Psoriatic arthritis biologics
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Psoriatic arthritis (PsA) is a chronic autoimmune, inflammatory form of arthritis.
The disease involves cytokines, T cells, possibly B cells, and other molecules that drive tissue damage. The elucidation of the pathogenesis of inflammatory arthritis has allowed the identification of targets and the developments of modern treatments for this disease.
The successful introduction of molecules that inhibit TNF-a has revolutionized the management of rheumatoid arthritis and these drugs are now being investigated in related diseases including PsA, psoriasis, and ankylosing spondylitis (AS).
Today, it is accepted that structural damage occurs from the beginning of the disease, and early and more aggressive management is now favored. There has been a change in emphasis in treatment and the goals of therapy are now to prevent joint destruction rather than just manage symptoms.
Biologic drugs that target the molecules involved in the
pathogenesis of inflammatory diseases have revolutionized the treatment of RA and PsA. TNF-a antagonists not only improve signs and symptoms of these diseases, but have been shown to slow or even prevent radiographic progression. With these and similar drugs available to the rheumatologist, aiming for remission early in the course of the disease is a desirable and achievable goal. Other newer biologics may also be effective.
There is evidence that because psoriatic arthritis is an enthesopathy (a disease that attacks tendon insertions), that the same immunologic abnormalities that cause psoriatic arthrits are different from the ones that cause rheumatoid arthritis. More selective biologic drugs are being developed for psoriatic arthritis.
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