Who does best on a biologic? How long do results last?

| Melissa Leavitt

Maybe you caught a commercial for a biologic drug when you were watching television last night. Or you clicked on your go-to news site and learned that a new biologic has been approved. Or you opened an email from the National Psoriasis Foundation and read about the latest trial results for a biologic in development.

You may feel like wherever you turn, you’re getting hit with more information about biologic drugs, which are injectable medications that can be used to treat psoriasis and psoriatic arthritis.

Many biologics on the market can deliver dramatic improvement to patients. And there are more biologics on the way; several are currently being tested in clinical trials.

But even with all the statistics out there, you may still have questions about how well a biologic will work for you. How do you know whether you’ll see the results you want? And what happens if you decide to stop taking it?

Research presented at the European League Against Rheumatism meeting in June offered answers to some of these questions.

Several studies examined how well certain biologics treated psoriatic arthritis in the real world, tackling topics like who would do the best on biologic treatment and how long results might last.

Study offers clues on who will respond best to a biologic

One study searched for clues indicating which psoriatic arthritis patients might expect to get the best results on a biologic.

Using a large Canadian medical database, researchers analyzed which people were most likely to achieve a level of improvement known as Minimal Disease Activity (MDA), which can be considered a sign of treatment success.

MDA evaluates things like the number of tender or swollen joints, skin severity, pain and quality of life.

The study included almost 200 patients who had psoriatic arthritis for an average of about five years. Patients in the study took either Remicade (infliximab) or Simponi (golimumab) for their psoriatic arthritis.

These biologics work by blocking a pro-inflammatory protein called tumor necrosis factor-alpha (TNF-alpha).

Researchers found that about half of these patients achieved MDA after being on treatment for a year. A little more than 40 percent achieved MDA after just six months.

When comparing the characteristics of patients who did and did not achieve MDA, researchers identified a few factors that could predict treatment success.

It boils down to being in better health when you start your biologic.

Having fewer tender joints and less enthesitis (inflammation where the tendon or ligament inserts into the bone) both predicted a better response to the drug, as well as having better physical function.

Previous research has found that getting diagnosed and treated for psoriatic arthritis early can lead to better outcomes down the road.

Stopping a biologic may cause PsA symptoms to return

Once you start a biologic, you may wonder how long you’ll need to stay on it. According to results of another study presented at the conference, quitting your biologic may not be a good choice.

For most patients, psoriatic arthritis symptoms returned after going off the drug, researchers found.

The study used data from Corrona, which maintains registries of data from patients with psoriatic arthritis, psoriasis and other diseases. NPF launched a psoriasis registry in collaboration with Corrona in 2015.

Examining data from 94 psoriatic arthritis patients, the study analyzed how long it took for joint symptoms to return after patients stopped taking their biologic. A number of biologics were included in the study, including Humira (adalimumab), Enbrel (etanercept), Remicade and Simponi.

These biologics block TNF-alpha.

To be eligible for the study, patients had to have experienced strong improvement on the biologic.

For almost 75 percent of patients, psoriatic arthritis symptoms returned by the time of their first follow-up visit with their doctor after discontinuing their biologic.

The median time it took for symptoms to return was eight months, according to the findings.

The results indicate that even when treatment with biologics has been successful, doctors and patients should carefully consider whether to stop the biologic, the researchers concluded. 

Always work with your doctor to find the best treatment plan for your psoriasis and psoriatic arthritis. NPF’s Patient Navigation Center can help answer your treatment questions.



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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