The first-ever international guidelines for the treatment of psoriatic arthritis have been published, thanks to the joint efforts of arthritic wellness experts such as rheumatologists, dermatologists, and patient advocates. The disease mainly affects the wellbeing of people who have psoriasis, but some people without it may also be at risk of psoriatic arthritis.
The guidelines were published by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), led by Christopher Ritchlin, MD, MPH, professor of Medicine at the University Of Rochester Medical Centre. Ritchlin, who treats about 250 patients with psoriatic arthritis, is also the director of the Clinical Immunology Research Unit at the Medical Centre and presented the guidelines.
‘In the past few years, new medications have become available that are incredibly effective for the various manifestations of psoriatic arthritis,’ he said. ‘Many patients’ find their lives changed for the better within just a couple of weeks. These guidelines are designed as a platform to make sure physicians around the world are aware of what’s available for their patients and to help them make sound treatment decisions.’
Doctors say that about one out of four patients with psoriasis also gets psoriatic arthritis, and roughly 15% of people who get the disease don’t have psoriasis. The autoimmune disease works by causing your body to attack itself by activating signalling molecules. Psoriatic arthritis literally eats away at your joints, which causes some bones to shrink or disappear and others to grow in an abnormal, disfiguring and disabling way. The disease also increases your risk of diabetes, high blood pressure, and heart attacks.
According to Ritchlin, ‘The presenting symptoms of psoriatic arthritis vary tremendously from patient to patient. It’s a very challenging disease to treat, because so many different parts of the body can be involved. The skin can be inflamed, a particular joint or tendon can hurt tremendously, the patient might have back pain, or a single swollen finger or toe. Oftentimes a patient will come in with something you might call ‘tennis elbow,’ or they might have a sore Achilles heel, and that’s their only symptom. It can be very difficult to diagnose.’
A broad range of treatments is available to treat the disease. The group recommended that, as soon as you suspect psoriasis or psoriatic arthritis, you consult a specialist, such as a dermatologist or rheumatologist to find the best plan for you. The group also urged physicians to consider ewer medications that inhibit a molecule known as TNF (tumour necrosis factor). ‘Most people respond rapidly and dramatically to these medications,’ Ritchlin said.