Guidelines for Psoriatic Arthritis Treatment Released
Posted Jun 05 2010 7:46pm
New guidelines for management of psoriasis and psoriatic arthritis were published in the May issue of the Journal of the American Academy of Dermatology. It is estimated that over 6 million Americans are affected by psoriasis and up to 750,000 of those suffer from psoriatic arthritis.
The new guidelines provide recommendations for treating patients with mild to severe cases of these conditions. Psoriasis is a genetic disease with at least eight chromosomes so far that researchers have identified as being connected to the genetic transmission of the disease. There are also several environmental factors that play key roles in the development of psoriasis, among them are drugs, skin trauma, infection and stress.
Based on a thorough examination of current studies on treatments for psoriasis, the Academy’s guidelines summarize the benefits and limitations of topical and systemic treatments that are currently available to treat psoriasis.
The guidelines indicate that topical therapies are appropriate for patients who are good candidates for localized treatment, but should not be used exclusively to treat psoriasis if a combination of systemic and/or phototherapy treatments would provide more benefit. The dermatologist should determine if established systemic treatments – such as methotrexate, cyclosporine and oral retinoids – phototherapy, or the newer biologic agents appropriate for each individual.
Recent introduction of biologic therapies have given dermatologist more options to treat psoriasis and psoriatic arthritis. Biologic therapies are given by injection or infusion and are systemic medications that identify precise immune responses involved with psoriasis and psoriatic arthritis. Biologics act, to some extent, as a tumor necrosis factor (TNF) inhibitor to slow the inflammatory response. There are studies which confirm that biologics can effectively alleviate the chronic physical symptoms of moderate to severe psoriasis, as well as help improve the patient’s quality of life.
There are currently five biologic agents that are approved by the U.S. Food and Drug Administration (FDA) for the treatment of psoriasis. Three of these are approved for psoriatic arthritis. Since these therapies target the immune system, the new guidelines state the importance of efforts to prevent infection, including vaccinations. Once biologic therapy has been started, the patient should avoid vaccinations with live vaccines under all circumstances. In addition, patients should be periodically re-evaluated by their dermatologist for any new symptoms, including infections and potential cancers.