Drug Shows Promise Against Psoriatic Arthritis
New medication improved skin condition, lessened swelling, study finds
"There are also certain genes that are present in people who develop the arthritis that are not present in people with psoriasis. So there seems to be a heavy genetic component for determining who gets psoriasis and goes on to get psoriatic arthritis," he said.
Current treatment for psoriatic arthritis depends on how much pain the patient has. Treatment usually starts with painkillers such as ibuprofen (Motrin or Advil) or naproxen (Aleve).
Mease noted that many patients are also given methotrexate (Trexall), which treats both arthritis and psoriasis. Other drugs, known as biologic therapy, that are also used to treat both conditions include adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi) and infliximab (Remicade).
Current drugs such as methotrexate target a substance called tumor necrosis factor-alpha, which is produced in response to inflammation. But these drugs tend to be less effective over time, Mease said.
Brodalumab works differently. It acts against interleukin-17 receptor A, a substance found in higher levels in people with psoriatic arthritis, according to the study.
For the current phase 2 trial of brodalumab, Mease and colleagues randomly assigned 168 patients with psoriatic arthritis to a low (140 milligrams) or high dose (280 milligrams) of brodalumab, or a placebo.
The average age of the study participant was 52 years. Two-thirds of the study volunteers were women and 94 percent were white (which included Hispanics and Latinos). The average amount of time they'd had psoriatic arthritis was nine years, according to the study.
After 12 weeks, patients taking either dose of brodalumab had a greater response to treatment than those receiving placebo (37 percent and 39 percent versus 18 percent).
Moreover, 14 percent of those taking brodalumab had a 50 percent improvement in symptoms based on the American College of Rheumatology response criteria, compared with 4 percent who received the placebo, the researchers found.
Improvements were seen in both patients who had previous biologic therapy, as well as those who had not had biologic therapy in the past, the researchers noted.
After 24 weeks of treatment, 51 percent of patients taking the lower dose of brodalumab and 64 percent taking the higher dose responded to the drug. In addition, 44 percent of the patients who switched from placebo to brodalumab responded to treatment.