Psoriasis Psoriatic Arthritis

Specific Therapies for Psoriatic Arthritis

Biologic medications, specifically tumor necrosis factor-alpha (TNF-alpha) blockers, are considered a promising new therapy for the treatment of psoriatic arthritis (PsA), especially in people who have moderate to severe cases of the disease. For the most part, candidates for therapy with biologic response modifiers, or biologics, have not responded to or cannot tolerate more conventional forms of treatment. The following biologic agents are currently approved by the Food and Drug Administration (FDA) for the treatment of psoriatic arthritis:

Etanercept (Enbrel®) became the first biologic medication approved by the FDA for treating the signs and symptoms of psoriatic arthritis in 2002. Now, Enbrel is also indicated for inhibiting the progression of joint destruction and improving physical function in patients who have psoriatic arthritis. Enbrel is a man-made protein that acts like a sponge, soaking up TNF-alpha and blocking it from causing inflammation. It is given as an injection that can be administered at home.

According to clinical studies, after six months of treatment, Enbrel was proven effective at reducing the number of tender and swollen joints in patients with psoriatic arthritis. Nearly two out of five patients experienced a 50 percent improvement in arthritis severity scores. These scores are based on the severity of swelling in and around the joints, joint tenderness, pain, physical function and morning stiffness. The results could be seen after four weeks of treatment.

The side effects associated with Enbrel range from mild to severe. Mild side effects include itching, pain, swelling and redness at the site of the injection. Nasal and throat irritation, dizziness and headaches have also been noted.

Since Enbrel can suppress the immune system, the more severe side effects include an increased risk for an infection such as tuberculosis. There are also cases linking the use of Enbrel to multiple sclerosis and other diseases of the central nervous system. Reports of an increased risk of congestive heart failure have prompted doctors to use caution when patients have already been diagnosed with that condition. Finally, studies indicate there may be an association between Enbrel and an increased risk of cancer, specifically lymphoma.

Adalimumab (Humira®) was approved by the FDA in 2005 for treating active psoriatic arthritis. It is a synthetic, self-administered injection taken every two weeks and is used for reducing the signs and symptoms of psoriatic arthritis. It blocks TNF-alpha production, which slows the destruction of the joints caused by the disease and improves physical function in adults.

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