Spotlight: trends I see in psoriatic arthritis treatment

By Elizabeth Ortiz, MD, as told to Janie McQueen

The understanding of psoriatic arthritis has improved

I’ve seen a big increase in our understanding of psoriatic arthritis just in my time in the practice. This has resulted in more specific treatments but also in our ability to diagnose more quickly.

There are no specific blood tests for psoriatic arthritis. Making a diagnosis is highly dependent on the experience and degree of suspicion of the doctor. As we’ve learned more about what to look for and how symptoms can vary between men, women, and people of color, our experience and suspicion have collectively increased. As a result, patients arrive at an appropriate diagnosis more quickly.

We still have a long way to go, as far too many people deal with psoriatic arthritis for longer than they should. But we are certainly making progress.

Personalized therapies for psoriatic arthritis

There are always a number of clinical trials being conducted to evaluate the effectiveness of targeting new inflammatory proteins along the complicated inflammatory cascade that is activated in psoriatic arthritis. What’s most exciting to me is the work being done to help us determine which patient will respond best to which therapy.

Currently, medication choices are largely made on the basis of physicians’ experience. The art of choosing the right organic is just that, an art. Rheumatologists have long needed more science to aid their decision-making in choosing the right biologics for the right patient. We are now much closer to that.

New treatments for psoriatic arthritis are game-changers

There is no question that biologic therapies have revolutionized the way we treat people with inflammatory arthritis. Understanding how different inflammatory conditions differ at the cellular level has further refined our ability to target certain inflammatory proteins in each condition. This allows us to be more specific in our treatment strategies.

Psoriatic arthritis in particular has benefited from this. We are no longer limited to using biologics developed for rheumatoid arthritis in psoriatic arthritis. What we’re moving to now is learning how to identify markers in the individual that will help determine which medication is most appropriate for them.

Another treatment option is the use of Janus kinase (JAK) inhibitors. They are not organic products. They come in pill form and can prevent your immune system from producing certain enzymes that lead to psoriatic arthritis. Your rheumatologist may even prescribe these before you try a biologic.

Gathering Your Toolbox for Psoriatic Arthritis

Psoriatic arthritis can be frustrating, as joint and skin eruptions can become disconnected. Just when you think one is under control, the other will flare up. I work with patients to build a robust toolbox they can turn to when faced with a diverse set of flare-up symptoms. Medications are certainly a big part of that toolbox, but dietary changes, improved sleep, mindfulness, and exercise are also effective tools that can be used.

What health care providers need to know about psoriatic arthritis

I make sure caregivers are reminded that even when their loved one is “looking good,” inflammatory conditions, such as psoriatic arthritis, are still there and can affect the person in ways that aren’t obvious. Fatigue, brain fog, and generalized muscle pain may persist even if the skin and joints appear fine.