Source: Echocardiography  |  Posted 8 years ago

Effective treatments are available for psoriatic arthritis, which may have a higher prevalence in patients with psoriasis than previously expected, according to a recent Danish review.

Joint disease is a common co-morbidity experienced by patients with psoriasis, so much so that psoriatic arthritis has been characterised as an independent disease from rheumatoid arthritis. It is therefore necessary to test how these patients react to therapies for rheumatoid arthritis and to develop new treatment options.

Dr. Hugh Zachariae at the Aarhus University Hospital, Denmark, reviewed the topic of psoriatic arthritis with an emphasis on available and emerging therapies.

A recent study has suggested that the prevalence of arthritis may be as high as 30% in patients with psoriasis. This estimate is much higher than the previously accepted average of 7%. Furthermore, this large-scale study determined that arthritis has a significant effect on the quality of life of patients with psoriasis.

Arthritis appears to be mild in most of these patients. However, if therapy is necessary, a number of treatment options are available that can delay or even stop joint damage.

Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed for short or long-term relief of arthritic pain; however long term use has its limitations.

Psoriatic patients with more progressive joint disease can be treated with disease modifying antirheumatic drugs (DMARDs), such as methotrexate or cyclosporine. Methotrexate is the preferred drug for systemic therapy and has been shown to be effective in 60% of patients with psoriatic arthritis. However adverse effects have been seen on liver function. Cyclosporine has also been effective in the treatment of severe psoriasis, but has been associated with renal toxicity.

New types of biologic therapies are emerging, but so far are restricted to patients that do not respond to other available drugs. These new drugs include two anti-TNF-a agents infliximab and etanercept that are currently used to treat rheumatoid arthritis.

Dr. Zachariae is hopeful that "alone or in combination, the new drugs may achieve higher response rates and have better safety profiles than older therapies." He further emphasizes "the importance of overall management" and that "the collaboration between the dermatologist and rheumatologist is important."