4. Mortality, MACE & GLP-1 Agonists
Tsibadze et al., Abstract 08494
GLP-1 receptor agonists (GLP-1 RAs) have attracted great interest because of their benefits on cardiovascular and renal outcomes in patients with type 1 diabetes; more generally, the effects on weight loss are impressive. To investigate the effects of these agents on outcomes of patients with PsA, Tsibadze and colleagues used data from a large, global, multi-center research network called TriNetX; propensity score matching was used to create patient populations for comparison. In this way, the investigative team identified 4,104 patients with PsA taking GLP-1 RAs among a much larger cohort of PsA patients. The mean age of patients on GLP-1 RAs was 55.4 +/- 11.5 years, with a female preponderance. Patients who were white were the largest group. Of the patients on GLP-1 RAs, 67.3 % were obese and or overweight while 54.7% had diabetes.
Using the matching approach, the data on 3,303 GLP-1 RA and 3,303 control PsA patients indicated that GLP-1 RA use was associated with reduced risk for ischemic heart disease, cerebrovascular disease, acute myocardial infarction and cerebral infarction, but not heart failure or death. These data are important in supporting the benefit of GLP 1-RAs in a population of patients with PsA.
The mechanisms of the effects on cardiovascular disease (CVD), however, are not fully clear. Weight loss itself is one possibility because adipose tissue is a source of cytokines that can drive inflammation in the cardiovascular system, as well as joints. Future studies will determine more completely the action of these drugs, including any direct action on the immune system.
5. Axial PsA Explored
Ritchlin et al., Abstract 17535
The pathogenesis of PsA is complex because of the association with skin disease and heterogeneity of joint disease, specifically, the variable presence of axial inflammation. The basis of axial involvement, which affects about 30% of patients, is not clear but is important to understand when predicting outcomes and determining treatment.
Using the NSG-SGM3 mouse model, Ritchlin et al. treated animals with either serum or peripheral blood cells (PBMCs) of patients with PsA and inflammatory back pain and radiographic findings of MRI sacroiliitis or comparable samples from patients with PsA but without axial disease. NSG-SGM3 mice are a novel, triple-transgenic strain that expresses three human cytokines (IL-3, GM-CSF and SCF) on an immunodeficient scid (severe combined immunodeficiency) background; the presence of the human cytokines allows better engraftment of human cells.
