Before the modernization of medicine, symptoms of diseases like psoriatic arthritis (PsA) were addressed in interesting ways. In ancient Greece, symptoms were treated with tar and topical arsenic, prescribed by Hippocrates.1 In medieval times, PsA was thought to be contagious, and patients were put in isolation and treated with harmful, ineffective toxins, like sulfur and mercury.1

Medicine has come a long way since then, and although there is still no cure for PsA, we’ve witnessed significant breakthroughs in the scientific understanding of the disease since the coining of the term in 1860.1

In the US, more than 1 million people are living with PsA, a chronic rheumatologic disease characterized by joint pain, stiffness, and swelling.2,3 PsA can affect any part of the body, such as the fingertips and spine, or wherever your ligaments and tendons connect to the bone.3 Psoriatic arthritis affects approximately 30% of people with psoriasis (PsO), an inflammatory skin disease, and patients with PsA also experience PsO skin lesions and plaques.3


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Frédéric Lavie, MD, PhD

As we experience rapid advancements in technology from wearables to data science, and combine these advancements with the recent influx of new scientific insights, we are on the verge of another revolution in rheumatic disease medicine.

Current Treatment Landscape of PsA

During the last century, we’ve learned more about PsA manifestations and taken significant strides in patient care. Previously, physicians treated patients with PsA just as they would patients with rheumatoid arthritis, a more common and well-known rheumatic disease of the joints. In doing so, swollen joints were the only issue of PsA that were being addressed.

We now know that PsA is a heterogeneous disease affecting different domains of the body with varying degrees of severity for each patient – some patients have minimal skin issues and more arthritis signs and symptoms, and others, vice versa. Symptoms of PsA go beyond skin and joints too, with many patients experiencing debilitating symptoms, like fatigue and anxiety, which are now being considered when establishing a treatment plan.

Treatment options for PsA can range from disease-modifying antirheumatic drugs (DMARDs) to nonsteroidal anti-inflammatory drugs (NSAIDs) to topical creams. Currently, these options focus on slowing the progression of joint pain to prevent permanent joint damage, combat inflammation, and attain skin clearance.

Although there are many treatment options available today, there is still an incredible unmet need in this space, and rheumatologists face the challenge of providing lasting remission to patients covering the whole diversity of disease manifestations.

Patients at the Center of Scientific Innovation

To usher in the future of PsA therapy, we must cut across traditional disease area boundaries. First, we must continue to gain a better understanding of the patterns of this complex disease and its multifaceted symptoms. This will allow us to identify and unlock new pathways, mechanisms, and regimens for patients with limited or inadequate treatment options. We must continue to study our medicines in clinical practice settings and include patient, prescriber, and payer insights in our research efforts to reach a significantly broader population of patients with better and safer treatment approaches. Further, we must integrate patients into our decision-making process by engaging them in conversations about their treatment options.

Real-world evidence and patient-reported outcomes are leading to databases of information that are helping to advance therapeutic science. For example, we can now tap into these databases to gain new insights into a treatment’s safety and effectiveness and show trends across thousands of patients. We are also using connected devices to capture real-time patient health status, including monitoring movement, heart rate, and temperature. In rheumatic disease, wearable technology has enabled clinicians to assess patient flares using activity tracker data.4

A deeper understanding of disease patterns, pathogenesis, and patient-reported symptoms, paired with innovations in data and technology will create a winning combination that will lead to novel therapeutic options that restore immune balance and achieve remission.

Our Commitment as Researchers and Providers

We’ve come a long way since the days of tar and arsenic treatment for PsA, but we still have a way to go. At Janssen, we’re driven by a relentless focus on the unmet patient need and are excited by the tremendous opportunity we have to alter the current immunology treatment landscape. We’re rapidly advancing our data science capabilities, focusing on scientific insights and innovation, and keeping patients at the center of everything we do.

The future is exciting for us as scientists, but it’s especially meaningful and motivating to consider what the winning advancements could mean for the millions of people around the world living with PsA. How will we look back on today’s treatments for PsA? I can’t wait to find out.

Author’s Note: To learn more about these efforts, please visit https://www.janssen.com/immunology.

References

  1. Arthritis National Research Foundation. Getting under your skin – the history psoriatic arthritis (PsA). Published online February 25, 2020. Accessed May 19, 2021. https://curearthritis.org/getting-under-your-skin-the-history-psoriatic-arthritis-pa/
  2. Hammadi AA. Aljefri K. Psoriatic Arthritis: practice essentials, background, pathophysiology and etiology. Medscape. Updated July 15, 2020. Accessed May 19, 2021. https://emedicine.medscape.com/article/2196539-overview#a5
  3. Psoriatic Arthritis: causes, symptoms and treatment. National Psoriasis Foundation. Updated March 10, 2021. Accessed May 11, 2021. https://www.psoriasis.org/about-psoriatic-arthritis/
  4. James JA. Biomarkers in connective tissue diseases [abstract]. Presented at: Congress of Clinical Rheumatology 2019; May 2-5, 2019; Destin, FL.