{"id":25,"date":"2014-06-30T11:34:10","date_gmt":"2014-06-30T11:34:10","guid":{"rendered":"http:\/\/promotions.bmj.com\/ardsummaries\/?p=25"},"modified":"2014-06-30T11:34:10","modified_gmt":"2014-06-30T11:34:10","slug":"possible-new-drug-option-for-psoriatic-arthritis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2014\/06\/30\/possible-new-drug-option-for-psoriatic-arthritis\/","title":{"rendered":"Possible new drug option for psoriatic arthritis"},"content":{"rendered":"<p><strong>INTRODUCTION<\/strong><\/p>\n<p>Ustekinumab, a drug used to treat psoriasis, has now shown promising results for people with psoriatic\u00a0arthritis, including people for whom other treatments haven\u2019t helped.<\/p>\n<p><strong>WHAT DO WE KNOW ALREADY?<\/strong><\/p>\n<p>Psoriatic arthritis is a long-term condition that causes pain and swelling in some joints, including the spine, and\u00a0in the soft tissues around the joints, such as the tendons. As well as pain it can cause fatigue (being exhausted),\u00a0reduce people\u2019s mobility, and affect their quality of life.\u00a0There are drugs that can relieve the inflammation and symptoms of psoriatic arthritis. These include some\u00a0you may have heard of, such as methotrexate, and newer drugs called TNF-inhibitors (also called anti-TNF\u00a0drugs). But there is no one drug that works for everyone. And some people find that side effects stop them\u00a0using some medicines.<\/p>\n<p><!--more--><br \/>\nUstekinumab is a fairly new medicine of a type called a monoclonal antibody. Thus, like TNF-inhibitors, it is\u00a0a biological disease-modifying anti-rheumatic drug. It has been used for some years to treat psoriasis. And it is\u00a0now approved to treat people with psoriatic arthritis in US as well as in many countries in Europe.\u00a0The new study looked at 312 adults with psoriatic arthritis whose symptoms had not improved much with\u00a0other treatment, or who had stopped using other drugs because of side effects. More than half of the people in<br \/>\nthe study had already tried TNF-inhibitors.<\/p>\n<p>The people in the study took either ustekinumab or a dummy treatment (placebo) for six months. During\u00a0the study they were allowed to keep taking any other medicines that helped them.<\/p>\n<p><strong>WHAT DOES THE NEW STUDY SAY?<\/strong><\/p>\n<p>More people who took ustekinumab had improvements in their symptoms compared with people taking\u00a0placebo.\u00a0The main way the study measured symptom improvement was by using a tool called the ACR20. ACR is\u00a0short for American College of Rheumatology and the \u201820\u2019 refers to a 20 percent improvement in tender and\u00a0swollen joints and in other findings\/symptoms. After six months about 44 in 100 people taking ustekinumab\u00a0achieved ACR20 (their symptoms improved by at least 20 percent) compared with about 20 in 100 people\u00a0taking a placebo.<\/p>\n<p>The new drug also seemed to help people for whom TNF-inhibitors hadn\u2019t worked. About 36 in 100 of these\u00a0people who took ustekinumab achieved ACR20 compared with about 15 in 100 people who took a placebo.\u00a0More people taking ustekinumab had improvements in other symptoms including fatigue, psoriasis, physical\u00a0function (moving their joints), and in quality of life, compared with people taking placebo. Finally, ustekinumab<br \/>\ndidn\u2019t seem to cause any unexpected or alarming side effects.<\/p>\n<p><strong>HOW RELIABLE ARE THE FINDINGS?<\/strong><\/p>\n<p>This was a type of study called a randomised controlled trial, which is the best type of research for directly\u00a0comparing treatments. It was a well-conducted study with careful methods, so it should be fairly reliable.<\/p>\n<p><strong>WHAT DOES THIS MEAN FOR ME?<\/strong><\/p>\n<p>For now, ustekinumab is available in many countries for treatment of both psoriasis and psoriatic arthritis. For\u00a0some people, finding a helpful treatment for psoriatic arthritis involves a difficult journey through several\u00a0options. This study suggests that ustekinumab could become one of those options, but it is expected that clinicians<br \/>\nwill use methotrexate followed by TNF-inhibitors as the first options (also because TNF-inhibitors\u00a0usually are cheaper and seem to have similar efficacy on a group level). Thus, ustekinumab will be an important\u00a0rescue option for people not responding to TNF-inhibitors, in particular because ustekinumab has a different<br \/>\nmode of action by inhibiting other inflammatory mediators than TNF.<\/p>\n<p><strong>Disclaimer<\/strong>: This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. <span style=\"text-decoration: underline\">\u00a0It should not be relied on in any way whatsoever,<\/span> (which also means the Summary is not medical advice), and is simply supplied to aid a lay understanding of general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be accurate as errors can occur and also may be out of date as medical science is constantly changing. <strong>\u00a0It is very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care. Do not use this Summary as medical advice even if the Summary is supplied to the reader by a medical professional.<\/strong><br \/>\nPlease view our full <a href=\"http:\/\/www.bmj.com\/company\/legal-information\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Website Terms and Conditions<\/a>.<\/p>\n<p>Date summary prepared:\u00a0June 2014<\/p>\n<p>Summary based on research article published on: 30 January 2014<\/p>\n<p>From: Ritchlin, C. <em>et al<\/em>.\u00a0Efficacy and safety of the anti-IL-12\/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial.\u00a0<em>Ann Rheum Dis<\/em> 2014;73:990-999 <a href=\"http:\/\/ard.bmj.com\/content\/73\/6\/990.full\">doi:10.1136\/annrheumdis-2013-204655<\/a><\/p>\n<p>Copyright \u00a9 2015 BMJ Publishing Group Ltd &amp; European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our <a href=\"http:\/\/www.bmj.com\/company\/products-services\/rights-and-licensing\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Rights and Licensing<\/a> Team.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION Ustekinumab, a drug used to treat psoriasis, has now shown promising results for people with psoriatic\u00a0arthritis, including people for whom other treatments haven\u2019t helped. WHAT DO WE KNOW ALREADY? Psoriatic arthritis is a long-term condition that causes pain and swelling in some joints, including the spine, and\u00a0in the soft tissues around the joints, such [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/rheumsummaries\/2014\/06\/30\/possible-new-drug-option-for-psoriatic-arthritis\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":384,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,8],"tags":[],"class_list":["post-25","post","type-post","status-publish","format-standard","hentry","category-psoriasis","category-psoriatic-arthritis"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/25","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/users\/384"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/comments?post=25"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/25\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/media?parent=25"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/categories?post=25"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/tags?post=25"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}