Psoriatic Arthritis Patients Have a New Option

One in three patients with psoriasis will go on to develop psoriatic arthritis (PsA). For some of these patients, a new treatment option is on the horizon. On July 14, 2020, the U.S. Food and Drug Administration approved the use of Tremfya® (guselkumab) for use in adult patients with active psoriatic arthritis.

“PsA occurs in 30 percent of patients with psoriasis and is the most common comorbidity for these patients,” says Dr. Alice Gottlieb, M.D., Ph.D., Medical Director, Mount Sinai Beth Israel Dermatology and Clinical Professor, Department of Dermatology at Icahn School of Medicine at Mount Sinai, New York. “Every patient with psoriasis should be evaluated for PsA at every visit with their dermatologist.”

“The effect of PsA on patients’ lives can be significant,” says Dr. Atul Deodhar, M.D., M.R.C.P., Professor of Medicine, Division of Arthritis and Rheumatic Diseases, School of Medicine at Oregon Health and Science University. PsA can affect any joint and function can be very limited. A patient’s mental health can be affected, including having a significant risk for depression. “For patients with psoriasis, having psoriatic arthritis can lower their quality of life.”

Tremfya®, manufactured by Janssen, is proposed to work by binding to the p19 subunit of IL-23, thereby inhibiting its reaction with the IL-23 receptor. This action stops the release of proinflammatory cytokines and chemokines.

“PsA has 5 different domains, including skin, joint, nail, axial spine, and enthesis. Data resulting from studies on guselkumab (Tremfya) demonstrate that it may be effective on all domains, including the axial spine,” says Dr. Deodhar. “There is a need for new treatment options, especially ones with better safety and efficacy. This new treatment adds another option for patients who haven’t responded to other previous treatments.”

Tremfya® was previously approved for the treatment of adults with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.