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New Drug Shows Promise Against Psoriatic Arthritis

By Patricia Eifert

Psoriasis is a common occurrence when auto-immune disorders are present, causing the bodys own
immune system to over-react to stimuli by producing extra T-cells at key locations. This creates eruptions
of scaly red and white patches on the skin surface which although irritating, does not pose a health threat.
But for those with simple psoriasis outbreaks a larger danger awaits as they may also contract psoriatic
arthritis in which the joints also get affected by the attack of the bodys immune system.
About 40% of psoriatic arthritis patients have a family history of either psoriasis or arthritis which seems to
indicate hereditary influences in painful inflammation in the joints. Similar to surface psoriasis, the
symptoms of psoriatic arthritis may fluctuate, increasing or decreasing or even changing the location of
this affliction in the same person over time. In fact, any infection that compels the immune system to
become active may also trigger the development of psoriatic arthritis, and non-infectious psoriasis could
be linked to a streptococcal throat infection.
Characteristics of Psoriatic Arthritis
In most cases, psoriatic arthritis develops after psoriasis has appeared but in a few cases this may be
reversed with the psoriatic arthritis developing before psoriasis appears on the skin. The adverse effects
of psoriatic arthritis are dependent on where the disease attacks, which joints are affected, and how
serious the symptoms are. The usual points where psoriatic arthritis are first discovered is in the hands or
feet with the afflicted toes and finger joints becoming inflamed. If they swell up like a sausage it is called
dactylitis, although other types of arthritis may cause the same characteristics. Spondylitis is the name
given to psoriatic arthritis that attacks the spine and produces pain in the neck or back, and interferes with
bending.

The points where tendons join to bones and larger joints like hips, knees, lower back and ankles can also
become afflicted by this inflammation and even the nail beds can suffer inflammation. Another trait of
psoriatic arthritis, known as enthesitis, can result in painful areas around the tendons and ligaments that
join the bones. This can arise at the back of the heel, the bottom of the foot, near the elbows, and in some
other areas. Some common symptoms besides chronic pain are anaemia and fatigue and a few people
may also have fluctuating moods. These symptoms will also reduce when the arthritis and inflammation
are treated effectively.
Research and Treatments
Scientists are still searching for the precise root causes of psoriatic arthritis but research confirms that this
type of persistent inflammation can cause joint damage if left untreated. Hence, accurate and early
diagnosis and treatment is extremely important to avoid this from happening. Whilst scanning human
genetic material can help to locate the genes responsible for triggering psoriasis or that may increase the
risk of contracting psoriatic arthritis, the main break-through is expected in new therapies and more
effective treatments for the future which could lead to permanent cures and pain relief.
One methods currently used for research, so that we can have a better understanding of how this disease
affects the body, is magnetic resonance image scanning to help locate the points of inflammation. Unlike
other skin conditions caused by allergic reactions, psoriasis cannot be helped with skincare products,
especially when it progresses to the skeletal structure. The level of pain that one experiences with
psoriatic arthritis will determine what treatment should be used. Mild cases could be treated until the
symptoms disappear and the patient feels better and is free of pain but a variety of rheumatic diseases,
like ankylosing spondylitis, osteoarthritis, psoriatic arthritis, lupus and fibromyalgia requires stronger pain
treatments.
Dr. Philip Mease, a professor at the University of Washington, School of Medicine in Seattle and director
of Rheumatology Clinical Research division of the Swedish Medical Centre, recently revealed a new drug
that has shown remarkable results in clinical trials for treating psoriatic arthritis. His research team
randomly assigned 198 participants with a severe plaque psoriasis area and severity index score of 12 or
more and affected body surface area 10 percent or more various strengths of the drug brodalumab or a
placebo.
This drug is a human monoclonal antibody that is targeted to treat inflammatory diseases. The drug
effectively inhibits many IL-17 (interleukin-17) receptors that are prevalent in psoriasis, thus preventing
the development of the disease and hindering its spread. Results from this randomized, double-blind,
placebo-controlled, dose-ranging trial has shown promising reduction in outbreaks of plaque build up
along with asthmatic psoriasis and psoriatic arthritic inflammation which has been published in the New
England Journal of Medicine. Based on these results, additional clinical trials are warranted to further
assess the safety and efficacy of brodalumab.