Based on Together-PsA, would you favor starting all patients with PsA and comorbid obesity on combination therapy with tirzepatide + bDMARD or will you pursue initial bDMARD monotherapy with tirzepatide rescue in the event of bDMARD non-response?
In looking at the Together-PsA data, this was a challenging cohort to treat, and a reasonable increase in treatment response was seen with combination therapy. Multiple studies have shown that obese psoriatic arthritis (PsA) patients are less likely to achieve minimal disease activity (MDA) and have...
This is a very important question, but it is challenging to address with the current data. In an obese PsA patient with very mild disease, it might not be unreasonable to start a GLP-1RA in combination with an NSAID first to determine whether weight loss alone, along with a mild anti-inflammatory, i...
I think that really is up to the rheumatologist and the patient. This is really a shared decision-making kind of question.
I usually find it’s easier to start one at a time. The reason for that is that if you start both at the same time and the patient has side effects, you’re not really sure which o...