Eric M. Ruderman, MD

Over the past two decades, the treatment of active psoriatic arthritis (PsA) has been transformed by targeted biologic therapies. In this ReCAP, Dr Eric Ruderman, from the Feinberg School of Medicine at Northwestern University, reports on the safety and efficacy of several approved therapies.

Dr Ruderman first discusses different treatment options, including TNF inhibitors, which have been the standard first-line therapy for nearly two decades. He also reports that other agents, including Il-12/23 inhibitors abatacept, apremilast, and a number of JAK inhibitors, have shown efficacy for patients who don’t respond well or are intolerant to TNF inhibitors.

In recent years, various specific IL-23 inhibitors have been approved to treat psoriasis and, most recently, psoriatic arthritis in psoriasis. Guselkumab, risankizumab, and tildrakizumab were approved to treat the skin disease.

In psoriatic arthritis, guselkumab and risankizumab have also been approved. These drugs have shown more efficacy than the IL-12/23 inhibitor, according to Ruderman, and show a lower risk for infection compared with some of the other agents.

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Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Division Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Bristol Myers Squibb; Janssen; Lilly; Merck; Novartis; NS Pharma; UCB

Over the past two decades, the treatment of active psoriatic arthritis (PsA) has been transformed by targeted biologic therapies. In this ReCAP, Dr Eric Ruderman, from the Feinberg School of Medicine at Northwestern University, reports on the safety and efficacy of several approved therapies.

Dr Ruderman first discusses different treatment options, including TNF inhibitors, which have been the standard first-line therapy for nearly two decades. He also reports that other agents, including Il-12/23 inhibitors abatacept, apremilast, and a number of JAK inhibitors, have shown efficacy for patients who don’t respond well or are intolerant to TNF inhibitors.

In recent years, various specific IL-23 inhibitors have been approved to treat psoriasis and, most recently, psoriatic arthritis in psoriasis. Guselkumab, risankizumab, and tildrakizumab were approved to treat the skin disease.

In psoriatic arthritis, guselkumab and risankizumab have also been approved. These drugs have shown more efficacy than the IL-12/23 inhibitor, according to Ruderman, and show a lower risk for infection compared with some of the other agents.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Division Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Bristol Myers Squibb; Janssen; Lilly; Merck; Novartis; NS Pharma; UCB

Over the past two decades, the treatment of active psoriatic arthritis (PsA) has been transformed by targeted biologic therapies. In this ReCAP, Dr Eric Ruderman, from the Feinberg School of Medicine at Northwestern University, reports on the safety and efficacy of several approved therapies.

Dr Ruderman first discusses different treatment options, including TNF inhibitors, which have been the standard first-line therapy for nearly two decades. He also reports that other agents, including Il-12/23 inhibitors abatacept, apremilast, and a number of JAK inhibitors, have shown efficacy for patients who don’t respond well or are intolerant to TNF inhibitors.

In recent years, various specific IL-23 inhibitors have been approved to treat psoriasis and, most recently, psoriatic arthritis in psoriasis. Guselkumab, risankizumab, and tildrakizumab were approved to treat the skin disease.

In psoriatic arthritis, guselkumab and risankizumab have also been approved. These drugs have shown more efficacy than the IL-12/23 inhibitor, according to Ruderman, and show a lower risk for infection compared with some of the other agents.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Division Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Bristol Myers Squibb; Janssen; Lilly; Merck; Novartis; NS Pharma; UCB

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta