Mental Health, Comorbidities, and PsA Combination Therapy Trials

"Mental Health, Comorbidities, and PsA Combination Therapy Trials" explores what the Together-PsA data showed beyond its primary endpoints.

Dr. Perkins notes that veterans living with PTSD and trauma often want mental health improvement alongside disease control. That adds another layer rheumatologists must juggle when managing complex disease. Dr. Bakewell then asks about research beyond the Together-PsA trial itself. She specifically asks about comparing ixekizumab plus tirzepatide against ixekizumab alone on purely rheumatologic outcomes. Dr. Perkins says psoriatic arthritis carries comorbidities that make this an active research area. That includes brain-body connections such as cognition, brain fog, focus, memory, and mood disorders, where few existing drugs show clear benefit. She says this drug class already demonstrates clear cardiac and cardiovascular protection, and changes to cholesterol and blood pressure. It also shows kidney protection, liver protection, and better sleep, separate from weight-loss effects alone. She adds that broader research is underway across autoimmune disease and osteoarthritis, not just psoriatic arthritis. Importantly, she says the trial demonstrated that the combination could be used safely. That addressed one of Kameillia's earliest questions, about whether she could keep her existing medication while adding a new one and still tolerate both without complications.

Dr. Perkins addresses the practical side of prescribing incretin therapy for psoriatic arthritis, starting with the early GI side effects patients commonly experience. She says patients must genuinely change how they eat, starting low, going slow, and learning to eat for satiety rather than habit. She notes rheumatologists are already well-versed in nutrition counseling from years of managing inflammatory disease, which makes this an easier fit than it might first appear.

Our next episode, "Emerging Research and Reduction in Medication Use with Combination PsA Care," focuses on emerging registry research and medication list reduction with combination therapy.