Benefits of Concomitant Treatment with Ixekizumab and Tirzepatide for Patients with Psoriatic Disease and Overweight/Obesity: An Overview of Results from the together Trials

Presenter: Joseph F. Merola

Psoriasis (PsO) and psoriatic arthritis (PsA) frequently coexist with overweight or obesity, making weight management an important component of patient care. In the open-label Phase 3b TOGETHER-PsO (N=274) and TOGETHER-PsA (N=271) trials, adults were randomised 1:1 to concomitant ixekizumab plus tirzepatide (IXE+TZP) or ixekizumab (IXE) alone for 52 weeks with lifestyle counselling; key endpoints were multiplicity-controlled, others nominal (95% confidence intervals [CIs], Wald method). At week 36, combination therapy improved simultaneous Psoriasis Area and Severity Index 100 (PASI100) or American College of Rheumatology 50% improvement (ACR50) with ≥10% weight reduction occurred in 27.1% vs 5.8% in PsO (treatment difference [Δ] 21.2%; 95% CI 12.8–29.7) and 31.7% vs 0.8% in PsA (Δ 30.9%; 22.6–39.1); p<0.001. Dermatology Life Quality Index (0,1): 71.7% vs 58.3% (p=0.021); itch did not differ (p=0.800). In PsA, fatigue (8.6 vs 4.8), disease impact (−2.7 vs −2.0), disability (−0.5 vs −0.3), mental (3.1 vs 0.4) and physical (9.7 vs 6.2) health favoured IXE+TZP. Concomitant treatment with ixekizumab and tirzepatide was associated with greater improvements in disease control, weight loss, cardiometabolic outcomes, and quality-of-life measures compared with ixekizumab alone. These highlights the potential benefits of integrating weight management into the care of patients with psoriatic disease and overweight/obesity.

Beyond The Skin: Nail involvement as a Potential Early indicator of Psoriatic Arthritis in Pediatric Psoriasis

Presenter: Line Baalbaki

Nail abnormalities in pediatric psoriasis have been linked to greater severity and possible musculoskeletal involvement, but their relationship with early psoriatic arthritis (PsA) remains unclear. This scoping review searched PubMed, Scopus and Google Scholar (English-language studies, January 2010–March 2026) and qualitatively synthesised 24 studies, mainly observational cohorts and case series. Nail involvement prevalence in pediatric psoriasis ranged from approximately 15% to 32%, with pitting, onycholysis, subungual hyperkeratosis and dystrophy. Nail disease was associated with scalp involvement, higher severity scores, enthesitis, arthralgia and early PsA features; in one cohort of 313 children, nail involvement occurred in 32.3% and was significantly associated with PsA. Psychosocial and functional burden was greater. Biologics improved skin and nail symptoms; longitudinal pediatric data were limited. Nail involvement may identify children requiring closer musculoskeletal monitoring, supporting earlier monitoring and multidisciplinary management.

Cardiovascular Risk in Patients with Psoriasis: Prevalence of Risk Factors and Need for Multidisciplinary Screening in Routine Practice

Presenter: Tatiana Golovanova

 Psoriasis is associated with increased cardiovascular (CV) morbidity and mortality, yet CV risk is frequently underestimated. This single-centre, case-control study assessed CV risk factors and 10-year risk in 32 adults >40 years with psoriasis from a very high-risk region, using clinical data, lipids, glucose and age-adapted Systematic COronary Risk Evaluation 2 (SCORE2)/SCORE2-Older Persons (OP). At least one traditional risk factor affected 30 patients (94%); three or more, 14 (44%) of those with moderate-to-severe psoriasis. Hypertension affected 22 (69%), dyslipidemia 19 (59%), smoking 15 (47%). SCORE2/OP classed 2 patients (6%) as low, 11 (35%) high and 19 (59%) very high risk. Higher Psoriasis Area and Severity Index scores and longer disease duration were associated with higher risk (p<0.01). Most of the patients had not been examined by a cardiologist or properly treated (antihypertensive, lipid-lowering). Risk factors were common, especially in severe, long-standing disease, supporting systematic CV assessment and multidisciplinary collaboration.

Characteristics Influencing the Prevention of Psoriatic Arthritis with Secukinumab in Patients with Moderate to Severe Plaque Psoriasis: 5-Year Real-World Results from The Serena Study

Presenter: Matthias Augustin

Psoriatic arthritis (PsA) can develop in people with psoriasis (PsO), and identifying characteristics associated with its occurrence remains clinically relevant. The SERENA study previously reported an approximately 67% reduction in annual PsA incidence with secukinumab versus a historical nonbiologic treatment cohort. This post hoc analysis of a prospective, observational real-world study examined factors associated with PsA development in 1,334 adults with moderate-to-severe plaque PsO and no prior PsA, across 438 sites in 19 countries, with 4,672 patient-years of follow-up. In 5 years, 96.9% (1292/1334) remained free from PsA; the exposure-adjusted incidence rate was 0.90 per 100 patient-years. Male sex was associated with lower risk than female sex (hazard ratio [HR], 0.52; P=0.0353). PsO duration <15 versus ≥15 years showed a similar trend (HR, 0.48; P=0.0546), which did not meet conventional statistical significance. Age, weight, body mass index, race, prior biologic exposure, smoking, baseline Psoriasis Area and Severity Index, nail involvement, Physician Global Assessment and body surface area were not significantly associated with PsA development. At 5 years, 67.3% achieved PASI 90 and 44.0% PASI 100. Long-term secukinumab therapy was associated with sustained skin clearance and potential reduction in PsA risk.

Efficacy of Secukinumab in Patients with Psoriasis Affecting Difficult to Treat Areas: A Post Hoc Analysis of 4 Phase 3 Secukinumab Trials

Presenter: April W. Armstrong

Scalp and palmoplantar psoriasis (PsO) are difficult-to-treat manifestations that can make disease control challenging. This post hoc analysis pooled patients with moderate-to-severe scalp PsO from STATURE/GAIN and palmoplantar PsO from GESTURE/2PRECISE, four Phase 3 secukinumab trials. Scalp outcomes were assessed at Week 24 and palmoplantar outcomes at Week 16. Among patients with scalp PsO receiving secukinumab 300 mg (n=575), 64.7%, 58.8% and 47.1% achieved 75%, 90% and 100% improvement in the Psoriasis Scalp Severity Index (PSSI75/90/100), respectively; Investigator’s Global Assessment (IGA) ≤1 and scalp-specific IGA ≤1 were achieved by 56.9% and 62.7%. In palmoplantar PsO, secukinumab 150 mg (n=134) and 300 mg (n=260), versus placebo (n=138), achieved Palmoplantar Psoriasis Area and Severity Index (ppPASI) 75/90/100 response rates of 23.6%/31.8% versus 8.9%, 12.2%/19.6% versus 3.4%, and 6.1%/12.2% versus 1.4%, respectively. Palmoplantar IGA ≤1 rates were 22.1%/52.7% versus 1.5%. The results of this post hoc analysis highlight the clinical efficacy of secukinumab across difficult-to-treat scalp and palmoplantar psoriasis.

Psoriasis, Obesity and Eating Disorders: Is There a Clinically Relevant Correlation?

Presenter: Laura Calabrese

Obesity is frequently associated with psoriasis, but its relationship with eating disorder (ED)-related symptoms is not well established. This retrospective, multicentre study examined 104 adults aged 18–75 years with psoriasis and body mass index (BMI) ≥25 kg/m² across three Italian centres. Ed-related symptoms screened with Binge Eating Scale (BES; cut-off ≥17) and Eating Attitudes Test-26 (EAT-26; cut-off ≥20). Thirteen patients (12.5%) screened positive on at least one questionnaire: 5 (4.8%) on BES only, 6 (5.8%) on EAT-26 only and 2 (1.9%) on both. Positivity was 16.7% (7/42) in overweight patients, 9.1% (3/33) in obesity class I, 9.1% (2/22) in class II and 14.3% (1/7) in class III, with no significant difference across BMI groups (Fisher’s exact p=0.75). BES and EAT-26 scores did not differ significantly between overweight and obese patients. BMI was not correlated with BES scores (ρ=0.03, p=0.75) but showed a weak negative correlation with EAT-26 scores (ρ=−0.21, p=0.032). BMI alone may not identify ED-related symptoms reliably, supporting screening across excess-weight categories. These findings suggest importance of routine screening for ED-related symptoms among psoriasis patients with excess weight and, support an integrated approach addressing both metabolic and psychological health.

EADV Congress 2026, 30 SEP - 03 OCT 26, Vienna