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Plastic Is Starting to Generate a Staggering Proportion of Earth’s Carbon Pollution – Futurism
Posted: April 24, 2024 at 10:39 am
"The consequences of this industrys unfettered carbon emissions will reach everyone on the planet." Trash Mountain
Our species' bottomless appetite for plastic isn't just a problem because of all the waste it generates. Its production is also spewing unchecked greenhouse gas emissions, according to a new report released this week by scientists at the Lawrence Berkeley National Laboratory.
The work shows that our reliance on the ubiquitous material is undermining climate change mitigation efforts, not to mention adding endless plastic pollution to the environment and our bodies in the form of insidious and far reaching microplastics.
"Petrochemicals, the building block of plastic, are already poisoning communities that neighbor production facilities with cancer-causing pollution," Bloomberg Philanthropies Beyond Petrochemicals executive director and one of the report's sponsors Heather McTeer Toney toldThe Guardian. "The consequences of this industrys unfettered carbon emissions will reach everyone on the planet."
The scientists found that even a conservative scenario of the plastic sector growing at 2.5 percent per year would result in a future in which greenhouse gas emissions from plastic production could more than double by 2050 and make up 21 to 26 percent of the planetary carbon budget that keeps temperatures below 1.5 degrees Celsius.
A less conservative scenario in which the plastic sector grows by four percent per year would see greenhouse gas emissions increasing three fold by 2050, making up a staggering 25 to 31 percent of the planetary carbon budget to keep warming at 1.5 degree Celsius.
The team arrived at the findings by analyzing how plastic is produced, from the extraction of fossil fuels toproducing finished products.
The findings are grim, according to the scientists, and defy easy fixes much like the rest of the climate crisis, tragically.
More on plastic: Scientists Find Bottled Water Filled With Hundreds of Thousands of Microplastics
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Head of NASA Says China Is Hiding Military Experiments in Space – Futurism
Posted: at 10:39 am
"We believe that a lot of their so-called civilian space program is a military program." Full Nelson
NASA's administrator is once again making outrageous claims about China's space capabilities and in the process, fueling the off-world rivalry between the two.
"We believe that a lot of [China's] so-called civilian space program is a military program," Administrator Bill Nelson said during remarks on Capitol Hill this week, per The Guardian. "And I think, in effect, we are in a race."
The comments, as the website notes, came during a hearing before the House Appropriations Committee which means that Nelson was making them while asking for money for NASA, which has requested a whopping $25.384 billion for its 2025 funding.
"China has made extraordinary strides, especially in the last 10 years," Nelson continued, "but they are very, very secretive."
It's unclear from the reporting about the administrator's comments what evidence his claims are riding on. This is not, as we mentioned, the first time Nelson has made such bold accusations about our sometimes-ally.
Sworn in in May 2021, Nelson has for much of his tenure warned that China could usurp America's space advantage at any moment and has used similarly bold claims to demonstrate that point.
Just a year into the job and during another House Appropriations Committee hearing the administrator straight-up accused China of stealing American spacecraft designs.
"Yeah, they're pretty good at stealing," Nelson told the subcommittee in May 2022, "and I think that's incumbent upon us to take cybersecurity very, very seriously."
Just a few months later, he claimed in an interview with a random German newspaper that China wants to "steal" the Moon as well, which prompted a response from the rival nation.
"The US side has constantly constructed a smear campaign against China's normal and reasonable outer space endeavors," Chinese foreign ministry spokesperson Zhao Lijian said in a press statement, "and China firmly opposes such irresponsible remarks."
While there certainly is no love lost between Nelson and his Chinese counterparts, the incendiary discourse between these space race rivals generally seems to originate on the American side.
Last fall, Nelson again claimed that China plans to hoard lunar resources for itself, which would go against the United Nations' binding space treaty of 1967 and in his more recent remarks, he reiterated those remarks while begging for more money.
"The latest date they've said they're going to land [on the Moon] is 2030, but that keeps moving up," Nelson told Congress, per transcription from Sky News. "It is incumbent on us to get there first and to utilize our research efforts for peaceful purposes."
At this point, the lengthy list of receipts of this sort of recurrent rhetoric coming from the top of NASA does make one wonder: is China on the offensive, or is America?
More on NASA: NASA Admits Space Station Junk Crashed Through Man's Roof
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4240 book ban tries, not bad for media that futurists said would be dead by now – Manteca Bulletin
Posted: at 10:39 am
I do not consider myself a nerd.
But what you are about to read may make it hard to believe that statement.
My mom didnt splurge on luxuries.
She didnt own new furniture with the exception of a mahogany formal dining room set that was a wedding gift from my dad until she was in her late 50s.
But there were a few things that most wouldnt consider essential, that she made sure she bought regardless of the scrimping it took.
One of them was encyclopedias.
The value of books, especially encyclopedias, was instilled in my mom by her mother.
Edna Towles formal education ended in the eighth grade.
Grandmother taught in a one-room school house for two years in the wilderness that was the Smartville area in western Nevada County just after the dawn of the 20th century.
She became a cattle ranchers wife and then ended up as the rancher when my grandfather left her high and dry with seven kids to raise at the start of the Great Depression.
It clearly was a struggle. Despite that, she found a way for her kids to have a used encyclopedia set at home.
My mom started acquiring encyclopedias for her kids the way many households did in the 1950s and early 1960s.
It was one volume at a time through weekly grocery store promotions.
That is how our familys first encyclopedia set, The Golden Book Childrens Encyclopedia, was obtained.
It was also the way the second set, The Golden Book Encyclopedia for Home & High School, made its way into our household.
When my oldest brother was about to enter high school, mom decided she needed to get better encyclopedias.
The result were three sets she bought on the installment plan for what was then an ungodly sum of $200.
They were the Book of Knowledge, Grolier Encyclopedia, and The Book of Popular Science Encyclopedia.
She also, for a number of years, bought a hardback annual recap of world events the Book of Knowledge published each year.
When I was 7 years of age, there were five encyclopedia sets in our house.
My brothers used them to help with homework.
I went one step further.
I read them for pleasure. All of them.
I would entertain myself for hours doing just that.
If that doesnt strike you as a bit nerdish, it was just a precursor.
By the time I was in the eighth grade and earning money doing odd jobs, I was able to put aside money not needed for clothes to buy subscriptions to three magazines.
Boys Life? Sports Illustrated? Popular Mechanics?
Try Newsweek, Time, and US News & World Report.
Three weekly news magazines I couldnt wait to arrive in the mail.
I took it further.
My mom allowed me to tack the covers of Newsweek and Time US News & World Report was pretty boring to my bedroom wall.
Other preteens had posters of sports figures and such plastering their walls.
I had images of politicians and newsmakers.
Real photographs from Newsweek and artist renderings which was Times forte.
It goes without saying that I place a large degree of value in the printed word, literally and figuratively.
It doesnt take too much of a leap to figure out that I had a well-worn library card growing up.
That said, Im not a book collector, per se.
I do have some books that I keep and periodically reference and read again.
The biggest collection is centered around water and its politics.
Much of my reading today consists of PDFs produced by government agencies that are sometimes so laborious and lengthy, they take longer to download than the Titanic takes to upload.
Its been more than a few years since Ive made my way to the library to browse the shelves.
That, by the way, is the best way to find something of interest that youd never try on your own. More horizons and such get opened up that way.
Which is why I abhor algorithms think Netflix to recommend what you should explore. All it does is limit your world if you follow their led.
It is also why I take a dim view of those seeking to ban books that they dont agree with or feel threatened by.
There were 4,240 different book titles targeted for banning in 2023, according to the American Library Association.
Its the most titles ever since the association started tracking book ban efforts decades ago.
For a bit of comparison, the 2023 numbers for books targeted for banning in schools and public libraries was up 65 percent from the previous year.
Its roughly 15 times more than in 2015 when 275 titles were challenged including the Bible.
The two biggest states for attempts to ban books were Florida at 2,672 titles followed by Texas at 1,470.
James LeRue, Director of the Office for Intellectual Freedom back in 2015, noted book bans reflect the fact cultures change over time, and the things we fear, or celebrate, change with them.
Going from 275 unique books being targeted for banning a decade ago to 4,270 today does indeed reflect there is a lot of fear today.
California, by the way, in September of last year thanks to legislative action, became one of two states to outlaw book bans in public schools.
Book bans speak volumes.
Especially today, 24 plus years beyond when some futurists in the 1980s predicted libraries would be obsolete and printed books superfluous.
This column is the opinion of editor, Dennis Wyatt, and does not necessarily represent the opinions of The Bulletin or 209 Multimedia. He can be reached at dwyatt@mantecabulletin.com
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Chinese Cities Are Sinking Into the Earth, Scientists Find – Futurism
Posted: at 10:39 am
This is bad. Sinking Feeling
A new study has discovered that a staggering number of Chinese cities are sinking into the Earth.
According to the study, which was conducted by a team of over 50 Chinese scientists using radar observations and published this week in the journal Science, almost half of China's 82 major cities are experiencing rapid subsidence.
Subsidence, or the scientific term for the Earth's surface effectively sinking in on itself, is a serious issue. Not only does it present obvious infrastructure and safety dangers, but as NPR notes, sinking land is also known to expedite the problem of already-rising coastlines. And by these researchers' estimates, the extreme sinking observed in China could mean that about a quarter of the nation's coastal regions are below sea level by the year 2120.
Combine the problem of sinking cities with China's massive population, and as the researchers point out in their study, you have a recipe for a human and infrastructural disaster.
"Even a small portion of subsiding land in China," the researchers write, "could therefore translate into a substantial threat to urban life."
Subsidence isn't just a problem in China. Countries worldwide are experiencing a concerning level of land sink, and in January, a satellite-based study revealed that US' major East Coast population centers are similarly caving into the Earth, as are gulf cities like New Orleans and Houston.
"This is a big problem," Robert Nicholls, a professor of climate adaptation at the University of East Anglia in England who wasn't involved with the study, told NPR. "The scale is large."
"Without doubt," he added, this new study "brings home that this is not a local problem. This is a national, or even international, problem."
But while land sinking is an international problem, cities in Asia might be uniquely at risk. As Nicholls reportedly told NPR, Asian cities are commonly constructed on river deltas, which are particularly susceptible to subsidence. The Indonesian capital city of Jakarta, for example, was built on a river delta and is sinking beneath sea level at a deeply alarming rate.
In short, subsidence is a growing threat. And while mitigating subsidence is a complicated fix, this latest study highlights just how important those mitigation efforts might just be for protecting land for future generations.
"Our results underscore the necessity of enhancing protective measures," the researchers write, "to mitigate potential damages from subsidence."
More on subsidence: Satellites Show the East Coast Is Sinking
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How one ‘futurist’ is using tech to run the London marathon faster – City A.M.
Posted: at 10:39 am
Saturday 20 April 2024 8:00 am
Bill Quinn is a so-called futurist who is using technology to improve his performance in sporting events such as the London Marathon, which is this year sponsored by tech company Tata Consultancy Services.
First thing in the morning, most people reach for their phones. Not Bill Quinn though. Instead, he checks his rest and recovery data to gauge how well-rested he is from the previous days activities.
Quinn is a so-called futuristsomeone fascinated by exploring predictions about the future.
His particular focus is on the future of running. Having completed the New York marathon last year, hes now gearing up to join the 50,000 runners tackling the 26-mile course across London this weekend.
During these runs, Quinn, who considers himself an average runner, constantly monitors his progress using various devices. These include an Apple Watch on one wrist, a rest and recovery monitor on the other, and a glucose monitor measuring blood sugar levels on one arm.
I wanted to experiment with whether consumer-grade wearables could create a digital twin of myself, he explained.
Early on in his experiment, which has spanned a number of months, Quinn took the data from his devices and cobbled it all together in a spreadsheet. I could see what my average heart rate was when I was on this run, but then also what was my glucose level during that one, he said.
The point of stitching all this information together was to create a digital twin of himself. Using this modelling, Quinn could see exactly what he needed to do to enhance his athletic performance.
Its all about understanding whats going on in that environment, he explained, and then also being able to do scenario planning to plan and try out different scenarios to optimise for the future.
The 50-something-year-old estimated he spends around $1,000 per year on various health and fitness subscriptions.
It was really just kind of an experiment to understand whats available to the average person in terms of a digital twin, Quinn said.
By comparison, American tech entrepreneur Bryan Johnson is spending millions a year improving his fitness levels in an attempt to reverse the ageing process.
Although Quinn currently uses technology mostly for sports, it has heightened his awareness of diet. But long-distance running events like the London Marathon are just one of the circumstances where the concept of digital twin technology can make a difference.
Quinn also envisions a future where data will play a significant role in healthcare.
For example, health metrics could be continuously monitored and automatically shared between patients and doctors, rather than relying on sporadic annual check-ups.
This data-driven approach can detect and address conditions like heart disease, diabetes, and cancer early on, significantly reducing healthcare costs and enhancing overall wellness.
I think theres a huge opportunity in the medical field for this data to be leveraged, he said.
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MIPAD announces the Global Top 100 Futurists Edition on World Creativity and Innovation Day – Africa.com
Posted: at 10:39 am
NEW YORK, USA, 23 April, 2024,-/African Media Agency (AMA)/-The Most Influential People of African Descent (MIPAD) proudly announces thedistinguished honoreesof the Class of 2024 in theGlobal Top 100 Futurists Edition onWorld Creativity and Innovation Day.
Embracing the ethos of recognition and aligning with the 1st pillar of theInternational Decade for People of African Descent, MIPAD shines a spotlight onindividuals,organizations, andgovernmentswho have exemplified exceptional leadership in advancing people of African descent worldwide.
Kamil Olufowobi, Founder & Chairman of MIPAD, emphasized that these global lists signify the organizations ongoing commitment to showcasing the positive impact made by individuals of African descent across the globe. We are dedicated to amplifying the diverse narratives of the global Black community and illuminating the countless untold stories of our challenges and triumphs, spanning every corner of the world and reaching even the highest echelons of influence, he remarked.
MIPAD extends heartfelt congratulations to the exceptional individuals recognized in the Class of 2024. Their remarkable achievements and unwavering dedication serve as beacons of inspiration for humanity.
TheClass of 2024 Global Top 100 Futurists Editionencompasses three distinct categories:Afrofuturism & Creatives, Futurists, andInnovators & Changemakers.Recognizing individuals who have made remarkable contributions to shaping the future and pioneering innovative solutions within their respective fields.
Finalists are highlighted within three category:
AFROFUTURISM & CREATIVES:This category celebrates individuals who explore the intersection of African culture, science fiction, and art, shaping imaginative futures and pushing creative boundaries.
FUTURISTS:Recognizing those at the forefront of technological advancement, this category honors individuals who innovate in fields such as artificial intelligence, cybersecurity, and finance, shaping the future of technology and society.
INNOVATORS & CHANGEMAKERS:Highlighting individuals who drive change through groundbreaking sustainable practices, and transformative initiatives, this category acknowledges those who are shaping a better future for all.
Join us in celebrating the 2024 MIPAD Honorees for their transformative contributions to societies worldwide, their resilience, and their indomitable spirit in overcoming adversity. BRAVO!
Please visitwww.mipad.org/classof2024to see complete list.
We look forward to hosting all of our Honorees, past and present, in New York City for Most Influential 100Recognition Week 2024 (RW2024) September 20th 22ndfollowing the opening of the 79th United Nations General Assembly in New York City #UNGA
For congratulatory ads, sponsorship & speaking opportunities, please contactinfo@mipad.orgor call +1 917 541 8394or+1 917 256 9940(New York)
Distributed byAfrican Media Agency (AMA)on behalf of MIPAD.
About Most Influential People of African Descent(MIPAD)
The Most Influential People of African Descent (MIPAD), is a global civil society initiative in support of the International Decade for People of African Descent, proclaimed by United Nations General Assembly resolution 68/237, to be observed from 2015 to 2024. MIPAD identifies high achievers of African descent in public and private sectors from all around the world as a progressive network of relevant actors to join together in the spirit of recognition, justice and development.
MIPADs Global Most Influential 100 Publications2023|2022|2021|2020|2019|2018|2017
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Guselkumab Demonstrates Significant Improvement in Psoriasis Symptoms and HRQoL, Reduces Sexual Impairment … – Dermatology Times
Posted: April 18, 2024 at 3:39 pm
Guselkumab demonstrates significant improvements in psoriasis symptoms and health-related quality of life (HRQoL), according to week 28 results of the German G-EPOSS study published in the Journal of the European Academy of Dermatology and Venereology. The study also found that guselkumab reduced sexual impairment and perceived stigmatization in participants.1
Researchers Gerdes et al sought to evaluate the efficacy and safety of guselkumab, particularly in the above disease-specific and social domains. It is well-documented that the burden of psoriasis extends beyond physical symptoms, significantly impacting patients' quality of life, leading to psychological distress and social stigma.2
Furthermore, sexual impairment and stigmatization are significant yet often overlooked dimensions of psoriasis-related morbidity. Patients with psoriasis, especially those with genital involvement, are at increased risk of sexual dysfunction and stigmatization.3 In fact, the World Health Organization lists sexual impairment and perceived stigmatization as key components of its comprehensive psoriasis action plan.4
"Stigmatization affects 73%99% of patients with psoriasis and can result in social exclusion, depression, fear of loss of employment and embarrassment, and can impact on relationships/family planning," according to the study's authors.
Researchers conducted the G-EPOSS study, a prospective, non-interventional, multicenter study. Patients with moderate-to-severe plaque psoriasis were enrolled in the study between October 2019 and August 2021 across 44 study sites in Germany.
Participants were required to be 18 years of age and older with a plaque psoriasis diagnosis of moderate-to-severe nature as determined by a baseline Psoriasis Area and Severity Index (PASI) score of greater than 3 and were candidates for systemic therapy. Prospective patients were also required to be candidates for systemic therapy. Apart from biologic therapies, any individuals taking concomitant medications for their psoriasis were permitted to maintain usage of these medications.
All patients received 100 mg of guselkumab at weeks 0, 4, and every 8 weeks afterwards through a total duration of 76 weeks.
In total, 304 patients were part of the safety analysis, having received at least one dose of guselkumab, with 293 included in the evaluable set population. Patients were excluded from the evaluable set population if they lacked post-baseline PASI measurements or deviated significantly from the observational plan. Data was available for different time points: 282 patients at week 12, 252 at week 20, and 265 at week 28. Patient withdrawals before week 28 were minimal, with 6 (2.0%) attributed to adverse events.
Baseline characteristics, such as age, gender distribution, weight, BMI, and disease duration, were recorded. Prior treatment history indicated that a significant proportion of patients had received systemic (58.0%) or biologic (25.9%) therapy before participating in the study.
"Stigmatization affects 73%99% of patients with psoriasis and can result in social exclusion, depression, fear of loss of employment and embarrassment, and can impact on relationships/family planning."
The study demonstrated significant improvements in psoriasis severity and related symptoms with guselkumab treatment. A substantial percentage of patients achieved primary endpoints of PASI3 (83.0%), PASI1 (56.2%), and PASI=0 (35.1%) by week 28. Nail disease and anogenital psoriasis also showed considerable improvements.
Patient-reported outcomes, particularly Dermatology Life Quality Index (DLQI) and Relationship and Sexuality Scale (RSS), indicated enhanced quality of life and sexual satisfaction. DLQI scores improved, with a majority achieving DLQI 01 at W28. RSS responses showed decreased sexual impairment and fear of sexual intercourse, with an increase in satisfaction with sexual frequency.
Perceived stigmatization, as assessed by the Perceived Stigmatization Questionnaire, decreased over time, indicating reduced social discomfort associated with psoriasis.
Safety outcomes showed that adverse events were generally mild, with infections, skin disorders, and musculoskeletal issues being the most common. Drug-related adverse events were infrequent, with no drug-related serious adverse events or withdrawals due to such events.
"The PRO results demonstrate the clinical relevance of Q9 of the commonly used DLQI as a sentinel to trigger further investigations into sexual difficulties or anogenital skin involvement," wrote Gerdes et al. "Such a holistic approach to patient care may not only positively impact the patient's sense of self-esteem but also the patient's overall degree of social engagement and participation. Further results from the final W76 analysis of G-EPOSS will follow and provide further insights."
References
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Psoriasis Patients with Arthralgia At Increased Risk of Psoriatic Arthritis Development – MD Magazine
Posted: at 3:39 pm
Individuals with psoriasis with unexplained arthralgia and non-inflammatory symptoms are at a far greater risk of psoriatic arthritis (PsA) development, according to new findings, providing new information on subclinical PsA.1
These findings resulted from new research conducted due to the lack of real-world data on subclinical PsA, which is described as the existence of arthralgia in psoriasis patients. This was considered invaluable given the noted higher risk of PsA among those with subclinical PsA.
The new analysis was led by Alen Zabotti, from the department of medical and biological sciences at the University Hospital Santa Maria della Misericordia Rheumatology Clinic in Udine, Italy. Zabotti et al. acknowledged that a prior systematic literature review had indicated the lack of data on the transition between psoriasis to PsA.2
These could help to better define outcomes for PsA prevention studies in the context of prevention/interception of PsA and early diagnosis, Zabotti and colleagues wrote. Therefore, this study investigated the subclinical stage of PsA in terms of risk of progression and clinical symptoms, and to describe the clinical features of new-onset PsA in (psoriasis) cases.3
The investigators assessed data drawn from 2 ongoing European prospective cohorts of individuals with psoriasis, looking at both the Italian cohort, RAPSODI (Ultrasonographic Risk Factors to Develop Psoriatic Arthritis in Psoriatic Patients with and Without ClinIcal Arthralgia), and the German PACE cohort (Psoriasis and Psoriatic Arthritis Cohort Erlangen), both of which were longitudinal studies.1
Subjects featured within the 2 cohorts had been given a diangosis with definite psoriasis of the skin or nails by dermatologists. They were also enriched for PsA risk, with many having arthralgia suggesting a potential risk of PsA development.
The investigators looked at study participants that did not have clinical PsA by the time of their entry to the cohort and those with no visible swelling of joints. Subjects with a history of enthesitis, synovitis, dactylitis, or inflammatory back pain were not included in the research, and those who were included were reassessed every half year, being told by the team to report inflammatory symptoms to their designated rheumatologists.
In the period between January 2017 - December 2022, there had been 215 Italian participants enrolled in RAPSODI with psoriasis, of which 66.0% were shown to have baseline arthralgia indicating the presence of subclinical PsA. Within those in the PACE cohort, 169 participants in total between January 2011 - July 2018, all were determined to have subclinical PsA.
The investigators diagnosed new-onset clinical PsA at the time of follow-up through the use of experienced rheumatologists and with CASPAR criteria fulfillment. The team would also characterize the manifestations of subjects new-onset clinical PsA by enthesitis, dactylitis, peripheral arthritis, and axial involvement.
Additionally, the team recorded participants clinical features at the time of PsA diagnosis, some of which included enthesitis index, joint counts, and presence of dactylitis.
There were 384 individuals given a diagnosis of psoriasis who took part in the study, as well as an average follow-up duration of 33.0 months. Additionally, 80.9% of these individuals were shown to have subclinical PsA, indicating there had been an incidence rate of PsA of 7.7 per 100 patient-years.
The investigators reported that their subclinical PsA patients had a significantly higher risk of developing PsA as opposed to subjects that had psoriasis exclusively (HR=11.7, 95% CI 1.57 to 86.7, P = .016). The research team noted that the cumulative incidence function (CIF) estimated the probability of new-onset PsA was about 9.4% (95% CI 4.7% - 10.6%) by the 12-month mark and that it was 22.7% (95% CI 17.2% - 28.6%) by the 36-month mark.
A notable finding was that 58.9% of subjects had been shown to have inflammatory symptoms during the months immediately preceding their diagnosis of PsA, but 83.9% were found to have non-inflammatory symptoms before their PsA diagnosis. Additionally, the most frequent pattern of presentation was shown to be peripheral joint swelling for 82.1% of those with PsA.
We have confirmed that patients with (psoriasis) experiencing unexplained arthralgia, also reporting non-inflammatory symptoms, are at a significantly elevated risk of developing PsA, they wrote. Additionally, peripheral arthritis, mainly oligoarthritis, is the most common PsA presentation in cohorts with PsO enriched for arthralgia.
References
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Psoriasis Patients with Arthralgia At Increased Risk of Psoriatic Arthritis Development - MD Magazine
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Secukinumab 300 mg May Improve PsA or Active Psoriasis More Than 150 mg – MD Magazine
Posted: at 3:39 pm
Alan J. Kivitz, MD
Credit: Altoona Arthritis and Osteoporosis Center
A new study found certain doses of secukinumab had greater odds of alleviating psoriatic arthritis (PsA) symptoms than placebo.1
In general, US patients treated with secukinumab 300 mg and secukinumab 150 mg with loading dose achieved the highest response rates, including ACR50 and ACR70 responses and the proportions of patients showing at least an MCID improvement in the health-related quality-of-life measure HAQ-DI, wrote investigators, led by Alan J. Kivitz, MD, from the Altoona Center for Clinical Research/Altoona Arthritis and Osteoporosis Center.
PsA is linked to reduced quality of life, physical function, and work productivity. Five FUTURE studies have shown secukinumab, a selective inhibitor of interleukin 17A, provides rapid and significant improvement in the symptoms of PsA and has a favorable safety profile.2
Investigators aimed to compare secukinumab and placebo in challenging-to-treat US patients with PsA.1 They pooled data from patients enrolled in phase 3 FUTURE 2 5 studies, excluding FUTURE 1 due to the study including an intravenous loading dose that is not approved by the US Food and Drug Administration (FDA) or the European Commission (EC) for PsA.
The FUTURE 2 5 trials randomized US patients who were in the minority of the total population with a harder-to-treat disease. This means patients may have had a greater body weight, greater tender and swollen joint counts, and a greater likelihood of enthesitis, dactylitis, and prior exposure to tumor necrosis factor inhibitors (TNFi). Patients either received secukinumab 300 or 150 mg with or without a subcutaneous loading dose or placebo.
The team assessed efficacy, health-related quality of life, and safety at week 16. Subgroup analyses examined TNFi status and body mass index (BMI). With logistic regression, they estimated odds ratios for the American College of Rheumatology (ACR) 20/50/70 and Psoriasis Area and Severity Index (PASI) 75/90/100 responses by treatment.
Although 2147 patients were originally randomized, the current pooled analysis only included 279 patients with 55.6% women. Participants had a mean BMI of > 30 kg/m2 and 55.2% had prior TNFi treatment.
Overall, at week 16, patients on secukinumab 300 mg (59.7%; P < .0001) and secukinumab 150 mg with loading dose (43.4%; P < .0001) had significantly greater ACR20 response rates. Patients on secukinumab 150 mg without a loader dose had greater response rates than placebo but was non-significant (32.5%; P = .30).
When evaluating the PASI score at week 16, patients had greater response rates on secukinumab than on placebo, with more improvements on secukinumab 300 mg than secukinumab 150 mg. Compared to placebo (9.1%), more patients on secukinumab had improved nail disease, with mNAPSI75 rates of 36.4, 24.6, and 15% for secukinumab 300, 150, and 150 mg without loading dose, respectively. Patients also had more improvements in health-related quality of life at week 16 when on secukinumab.
Patients responded to secukinumab as early as week 4, and ACR50 and ACR70 responses were greater with any secukinumab dose than placebo. More patients on secukinumab than placebo had a 100% reduction in PsA symptoms.
When evaluating the odds ratio, the findings revealed patients receiving secukinumab 300 mg and 150 mg with loading dose had greater odds of responding to at least 20%, 50%, or 70% of the treatment in tender and swollen joints (ACR 20/50/70) (P < .05) than patients on placebo. This indicates patients on secukinumab 300 mg and 150 mg with loading doses have the greatest clinical response rates. In contrast, Patients on secukinumab 150 mg without loading dose did not have better odds than placebo.
Patients on all doses of secukinumab had greater odds of a 75% greater reduction in PASI scores from baseline (PASI75) compared to placebo (P < .05). As for a 90% of 100% improvement from baseline on the PSAI score (PASI90 and PASI100), only the secukinumab 300 mg group worked significantly better compared to placebo (P < .05).
Secukinumab was also demonstrated to be as safe as placebo, with the frequency of all treatment-emergent adverse events similar for patients receiving secukinumab 300 mg (51.4%), secukinumab 150 mg with loading dose (54.2%), secukinumab 150 mg without loading dose (55.9%), and placebo (64.4%). The most common adverse events were upper respiratory tract infection, nasopharyngitis, nausea, and sinusitis.
Overall, secukinumab brought rapid improvements in disease activity and quality of life. The results suggest secukinumab 300 mg better improves symptoms of PsA and active psoriasis than secukinumab 150 mg.
The team underlined many limitations, including not adjusting for logistic regression analyses, nominal P values were calculated for hypothesis generation, patients were not stratified based on weight or BMI at randomization, radiographic progression data was only available from FUTURE 5, and patients in all groups had variability in vdH-mTSS scores from baseline to week 24.
This analysis also suggests that a loading-dose regimenparticularly for patients receiving secukinumab 150 mgincreases the odds of optimal outcomes in US patients with PsA treated with secukinumab, investigators concluded.
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Secukinumab 300 mg May Improve PsA or Active Psoriasis More Than 150 mg - MD Magazine
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Guselkumab Led to Improvements Over Several Psoriatic Arthritis Disease Domains – MD Magazine
Posted: at 3:39 pm
Laura C. Coates, MBChB, MRCP, PhD
Credit: X (Twitter)
Guselkumab treatment led to early and durable improvements in key Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-recognized areas In biologic-nave psoriatic arthritis (PsA) patients through 2 years, according to new findings.1
These findings represented the conclusion of a new post-hoc analysis of the phase 3, double-blind, randomized, placebo-controlled trial assessing treatment of PsA with guselkumab among adults with active disease. The phase 3 analysis had been carried out in the period between July 2017 - November 2020.
This new post-hoc analysis was led by Laura C. Coates, MBChB, MRCP, PhD, from the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at University of Oxford in the UK. Coates and colleagues noted the 6 GRAPPA disease domains, adding that the GRAPPA guidelines urge achievement of the lowest possible disease activity level across all domains.2
Informed by the GRAPPA treatment goal of achieving the lowest possible level of disease activity in all affected disease domainsthe objective of the present post hoc analysis was to evaluate the long-term (Week 100) effectiveness of guselkumab across GRAPPA-identified PsA domains and related conditions assessed in DISCOVER-2, Coates and colleagues wrote.
As mentioned previously, the research team carried out their post-hoc analyses of the phase 3 data drawn from the DISCOVER-2 study, a trial which had been aimed at subjects who had been biologic or Janus kinase inhibitor-nave and active PsA. Active disease had been defined as maintaining 5 swollen joints minimum as well as 5 tender joints at least and a C-reactive protein level of 0.6 mg/dL or more.
Study subjects were randomized using a 1:1:1 ratio, being treated with either guselkumab every 4 weeks (Q4W) or the same treatment every 8 weeks (Q8W). The alternative was receiving a placebo with crossover to guselkumab in the subsequent period.
The investigators looked at several different domains highlighted by GRAPPA, which included peripheral arthritis, overall disease activity, enthesitis/dactylitis, axial disease, and skin psoriasis. Additionally, the research team assessed PsA-connected issues including uveitis and inflammatory bowel disease (IBD), evaluated through adverse events (AEs) reported up to the 112-week mark.
The team looked at post-baseline changes through the 100-week mark in continuous outcomes, implementing repeated measures mixed-effects models as well as adjusting for patients scores at baseline. Rates of response rates in binary measures were identified by the investigators through the use of non-responder imputation methods.
The research team reported that 90% of the subjects who had been randomized to be treated with guselkumab finished up the process by the 100-week point. Following an initial disease activity decrease with the drug, the team identified sustained signs of success over several of the aforementioned domains of PsA up to Week 100.
The investigators found that the participants rates of reaching their therapeutic targets showed signs of increasing through the 100-week mark with the drug administered to subjects Q4W or every 8 weeks (Q8W). These signs of improvement included low disease activity (LDA) achievement according to the Disease Activity Index for PsA being 62% with Q4W and 59% after Q8W.
The research team also noted enthesitis rates of resolution being 61% and 70% following Q4W and Q8W, respectively, and dactylitis resolution rates being 72% and 83% with Q4W and Q8W, respectively. Furthermore, the team found subjects with 100% improvement in their Psoriasis Area and Severity Index scores (PASI 100) were 59% and 53% with Q4W and Q8W, respectively.
Lastly, those reporting LDA according to the Psoriatic Arthritis Disease Activity Score were 51% and 49% with Q8W and Q4W, respectively, as well as minimal disease activity achievement among 38% and 40% with Q4W with Q8W, respectively.
The investigators found no instances up to the 112-week point of IBD among subjects who had been given guselkumab. Additionally, only a single case of uveitis was observed.
No exacerbations or new onset of IBD were reported, with a single occurrence of uveitis observed through Week 100 in guselkumab-treated patients, aligning with the established safety profile of guselkumab, they wrote.
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Guselkumab Led to Improvements Over Several Psoriatic Arthritis Disease Domains - MD Magazine
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