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

March 7, 2018|Internal Medicine News

EXPERT ANALYSIS FROM RWCS 2018

“This study was a surprise,” he continued. “I think it’s like rheumatoid arthritis was years ago. If you asked docs how they were doing, they would say, ‘My patients are doing great!’ But then you go to the office and measure the patients and it’s like, ‘Well, not so much.’ ”

Another speaker, Eric M. Ruderman, MD, concurred.

“If you say 23% of your rheumatoid arthritis patients are in remission, you’d have to say, ‘I’m not doing a very good job,’ because we’re getting 50%-60% rates of remission these days if you really push medications. And we have good drugs for psoriatic arthritis, too, but I don’t think we’re pushing as hard,” said Dr. Ruderman, professor of medicine and associate chief for clinical affairs in the division of rheumatology at Northwestern University in Chicago.

That being said, it’s also clear that rheumatologists aren’t doing as well in managing psoriatic arthritis as dermatologists are with psoriasis, where skin clearance or almost-clear rates unimaginable just a few years ago are now routinely attainable, he added.

“In dermatology they’re getting better and better and better and better with each successive new cytokine target. We’re not. The ACR responses with risankizumab [an investigational anti-interleukin-23 p19 inhibitor] are very much like we saw with the tumor necrosis factor inhibitors. The interleukin-12/23 inhibitor responses are very much like we’ve seen with the interleukin-17 inhibitors. So each successive improvement in getting skin disease under control hasn’t really gotten us very much further with joint disease. I don’t know that we’ve cracked that yet,” Dr. Ruderman said.