(RxWiki News) Psoriatic arthritis is a painful condition that, sadly enough, has no cure. The good news is patients can find relief from a variety of treatments, including medications and surgery.
Drugs that target T-cells (white blood cells involved in the body's immune system) may offer relief for patients with psoriatic arthritis. Surgery is another option that may offer substantial benefits for these patients.
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In a recent review, Michael S. Day, M.D., M.Phil., of the New York University Hospital for Joint Diseases, and colleagues concluded that mainstay of therapy for psoriatic arthritis is the use of TNF inhibitors - a class of drugs that target the protein responsible for the inflammation involved in arthritis.
Psoriatic arthritis is a form of arthritis that develops in up to 48 percent of people with psoriasis - a condition characterized by red patches on the body. In many people, the arthritis may be mild, only affecting a few joints. However, some patients suffer from more severe cases in which the joints become permanently damaged.
In order to combat these severe cases, doctors often prescribe disease-modifying antirheumatic drugs (DMARDs) in combination with TNF-inhibitors.
"Although these new immunosuppressive agents [i.e. TNF inhibitors] are expensive, they are the only agents that have demonstrated a decrease in radiologic progression of peripheral arthritis, and can be used to manage associated types of inflammation, as well as skin and nail disease," says Dr. Day.
In other words, TNF inhibitors may not be the cheapest option, but they are the most effective therapy for slowing down the progression of psoriatic arthritis. What's more, they can reduce other inflammatory problems associated with the condition.
Over the years, research has revealed a number of similarities between psoriatic arthritis and rheumatoid arthritis, another inflammatory form of arthritis. These similarities have led some researchers to think about early, aggressive treatment for psoriatic arthritis patients, as early treatment has proven to be a successful approach for rheumatoid arthritis patients.
The combination of TNF inhibitors and DMARDs is part of this early and aggressive treatment.
Surgery also should be considered an option for some psoriatic arthritis patients, particularly for those whose disease has led to irreversible joint damage and deformities.
According to Dr. Day, "The disease typically follows a moderate course, but up to 48 percent of cases develop into destructive arthritis in which the inflammatory process leads to bone erosion and loss of joint architecture."
"Those who do progress to joint destruction may benefit from surgery, and may provide researchers with insights and further data regarding outcomes as well as the risks of surgery in this population," says Susan Goodman, M.D., an assisting attending rheumatologist and internist at Hospital for Special Surgery and one of the study's authors.
Dr. Day and colleagues' review of the current state of treatment for psoriatic arthritis appears in the Journal of the American Academy of Orthopaedic Surgeons.
