A recent article at Healio Rheumatology highlights a presentation given by Dr. Arthur Kavanaugh of the University of California to attendees at the 2022 Clinical Rheumatology Congress East.
Dr. Kavanaugh discussed the ever-growing list of treatment options that are now available to rheumatologists and their patients living with psoriatic arthritis. Tumor necrosis factor (TNF) inhibitors, produced by the immune system to help control inflammation, have been the gold standard of treatment for many years.
The human body usually maintains steady TFN levels. However, if a person has an autoimmune disease such as psoriatic arthritis, the body produces an over-abundance of TNF which leads to inflammation. After TNF is infused into the patient’s blood, an immune response is triggered that helps to control inflammation.
New Options for RA Patients
At the conference, Dr. Kaufmann discussed several new additions to the list of TNF inhibitors, such as Interleukin 12/23 and IL-17 inhibitors that are excellent options in the treatment of inflammatory diseases. However, he also pointed out that for patients presenting with ankylosing spondylitis alongside psoriatic arthritis, IL-12/23 and IL-17 are ineffective.
Another new entry discussed by Dr. Kaufmann is cytotoxic T-lymphocyte-associated protein 4. Also known as CTLA-4, the protein is antigen-specific and capable of killing certain types of infected cells.
Janus kinase (JAK) inhibitors are medications that were developed to inhibit the activity of Janus kinase enzymes that are known to promote inflammation.
Researchers have also found, Dr. Kaufmann said, that IL-12/23 inhibitors have proven to be efficient in calming the skin around areas of the joints.
Research indicates that around 20 to 25 percent of psoriasis patients will develop the psoriatic type of arthritis. Yet the exact factors in these at-risk patients are as yet unknown.
Learn more about the new treatment options discussed by Dr. Kaufmann at the 2022 Clinical Rheumatology Congress East over at Healio Rheumatology.
Psoriatic Arthritis (PsA)
Psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis. It can affect any joint in the body and can lead to joint damage. The condition’s characteristic symptom is the development of red patches of skin topped with silvery scales.
Many people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint issues can develop before skin lesions appear.
Symptoms include:
- Development of red patches of skin topped with silvery scales
- Generalized fatigue
- Tenderness, pain and swelling over tendons
- Swollen fingers and toes that look like sausages
- Stiffness, pain, throbbing, swelling and tenderness in one or more joints
- A reduced range of motion
- Morning stiffness and tiredness
- Nail changes—for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
- Redness and pain of the eye, such as conjunctivitis
What causes psoriatic arthritis?
The cause of psoriatic arthritis is not entirely known. 40% of those diagnosed with the condition have a family member with psoriasis or arthritis, suggesting genetics may play a role.
Psoriatic arthritis can also result from an infection that activates the immune system. While psoriasis itself is not infectious, it might be triggered by a streptococcal throat infection, commonly known as strep throat.
