Psoriatic arthritis treatment: “We’re not doing so well”

MAUI, HAWAII – Two recent Scandinavian studies highlight the considerable room for improvement that exists in psoriatic arthritis outcomes, according to speakers at the 2018 Rheumatology Winter Clinical Symposium.

“We’re not doing so well. I think that in general, if you think of the treatments that we have and the treat-to-target approach, psoriatic arthritis lags behind rheumatoid arthritis, maybe by a decade,” declared Arthur Kavanaugh, MD, program director for the symposium and professor of medicine at the University of California, San Diego.

Bruce Jancin/Frontline Medical News

He was a coauthor of a Norwegian cross-sectional study of 141 psoriatic arthritis patients assessed during 2013-2014 by investigators who used an array of disease activity measures. Among the findings: The group’s median Disease Activity index for PSoriatic Arthritis (DAPSA) score was 14.5, the Disease Activity Score for 28 joints using erythrocyte sedimentation rate was 3.2, and – most tellingly – only 22.9% of them fulfilled the criteria for minimal disease activity (MDA), which requires very low or no activity in five of seven domains of psoriatic arthritis. Moreover, 42 patients weren’t on any disease-modifying antirheumatic drugs whatsoever (J Rheumatol. 2017 Apr;44[4]:431-6).

“If you say that MDA is remission, a 23% remission rate is not good enough. And there are some people who are not on treatment. So I think we’re still seeing a lag in psoriatic arthritis. We’re not treating it as aggressively as we are rheumatoid arthritis,” said Dr. Kavanaugh, director of the Center for Innovative Therapy in the university’s division of rheumatology, allergy, and immunology.