Anti-Inflammatory Rx May Ease Psoriatic Arthritis

Psoriatic arthritis treatment shows promise in reducing tenderness and swollenness

(RxWiki News) About 15 percent of psoriasis patients get arthritic inflammation that may cause joint pain, according to the American College of Rheumatology. A new therapy, however, may bring some relief.

Characterized by red and white scaly patches on the skin, psoriasis develops when the immune system pushes into overdrive. Sometimes the immune system attacks the joints as well as the skin, triggering inflammation that can be painful and make it difficult to use hands, stand or walk.

Recent research has shown that a novel medication called brodalumab alleviates symptoms of psoriatic arthritis (such as severe tenderness in the fingers and toes) and improves skin condition.

"Stay informed about developing therapies for psoriatic arthritis."

Philip Mease, MD, a rheumatologist with Swedish Medical Center in Seattle, and other investigators followed 168 patients with psoriatic arthritis.

Participants were randomly assigned to receive either brodalumab (in doses of 140 mg or 280 mg) or a placebo.

At the 12-week mark, researchers noted that 21 of the 57 patients taking the 140 mg of brodalumab (37 percent) and 22 of 56 taking the 280 mg dose (39 percent) saw a 20 percent improvement in response according to American College of Rheumatology criteria.

The criteria includes such symptoms as morning stiffness, joint tenderness, joint swelling and erythrocyte sedimentation rate—a test that measures how much inflammation is in the body. Only 18 percent of the placebo patients achieved these results.

A 50 percent improvement was achieved by 14 percent of both brodalumab groups and 4 percent of the placebo patients.

Some of the patients continued with the trial for an additional 12 weeks, but in this second stage, all the participants received doses of 280 mg brodalumab. At 24 weeks, 33 percent from both therapy groups reached 50 percent improvement in response compared to 20 percent of patients who were initially treated with placebo.

Currently, treatment varies depending on the level of pain, according to the American College of Rheumatology. Those with very mild arthritis may be treated only when joints are painful.

Initial treatment is often a non-steroidal anti-inflammatory medication such as ibuprofen or naproxen.

If this treatment fails, doctors may prescribe specific anti-rheumatic drugs, such as sulfasalazine (brand name Azulfidine), methotrexate (brand name Rheumatrex), cyclosporine (brand names Neoral, Sandimmune) and leflunomide (brand name Arava).

Developed by Amgen and AstraZeneca, brodalumab is a human monoclonal antibody, which binds to a specific receptor (interleukin-17) and prevents it from relaying inflammatory signals.

Additional testing is underway to further evaluate the effectiveness of this medication.

"These encouraging psoriatic arthritis data, showing that patients not only experienced improvements in clinical symptoms at week 12, but that those improvements continued over time and were sustained, were the basis for our decision to continue development of this molecule as a potential treatment for the many people who are looking to better control their disease,” said Sean E. Harper, MD, executive vice president of Research and Development at Amgen in a press release.

Study results were published June 11 in The New England Journal of Medicine and also presented presented in June at the 2014 European League Against Rheumatism (EULAR) Annual Congress in Paris. Authors reported receiving grants from Amgen during the conduct of the study.

Review Date: 
June 12, 2014