Popular Treatment for Psoriatic Arthritis Has No Effect on Aortic Inflammation

According to a story from Medical Xpress, the drug adalimumab (marketed as Humira), did not have a noticeable effect on aortic inflammation in patients with psoriatic arthritis or psoriasis. Humira is an antibody that is frequently used to treat a diverse array of chronic, inflammatory diseases, such as rheumatoid arthritis and Crohn’s disease. Although the drug did not change aortic inflammation–which is considered a critical marker for predicting future cardiovascular problems–it did have an impact on other inflammation markers, meaning that it still may confer some benefit to cardiovascular health.
Psoriatic arthritis is a form of long term arthritis that only appears in patients that are already affected by the skin disease psoriasis. A defining symptom of psoriatic arthritis is the swelling of fingers and toes, leading to a misshapen, somewhat sausage-like appearance. Changes to the nails of fingers and toes also occur, such as thickening, detachment from the nail bed, and pitting. In most patients, the reddish, scaly patches of skin caused by psoriasis typically appear before any arthritis symptoms, but in about 15 percent of cases psoriatic arthritis appears first. Pain in the affected joints, as well as extreme fatigue that cannot be resolved with rest, also occur. Psoriatic arthritis is an autoimmune disease, in which the immune system attacks part of the body by mistake. Obesity and certain types of psoriasis are risk factors. To learn more about psoriatic arthritis, click here.

Humira is an antibody that shuts down the activity of TNF-a, a protein that is well known for promoting the inflammatory response. The class of drugs it belongs to, called TNF inhibitors, are commonly prescribed for inflammatory disease. Another drug used for inflammation, called ustekinumab (marketed at Stelara), was able to cause a 19 percent decrease in aortic inflammation found in psoriasis and psoriatic arthritis patients. Researchers were hoping that Humira would display a similar effect.

The patients in the study were divided into three groups; one received Humira, another received a placebo, and the third group received ultraviolet phototherapy. The only group that saw any changes to aortic inflammation was the phototherapy group; however, the reduction was only by four percent.

This confirmed data from clinical trials of Humira. The study also observed the effect of the drug on HDL cholesterol (the “good” kind), and found that treatment reduced particle size, which reduced the effectiveness of HDL. However, this may be balanced out by the reduction of inflammation.

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