Biologics may be key to lasting improvement in psoriatic arthritis

| Melissa Leavitt

People with psoriatic arthritis taking a certain kind of biologic have good reason to hope for treatment success.

According to a recent study in Arthritis Care and Research, the majority of patients taking tumor necrosis factor-alpha (TNF-alpha) blockers, such as Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab) and Simponi (golimumab), achieved a level of improvement known as Minimal Disease Activity (MDA). MDA occurs when patients see dramatic relief from most of their psoriatic arthritis symptoms, and is considered by many doctors to be the goal of treatment.

In addition to studying the characteristics of patients who achieved MDA, researchers also examined whether patients who stopped treatment could sustain this level of improvement.

The study enrolled 226 people with psoriatic arthritis, approximately two-thirds of whom were men. Researchers checked in with patients every six to12 months to perform a physical examination and conduct blood tests, looking for symptoms such as joint damage and skin disease. To be considered in a state of MDA, patients had to meet criteria such as having no more than one swollen joint, and little or no skin psoriasis.

Almost two-thirds of patients achieved MDA within an average of about 15 months, the researchers reported. Among these, 88 were able to sustain MDA for at least a year, for an average duration of almost three-and-a-half years, according to the study.

Of the patients who achieved MDA, nine reduced their therapy dose and eight stopped taking the drug altogether. These patients stayed in MDA state for an average of about two years, although, the researchers noted, people who only reduced their therapy sustained MDA for longer than people who stopped.

Researchers also found that men were more likely than women to achieve MDA, as were people with lower levels of inflammation. Researchers measured inflammation by testing patients’ erythrocyte sedimentation rate (ESR). According to the Mayo Clinic, ESR is a measurement of how quickly red blood cells clump together, which can be a sign of inflammation. A normal ESR, indicating less inflammation, more than doubled the odds of achieving MDA, the researchers reported.

Although many patients in the study did see dramatic improvement, more than a third did not achieve MDA, the researchers noted. More studies are needed to better understand how to manage treatment with TNF-alpha blockers, and how to treat patients who do not respond to these drugs, the researchers conclude.

Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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