Study in focus 1:

Bimekizumab treatment in biologic DMARD-naïve patients with active psoriatic arthritis: long term efficacy and safety [1]
Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A. The benefits of dual neutralisation were demonstrated clinically in a phase IIIb clinical trial in psoriasis, where skin clearance was significantly higher with BKZ when compared with Secukinumab. Primary results from two phase III studies of BKZ treatment in patients with psoriatic arthritis (PsA) who werebDMARD-naïve;(BE OPTIMAL) or who had a previous inadequate response or intolerance to  TNFi (BE COMPLETE) demonstrated a ACR response of 50.4 % in both patient populations at Week 16.  PsA is a chronic, long-term disease, therefore it is important to assess the long-term efficacy and safety of new treatment options for PsA. The 52-week randomised controlled trial BE OPTIMAL assessed the long-term efficacy of BKZ across joint, skin, enthesitis, dactylitis and radiographic outcomes. Improvements in joint, skin clearance and composite outcomes observed at week 16 were sustained to week 52 in patients initially randomised to BKZ. ACR20/50/70, PASI75/90/100 and MDA responses were sustained with BKZ to week 52, consistent with results observed at week 16. Patients who switched to BKZ at week 16 demonstrated improvements in efficacy with similar results to BKZ-randomised patients by week 52. Higher rates of mucocutaneous Candida infections were noted in BKZ group when compared with adalimumab group.

Study in focus 2:

Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis [2]
Rheumatoid arthritis (RA) and systemic glucocorticoid (GC) use are associated with increased risk of cardiovascular (CV) disease.  Even after combination of DMARDs, it is some time difficult to completely stop GC. Real-world data reported that up to 60% of patients with RA use GC chronically. Whether there exists a CV-safe dose or duration of GC in the treatment of RA is still debatable and of great clinical interest.In this study, patients with RA without major cardiovascular events (MACE) at baseline were recruited from a Hong Kong citywide database from 2006 to 2015 and followed till 2018.

Among 12233 RA patients with 105 826 patient-years of follow-up and a mean follow-up duration of 8.7 years, 860 (7.0%) developed MACE. In the time-varying analyses after controlling for confounding factors, a daily prednisolone dose of ≥5 mg significantly increased the risk of MACE (erythrocyte sedimentation rate model: HR 2.02, 95% CI 1.72 to 2.37; C reactive protein model: HR 1.87, 95% CI 1.60 to 2.18), while a daily dose below 5 mg was not associated with MACE risk, compared with no GC use. In patients receiving daily prednisolone ≥5 mg, the risk of incident MACE was increased by 7% per month. In summary, GC was associated with a duration and dose-dependent increased risk of MACE in patients with RA. A low dose prednisolone (<5 mg daily) did not appear to confer excessive CV risk.

References:

1. Ritchlin CT, Coates LC, McInnes IB, et al. Bimekizumab treatment in biologic DMARD-naïve patients with active psoriatic arthritis: 52-week efficacy and safety results from the phase III, randomised, placebo-controlled, active reference BE OPTIMAL study. Ann Rheum Dis. 2023;82(11):1404-1414.
2. So H, Lam TO, Meng H, Lam SHM, Tam LS. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: a population-based study. Ann Rheum Dis.2023;82(11):1387-1393.