Dr. Philip Mease at Washington University’s Medical Center likes to tell his patients that they are unique. According to a recent Healio report, Dr. Mease spoke at the 2020 Clinical Rheumatology Congress on the subject of managing novel, targeted therapy options.
He advised the attendees that it is necessary to have an understanding of which patient will respond to a TNF or a JAK inhibitor, an IL-17, or an IL-23.
About Psoriatic Arthritis (PsA)
People diagnosed with PsA may have enthesitis, spondylitis, dactylitis, and uveitis. These are just some of the myriad of gastrointestinal complications accompanying PsA.
Other common complications are dermal, spinal, and musculoskeletal disorders. Dr. Mease cautions that these issues must be evaluated and addressed.
Clinical Trial NCT02745080
Currently, there are a few clinical trials that provide therapeutic treatments for these patients. The EXCEED trial, NCT02745080, compares the efficacy and safety of adalimumab and secukinumab monotherapies in patients who have psoriatic arthritis.
Secukinumab was somewhat of an improvement over areas in the joints but according to Dr. Mease, it made a significant difference in the skin.
About IL-17A Antibody Ixekizumab
Dr. Mease noted that ixekizumab was compared to adalimumab in a study that resulted in skin clearance and a positive reaction in joints. He added that ixekizumab was superior to enthesitis as well as dactylitis.
In addition to these two trials which have similar safety evaluations, other related medications such as:
- bimekizumab(UCB): a psoriatic arthritis treatment
- guselkumab (Tremfya) has demonstrated improvements in the skin
- risankizumab (Skyrizi)
- tildrakizumab (Ilumya): a new drug currently used by people with psoriasis
- Several oral medications are being developed, such as Janus kinase (JAK) inhibitor tofacitinib and JAK inhibitor filgotinib
- upadacitinib (Rinvoq) has shown positive skin activity
Dr. Mease acknowledged the data are significant but added that developing biomarkers to determine who will receive the most benefit is the next challenge.
