;p&gt;The decision to use once-weekly or twice-weekly etanercept (Enbrel) in patients with both psoriasis and psoriatic arthritis should be determined by the cutaneous and joint symptoms of the patient, researchers said.&lt;/p&gt;
&lt;p&gt;In a blinded, multicenter study, 46% of patients who received the drug twice a week had cleared or almost cleared their skin manifestations of psoriasis at week 12, compared with 32% of those who received the drug only once each week (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.001), according to Wolfram Sterry, MD, of Charite University Medicine in Berlin, and colleagues.&lt;/p&gt;
&lt;p&gt;In contrast, there were no differences in response for arthritis symptoms, with 77% of those in the twice-weekly group and 76% of those in the once-weekly group meeting predetermined psoriatic arthritis response criteria at week 12, the researchers reported online in the &lt;em&gt;BMJ&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;An estimated 30% of patients with psoriasis have an arthritic component to their disease, manifesting as chronic inflammation of the joints and entheses.&lt;/p&gt;
&lt;p&gt;&quot;The challenge of treating patients with both active psoriasis and active psoriatic arthritis is to optimize the treatment of both disease manifestations to give the best overall outcome,&quot; the investigators wrote.&lt;/p&gt;
&lt;p&gt;Etanercept, a fully human tumor necrosis factor (TNF) inhibitor, is approved for use in both conditions based on findings showing that TNF and other cytokines are upregulated in both inflamed joint and skin tissues.&lt;/p&gt;
&lt;p&gt;To determine the efficacy of two different treatment regimens in patients who had not previously received a TNF inhibitor but had moderate-to-severe skin symptoms and active arthritis, Sterry and colleagues recruited 752 patients from 98 centers for PRESTA (Psoriasis Randomized Etanercept STudy in subjects with psoriatic Arthritis).&lt;/p&gt;
&lt;p&gt;They paired rheumatologists and dermatologists to cooperatively assess effects of the drug.&lt;/p&gt;
&lt;p&gt;Patients were randomized to receive subcutaneous etanercept, 50 mg once or twice weekly for 12 weeks, and for an additional 12 weeks both groups received 50 mg once weekly.&lt;/p&gt;
&lt;p&gt;To maintain blinding, the once-weekly group also received a placebo injection during the first 12 weeks.&lt;/p&gt;
&lt;p&gt;Participants&apos; mean age was 46.5 years. Mean duration of psoriasis was 18.9 years, and mean duration of arthritis was seven years. Most were white men.&lt;/p&gt;
&lt;p&gt;For the joint symptoms, the proportions of patients who achieved American College of Rheumatology (ACR) responses were similar at weeks 12 and 24 in the two groups.&lt;/p&gt;
&lt;p&gt;At week 12, 66.4% and 60.8% of patients in the twice- and once-weekly groups, respectively, had achieved ACR20 responses (representing a 20% improvement). At week 24, the corresponding proportions were 69% and 71.7%.&lt;/p&gt;
&lt;p&gt;At week 12, the percentage reductions in physician&apos;s global assessment of arthritis were 60% and 62% for the twice- and once-weekly groups (&lt;em&gt;P&lt;/em&gt;=0.823), and at week 24 the corresponding percentages were 73% and 74% (&lt;em&gt;P&lt;/em&gt;=0.760).&lt;/p&gt;
&lt;p&gt;At baseline, enthesitis was found in 287 patients and dactylitis in 318. These two symptoms decreased comparatively in both groups at weeks 12 and 24.&lt;/p&gt;
&lt;p&gt;Skin findings included the following for the twice-weekly and once-weekly groups, respectively: &lt;ul&gt; &lt;li&gt;Improvement in physician&apos;s global assessment at week 12, 52% versus 45%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001&lt;/li&gt; &lt;li&gt;At week 24, 57% versus 55%, &lt;em&gt;P&lt;/em&gt;=0.420&lt;/li&gt; &lt;li&gt;Improvement in psoriasis area and severity index at week 12, 71% versus 62%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001&lt;/li&gt; &lt;li&gt;At week 24, 78% versus 74%, &lt;em&gt;P&lt;/em&gt;=0.110&lt;/li&gt; &lt;li&gt;75% improvement in psoriasis area and severity index at week 12, 55% versus 36%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001&lt;/li&gt; &lt;li&gt;At week 24, 70% versus 62%, &lt;em&gt;P&lt;/em&gt;&amp;lt;0.026&lt;/li&gt; &lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;Clearly there were differences in the optimal dosages for the skin lesions at week 12, but when the dosage was decreased to once weekly for the two groups, improvements in both joint and skin symptoms continued to improve, and at week 24 the responses were similar in the two groups, the investigators observed.&lt;/p&gt;
&lt;p&gt;&quot;We found that initial treatment of the psoriasis with etanercept 50 mg twice weekly may allow for more rapid clearance of skin lesions than a 50 mg weekly regimen,&quot; they wrote, noting that the higher dose therefore may be preferable for patients with more severe cutaneous involvement.&lt;/p&gt;
&lt;p&gt;In contrast, at no time was the twice-weekly regimen more effective in treating the articular symptoms, so 50 mg once weekly is a sufficient dose for the treatment of joint symptoms alone, they concluded.&lt;/p&gt;
&lt;p&gt;There were no differences in safety between the regimens.&lt;/p&gt;
&lt;p&gt;It is not clear why the higher dose cleared the skin symptoms more rapidly than the low dose but did not have an additional benefit for the joint symptoms.&lt;/p&gt;
&lt;p&gt;&quot;These two different organ systems may have dissimilar autoimmune inflammatory environments, allowing for differences in local concentrations of tumor necrosis factor or in disease burdens or a subtle difference in tissue penetration of drug, although little information is available to support any particular mechanism,&quot; the researchers noted.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;Wyeth Research, which was acquired by Pfizer in October 2009, sponsored the trial.&lt;/p&gt;&lt;p&gt;Authors and sponsor were involved in study design, interpretation of data, manuscript preparation, and decision to publish.&lt;/p&gt;&lt;p&gt;Statistical analyses were done by the biostatistics department of Wyeth Research.&lt;/p&gt;&lt;p&gt;Several co-authors are employees of Pfizer, and others have received fees from multiple pharmaceutical companies including Wyeth.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_190"
                     title="Rising Costs -- the Real Heartbreak of Psoriasis (CME/CE)"
                     score="-0.005"
                     href="http://www.medpagetoday.com/Dermatology/Psoriasis/tb/18028?impressionId=1265792586891"
                     
      &lt;p&gt;The heartbreak of psoriasis used to be the disease itself. Now it&apos;s the skyrocketing cost of treatment.&lt;/p&gt;
&lt;p&gt;From 2000 through 2008, the cost of brand-name drugs increased 66% on average, according to Vivianne Beyer, MD, and Stephen Wolverton, MD, of the Indiana University School of Medicine in Indianapolis (Beyer is currently at St. Vincent Hospital in Indianapolis).&lt;/p&gt;
&lt;p&gt;The cost of several of the drugs &quot;greatly outpaced&quot; both general inflation and the overall increase in cost of prescription medicines, the researchers reported in the January issue of &lt;em&gt;Archives of Dermatology.&lt;/em&gt;&lt;/p&gt;
&lt;p&gt;The disease, a chronic autoimmune illness, affects between 4.5 million and 7.5 million people in the U.S., the researchers noted.&lt;/p&gt;
&lt;p&gt;Up to a third of those do not respond to topical therapy. However, more effective systemic treatments appear to be underused, they said  --  perhaps in part because of cost, a major issue with newer biologic drugs.&lt;/p&gt;
&lt;p&gt;Analysis showed that current annual costs ranged from $1,197 for methotrexate (Rheumatrex, Trexall), at 7.5 milligrams a week, to $27,577 for two 12-week courses of alefacept (Amevive).&lt;/p&gt;
&lt;p&gt;Phototherapy costs ranged from $3,083 for a year of UV-B therapy to $7,288 annually for psoralen-UV-A treatment, including induction and maintenance.&lt;/p&gt;
&lt;p&gt;Acitretin (Soriatane) at 25 milligrams a day cost $9,163, comparable to the $9,999 for 400 milligrams daily of cyclosporine. But some patients need twice the dose of acitretin, which increases the annual cost to $17,613, the researchers said.&lt;/p&gt;
&lt;p&gt;The annual costs of the biologics used to treat psoriasis ranged from $18,384 to $27,577, but those requiring a loading dose  --  such as adalimumab (Humira) and infliximab (Remicade)  --  were more costly during the first year of treatment than in following years, they said.&lt;/p&gt;
&lt;p&gt;To obtain information about trends, the researchers compared year-over-year average wholesale prices for the various treatments.&lt;/p&gt;
&lt;p&gt;They found that percentage changes in drug prices between 2000 and 2008 ranged from a drop of 24.1% for methotrexate to an increase of 316% for the brand-name version of methoxsalen  --  Oxsoralen-Ultra.&lt;/p&gt;
&lt;p&gt;The second-largest increase was 157.5% for acitretin, they said.&lt;/p&gt;
&lt;p&gt;The biologics also increased in price, but not all were available for the entire period. For example, the cost of efalizumab (Raptiva) increased by 35.1% over a four-year period, while adalimumab&apos;s cost increased by 27.2% during a five-year interval, the researchers said.&lt;/p&gt;
&lt;p&gt;On average the increase was 66%, they said, which is markedly higher than inflation. Over the same period, the consumer price index-urban for all items rose 25.8%, and 30.1% for prescription drugs.&lt;/p&gt;
&lt;p&gt;The researchers did not include indirect costs, such as time away from work, direct costs such as inpatient care, or costs that arose because of adverse effects.&lt;/p&gt;
&lt;p&gt;One clinical implication of the findings is that physicians should consider cost as well as efficacy and tolerability when prescribing drugs for psoriasis, the researchers concluded.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The researchers did not report external support for the study. Wolverton reported financial links with Eli Lilly and Amgen.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_1452"
                     title="SID: Cardiovascular Mortality Risk Debated in Severe Psoriasis"
                     score="-0.005"
                     href="http://www.medpagetoday.com/MeetingCoverage/SID/tb/14140?impressionId=1265792586891"
                     
       MONTREAL, May 11 -- Mortality rates over nearly 30 years were significantly increased in patients with severe psoriasis compared with rates in the general population, results of two studies showed. 
              &lt;p&gt;
              &lt;p&gt;But the studies differ on whether cardiovascular mortality is increased, according to the researchers who reported on them at the annual meeting of the Society for Investigative Dermatology. 
              &lt;p&gt;
              &lt;p&gt;&quot;In patients with extremely severe psoriasis, there is an increased risk of death from noncardiovascular, but not cardiovascular causes,&quot; said Robert Stern, M.D., of Harvard and Beth Israel Deaconess Medical Center. 
              &lt;p&gt;
              &lt;p&gt;His findings are in direct contrast to those of another study presented in the same session, and conflict with a growing body of evidence. 
              &lt;p&gt;
              &lt;p&gt;&quot;Severe psoriasis may be an independent risk factor for cardiovascular mortality,&quot; said Rahat Azfar, M.D., of the University of Pennsylvania, whose study showed a 50% increase in cardiovascular deaths in this patient population. 
              &lt;p&gt;
              &lt;p&gt;&quot;Dr. Stern&apos;s study results need to be interpreted with extreme caution due to the inherent bias in his study design,&quot; warned Joel Gelfand, M.D., M.S.C.E., also of the University of Pennsylvania, and an investigator on the study reported by Dr. Azfar. 
              &lt;p&gt;
              &lt;p&gt;Numerous studies, dating back to the 1970s, have shown that patients with psoriasis, particularly severe disease, have an increased cardiovascular risk, said Dr. Gelfand in an interview. 
              &lt;p&gt;
              &lt;p&gt;His group has also shown that psoriasis is associated with an increased risk of myocardial infarction (MI) and stroke, independent of traditional cardiovascular risk factors for these events. 
              &lt;p&gt;
              &lt;p&gt;&quot;Previous studies of cardiovascular mortality have not controlled for traditional cardiovascular risk factors, as our work has done,&quot; commented Dr. Azfar. 
              &lt;p&gt;
              &lt;p&gt;Dr. Azfar and colleagues examined records from the U.K.&apos;s General Practice Research Database from 1987 through 2002. The cohort consisted of more than 3,000 patients with severe psoriasis matched to more than 14,000 controls. 
              &lt;p&gt;
              &lt;p&gt;Compared with controls, patients with severe psoriasis had a significantly increased risk of all-cause mortality (odds ratio [OR] 1.78), Dr. Azfar said. 
              &lt;p&gt;
              &lt;p&gt;After controlling for traditional cardiovascular risk factors including stroke, transient ischemic attack, diabetes, hypertension, hyperlipidemia, age, gender, body mass index, and smoking, the psoriasis patients had a clinically significant increased risk of cardiovascular death (hazard ratio [HR] 1.55). 
              &lt;p&gt;
              &lt;p&gt;This risk was modified by age, with patients 40 and younger being at greater risk (HR 2.65) than those between 41 and 60 (HR 1.90). 
              &lt;p&gt;
              &lt;p&gt;This translated to an excess risk of 5.78 cardiovascular deaths per 10,000 person years at age 40, and 58.9 per 10,000 person years at age 60, Dr. Azfar said. 
              &lt;p&gt;
              &lt;p&gt;&quot;Patients with psoriasis, especially if disease is severe, should be counseled about managing traditional cardiovascular risk factors as part of their routine care,&quot; she concluded. 
              &lt;p&gt;
              &lt;p&gt;Dr. Stern agreed that cardiovascular risk factors are important in patients with severe psoriasis, but his data suggest that they are no more important than other risk factors. 
              &lt;p&gt;
              &lt;p&gt;&quot;A lot of people with psoriasis are scared by some of the new data. They say &apos;I have severe psoriasis, so that means I am more likely to die from a heart attack.&apos; But our data showed that liver disease and nonmelanoma skin cancer accounted for more than half the approximately 70 excess deaths we observed in our cohort,&quot; he said. 
              &lt;p&gt;
              &lt;p&gt;His prospective study followed 1,376 patients from the PUVA cohort study for 28 years, from 1976 to 2004. 
              &lt;p&gt;
              &lt;p&gt;The patients were from 16 tertiary care academic centers across the U.S., with a disease severity ranging from mild to extreme severity. They underwent 22 cycles of interviews. 
              &lt;p&gt;
              &lt;p&gt;Comparing the observed and expected mortality rates among patients and controls, Dr. Stern and colleagues found an increased all-cause mortality rate (HR 1.51) among only those patients with the most severe psoriasis, defined as a body surface involvement (BSA) of 43 to 100%. 
              &lt;p&gt;
              &lt;p&gt;When cause of death was examined in this extremely severe disease group, noncardiovascular reasons explained the increased risk (HR 1.74), and there was a nonsignificant increase in the rate of cardiovascular deaths compared to controls (HR 1.29), Dr. Stern said. 
              &lt;p&gt;
              &lt;p&gt;&quot;If you are a psoriasis patient, don&apos;t think about your psoriasis killing you, or giving you a heart attack. Think about all the other things that you need to do to stay healthy,&quot; Dr. Stern said in an interview. 
              &lt;p&gt;
              &lt;p&gt;Dr. Stern&apos;s study design compares apples to oranges, commented Dr. Gelfand. 
              &lt;p&gt;
              &lt;p&gt;&quot;Patients who participate in psoriasis clinical trials at tertiary care medical centers may be healthier, better educated, and have better access to medical care than the general U.S. population,&quot; he noted. 
              &lt;p&gt;
              &lt;p&gt;&quot;Our study used the epidemiological gold standard design -- in that it was population-based and, in effect, compared apples to apples,&quot; Dr. Gelfand said. 
              &lt;p&gt;
              &lt;p&gt;Dr. Stern explained that, among the noncardiovascular causes of death in his study, liver disease and nonmelanoma skin cancer conferred &quot;a substantially significant increased risk.&quot; 
              &lt;p&gt;
              &lt;p&gt;&quot;Those two types of mortality probably reflect our population, which got a fair amount of PUVA therapy and subsequent UV therapy, which increases the risk of those tumors. The liver disease probably stems from the fact that alcohol use seems to be more prevalent among people with psoriasis, and also our cohort had a very high level of exposure to methotrexate.&quot; 
              &lt;p&gt;
              &lt;p&gt;Exposure to PUVA therapy might also be an explanation for the lack of increased cardiovascular mortality in Dr. Stern&apos;s psoriasis group, suggested James Krueger, M.D., Ph.D.,  from New York&apos;s The Rockefeller University, during the question period. 
              &lt;p&gt;
              &lt;p&gt;&quot;PUVA is one of the best treatments we have to suppress skin inflammation and it may actually modify the natural history of inflammation, both in the skin and systemically, so I think this might even suggest that PUVA treatment alters the cardiovascular risk of this disease,&quot; Dr. Krueger said. 
              &lt;p&gt;
              &lt;p&gt;&lt;table cellspacing=&quot;0&quot; hspace=&quot;1&quot; style=&quot;border-style:solid; border-width:1px; border-color:#8dabbc; font-family:arial; font-size:12px; background-color:#DBE9F2; padding:5px 5px 5px 5px;&quot;&gt;
&lt;tr&gt;&lt;td&gt; Dr. Azfar&apos;s study was funded by funded by the National Institutes of Health and a grant from Centocor. 
              &lt;p&gt;Dr. Azfar declared no conflicts of interest.
              &lt;p&gt;Dr. Stern made no statement on funding and declared no conflicts of interest.&lt;/td&gt;&lt;/tr&gt;&lt;/table&gt;
    </recommendedItem>
    <recommendedItem id="20090101_19_1467"
                     title="SID: Beer Consumption Increases Risk of Psoriasis"
                     score="-0.005"
                     href="http://www.medpagetoday.com/MeetingCoverage/SID/tb/14161?impressionId=1265792586891"
                     
      MONTREAL, May 12 -- Women who drink beer -- but not other types of alcohol -- are more likely to develop psoriasis than other women, researchers found. 
              &lt;p&gt;
              &lt;p&gt;An analysis of data from the Nurses&apos; Health Study found that beer drinking was a significant independent predictor (relative risk 1.83, 95% CI 1.16 to 2.86) for the development of psoriasis, according to Patrick Dominguez, M.D., of Harvard and Brigham and Women&apos;s Hospital in Boston. 
              &lt;p&gt;
              &lt;p&gt;&quot;These findings have implications for psoriasis prevention and management,&quot; said Dr. Dominguez, who presented his findings at the Society for Investigative Dermatology meeting. 
              &lt;p&gt;
              &lt;p&gt;At study entry in 1989, women were asked about their level of alcohol consumption in grams per week. 
              &lt;p&gt;
              &lt;p&gt;According to the CDC, a standard drink -- defined as 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of distilled spirits -- contains 13.7 grams of alcohol. 
              &lt;p&gt;
              &lt;p&gt;Over a 14-year period, biennial questionnaires were used to monitor both the amount and type of alcohol they consumed -- regular beer, light beer, red wine, white wine, or liquor -- said Dr. Dominguez. 
              &lt;p&gt;
              &lt;p&gt;In 2005, he and his colleagues asked participants if they had psoriasis. A total of 2,169 reported a diagnosis of psoriasis, with 1,162 of these being prevalent cases, and the remaining 1,007 being new onset, or incident cases, said Dr. Dominguez. 
              &lt;p&gt;
              &lt;p&gt;After excluding incident cases for which there was incomplete information on alcohol consumption, a total of 955 participants with new-onset psoriasis were included for analysis. 
              &lt;p&gt;
              &lt;p&gt;Compared with abstainers, women who drank alcohol (defined as consumption of 30 grams, or roughly two drinks, or more per week) had a significantly increased risk of developing psoriasis, with a relative risk of 1.59 (95% CI 1.02 to 2.49), Dr. Dominguez said. 
              &lt;p&gt;
              &lt;p&gt;However, when the researchers examined the data by type of alcohol, only consumption of regular beer -- and five or more cans a week -- was a significant independent predictor. 
              &lt;p&gt;
              &lt;p&gt;&quot;For any amount of light beer, wine, or liquor consumed, the relative risks were not significant,&quot; he explained. 
              &lt;p&gt;
              &lt;p&gt;There was no difference in age between abstainers and women who drank alcohol. Abstainers had a slightly higher BMI, and drinkers were more physically active -- with a higher percentage of drinkers also reporting current or past smoking. 
              &lt;p&gt;
              &lt;p&gt;&quot;We also measured dietary folate, which may be a modifier for alcohol&apos;s effect in psoriasis, and folate intake was higher in the drinkers, but not significantly so,&quot; said Dr. Dominguez. 
              &lt;p&gt;
              &lt;p&gt;One possible explanation for the study&apos;s findings might be that gluten, a nonalcoholic ingredient found in beer, might trigger the onset of psoriasis, he said.
              &lt;p&gt;
              &lt;p&gt;&quot;There are multiple case series in which patients with gluten sensitivity, or celiac disease, and psoriasis go on a gluten-free diet and their psoriasis clears up,&quot; he said in an interview. 
              &lt;p&gt;
              &lt;p&gt;&quot;Beer is the only alcoholic drink that contains gluten. Light beer has some gluten but much less.&quot; 
              &lt;p&gt;
              &lt;p&gt;&lt;table cellspacing=&quot;0&quot; hspace=&quot;1&quot; style=&quot;border-style:solid; border-width:1px; border-color:#8dabbc; font-family:arial; font-size:12px; background-color:#DBE9F2; padding:5px 5px 5px 5px;&quot;&gt;
&lt;tr&gt;&lt;td&gt;The Nurses&apos; Health Study is funded by the National Institutes of Health.
              &lt;p&gt;
              &lt;p&gt;Dr. Dominguez made no financial disclosures. &lt;/td&gt;&lt;/tr&gt;&lt;/table&gt;
             
    </recommendedItem>
    <recommendedItem id="20090101_19_701"
                     title="AAD: Anti-TNF Therapy Improves Psoriasis and Psoriatic Arthritis"
                     score="-0.006"
                     href="http://www.medpagetoday.com/MeetingCoverage/AAD/tb/13172?impressionId=1265792586891"
                     
      SAN FRANCISCO, March 9 -- Patients with psoriasis and concomitant psoriatic arthritis got relief from both conditions when treated with the monoclonal antibody adalimumab (Humira), according to pooled data from three large clinical trials.
              &lt;br&gt; 
              &lt;br&gt;The antibody, which targets tumor necrosis factor (TNF), reduced psoriatic arthritis-related adverse events by about 75% and was associated with a sixfold improvement in pain compared with placebo, Philip Mease, M.D., of the University of Washington in Seattle, reported at the American Academy of Dermatology meeting.
              &lt;br&gt; 
              &lt;br&gt;Consistent with data from studies of other anti-TNF therapies, the results suggest that a single therapy can provide relief from both conditions when they coexist.
              &lt;p&gt; 
              &lt;p&gt;&quot;Dermatologists should be looking for evidence of psoriatic arthritis in their psoriasis patients because it occurs commonly,&quot; said Dr. Mease.
              &lt;p&gt; 
              &lt;p&gt;&quot;Additionally,&quot; he said, &quot;this study supports the observations that we have already made in pure psoriatic arthritis trials that the anti-TNF therapies significantly reduce psoriatic arthritis clinical symptoms and signs.&quot;
              &lt;p&gt; 
              &lt;p&gt;The findings came from a pooled analysis of data from three placebo-controlled clinical trials of adalimumab in patients with moderate to severe psoriasis. About a quarter of the patients had concomitant psoriatic arthritis.
              &lt;p&gt; 
              &lt;p&gt;The primary outcome measures were adverse events related to psoriatic arthritis and patient-rated pain associated with psoriasis or psoriatic arthritis at 16 weeks.
              &lt;p&gt; 
              &lt;p&gt;Psoriatic arthritis-related adverse events were defined as patient-reported signs and symptoms consistent with &quot;psoriatic arthropathy.&quot;
              &lt;p&gt; 
              &lt;p&gt;Collectively, the three trials included 413 patients with a history of psoriatic arthritis, 274 of whom were assigned to adalimumab.
              &lt;p&gt; 
              &lt;p&gt;The frequency of psoriatic arthritis adverse events was 4.3% in placebo-treated patients compared with 1.1% in the adalimumab group (&lt;em&gt;P&lt;/em&gt;=0.025).
              &lt;p&gt; 
              &lt;p&gt;Adalimumab treatment was associated with an average reduction of 31.3 units on the 100-unit pain scale compared with 5.6 units among placebo-treated patients (&lt;em&gt;P&lt;/em&gt;&lt;0.001).
              &lt;p&gt; 
              &lt;p&gt; 
              &lt;p&gt;&lt;table cellspacing=&quot;0&quot; hspace=&quot;1&quot; style=&quot;border-style:solid; border-width:1px; border-color:#8dabbc; font-family:arial; font-size:12px; background-color:#DBE9F2; padding:5px 5px 5px 5px;&quot;&gt;
&lt;tr&gt;&lt;td&gt;The study was funded by Abbott Laboratories.
              &lt;p&gt; 
              &lt;p&gt;Dr. Mease disclosed that he is a consultant and member of the speakers&apos; bureau for Abbott Laboratories and has received honoraria from Abbott. Two of the co-authors are employees of Abbott Laboratories.&lt;/td&gt;&lt;/tr&gt;&lt;/table&gt;
       
    </recommendedItem>
</recommendedContent>