This Danish registry study evaluated ixekizumab in 709 patients with axial spondyloarthritis or psoriatic arthritis, many of whom had difficult-to-treat disease and had already failed multiple targeted therapies. Half of the patients with axial spondyloarthritis and nearly 40% of those with psoriatic arthritis had previously tried three or more targeted therapies. At 6 months, 24% of patients with axial spondyloarthritis and 43% of patients with psoriatic arthritis achieved low disease activity. Disease activity scores improved overall, including in some patients who had previously tried another IL-17 inhibitor.

Treatment retention was lower among patients with prior IL-17 inhibitor exposure, with many discontinuing ixekizumab within the first year. Retention was better among patients who had not previously used an IL-17 inhibitor. The authors suggested that ixekizumab may still be worth considering in heavily pretreated patients with axial spondyloarthritis or psoriatic arthritis who have limited remaining options, while emphasizing that the findings come from real-world registry data. Key limitations included possible bias, unmeasured confounders, lack of detail on why prior therapies were stopped, and limited information on non-joint manifestations in patients with psoriatic arthritis.

Reference: Jensen KY, Grøn KL, Hetland ML, Glintborg B. Effectiveness of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis: a nationwide cohort study. RMD Open. 2025;11(3):e005806. doi: 10.1136/rmdopen-2025-005806. PMID: 40701624; PMCID: PMC12306273

This systematic review and meta-analysis evaluated all-cause mortality in patients with psoriatic arthritis (PsA) by pooling data from 20 observational studies involving more than 130,000 patients. Overall, patients with PsA had a modest but statistically significant increase in mortality compared with the general population. The increased risk appeared more pronounced in female patients and in studies from Asian countries. However, the authors noted substantial heterogeneity across studies and urged cautious interpretation.

The most commonly reported causes of death were malignancy, cardiovascular and cerebrovascular disease, and infection or respiratory disease. Potential mortality risk factors included older age, male sex, elevated inflammatory markers, and comorbidities, although available data were limited and could not support a full meta-analysis of predictors. The authors concluded that PsA is associated with increased mortality risk and emphasized the importance of broader risk assessment in clinical care, including attention to cardiovascular health, cancer screening, infection risk, and comorbidity management.

Reference: Huang H, Xie W, Geng Y, Fan Y, Zhang Z. Mortality in patients with psoriatic arthritis: a systematic review and meta-analysis. Front Immunol. 2025 Aug 18;16:1622159. doi: 10.3389/fimmu.2025.1622159. PMID: 40901477; PMCID: PMC12399637.

This cross-sectional study evaluated whether ultrasonography could detect subclinical psoriatic arthritis (PsA) in patients with psoriasis who had no musculoskeletal complaints. Researchers examined lower limb entheses in 36 adults with psoriasis and 36 controls using the Glasgow Ultrasound Enthesitis Scoring System. Ultrasound identified inflammatory articular findings in 33 patients, and 26 patients met classification criteria for psoriatic arthritis (CASPAR) criteria for subclinical PsA because they also had psoriatic nail involvement. Common ultrasound findings included entheseal thickening, enthesophytes, and knee effusion.

The study found that quadriceps tendon thickness, enthesophytes, and bilateral quadriceps tendon thickening were more common in patients with subclinical PsA than in those without. Enthesophytes emerged as the strongest predictor of subclinical PsA in the analysis. The authors concluded that ultrasound may detect early inflammatory joint or entheseal changes that are not apparent on clinical examination. This could help identify patients with psoriasis who may be at higher risk for developing PsA and support earlier clinical consideration of joint involvement.

Reference: El-Sherif SM, Gaweesh T, Genedy RM. Diagnosis of subclinical psoriatic arthritis in patients with psoriasis using CASPAR criteria: a sonographic study. Egypt Rheumatol Rehabil. 2022 Nov 1;49:60. doi: 10.1186/s43166-022-00158-6.