Abstract:PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers.
“…Progression of radiographic joint damage and the presence of enthesitis and dactylitis can lead to decreased physical function and disability. The totality of these symptoms contributes to the significant psychosocial burden of PsA .Intravenous golimumab 2 mg/kg was effective in reducing the signs and symptoms of active psoriatic arthritis in adult patients with a robust response through 1 year of treatment.Improvements in health‐related quality of life in adult patients treated with intravenous golimumab 2 mg/kg were maintained through 1 year.Patients who crossed over from placebo to golimumab 2 mg/kg at week 24 generally achieved efficacy responses similar to those of patients who received golimumab from baseline in this 1‐year study.The safety profile observed in this study was consistent with the known safety profile of anti–tumor necrosis factor agents, including previous studies of golimumab.…”
Objective. The present study was undertaken to evaluate the safety and efficacy of intravenous (IV) golimumab in patients with active psoriatic arthritis (PsA) through 1 year.Methods. GO-VIBRANT was a phase III, randomized, placebo-controlled trial of 480 adults with active PsA. Patients were randomized to receive IV placebo (n = 239) or golimumab 2 mg/kg (n = 241) at weeks 0, 4, and every 8 weeks, with placebo crossover to golimumab at weeks 24, 28, and every 8 weeks thereafter. Efficacy through week 52 was assessed using the American College of Rheumatology (ACR) ≥20%, 50%, or 70% improvement criteria (ACR20/50/70), and the Psoriasis Area and Severity Index ≥75% improvement criteria (PASI75). Radiographic progression was measured using the PsA-modified Sharp/van der Heijde score (SHS). Adverse events (AEs) were monitored through week 60.Results. The primary and major secondary end points through week 24 were achieved. At week 52, 76.8% of patients in the golimumab group and 77.0% in the placebo-crossover group achieved an ACR20 response, 58.1% and 53.6%, respectively, achieved an ACR50 response, and 38.6% and 33.9%, respectively, achieved an ACR70 response. Among patients with ≥3% body surface area affected, 71.9% in the golimumab group and 60.6% in the placebo-crossover group achieved a PASI75 response at week 52. Mean change from baseline in total SHS at week 52 was -0.5 in the golimumab group and 0.8 in the placebo-crossover group. Through week 60, 50.9% of all golimumabtreated patients had ≥1 AE, and 5.2% had ≥1 serious AE. There were no opportunistic infections, 2 malignancies, and 1 death in patients treated with golimumab.Conclusion. Sustained improvements in joint and skin disease in patients with PsA were maintained through 1 year in the GO-VIBRANT study. No new safety signals for IV golimumab were identified.
“…Progression of radiographic joint damage and the presence of enthesitis and dactylitis can lead to decreased physical function and disability. The totality of these symptoms contributes to the significant psychosocial burden of PsA .Intravenous golimumab 2 mg/kg was effective in reducing the signs and symptoms of active psoriatic arthritis in adult patients with a robust response through 1 year of treatment.Improvements in health‐related quality of life in adult patients treated with intravenous golimumab 2 mg/kg were maintained through 1 year.Patients who crossed over from placebo to golimumab 2 mg/kg at week 24 generally achieved efficacy responses similar to those of patients who received golimumab from baseline in this 1‐year study.The safety profile observed in this study was consistent with the known safety profile of anti–tumor necrosis factor agents, including previous studies of golimumab.…”
Objective. The present study was undertaken to evaluate the safety and efficacy of intravenous (IV) golimumab in patients with active psoriatic arthritis (PsA) through 1 year.Methods. GO-VIBRANT was a phase III, randomized, placebo-controlled trial of 480 adults with active PsA. Patients were randomized to receive IV placebo (n = 239) or golimumab 2 mg/kg (n = 241) at weeks 0, 4, and every 8 weeks, with placebo crossover to golimumab at weeks 24, 28, and every 8 weeks thereafter. Efficacy through week 52 was assessed using the American College of Rheumatology (ACR) ≥20%, 50%, or 70% improvement criteria (ACR20/50/70), and the Psoriasis Area and Severity Index ≥75% improvement criteria (PASI75). Radiographic progression was measured using the PsA-modified Sharp/van der Heijde score (SHS). Adverse events (AEs) were monitored through week 60.Results. The primary and major secondary end points through week 24 were achieved. At week 52, 76.8% of patients in the golimumab group and 77.0% in the placebo-crossover group achieved an ACR20 response, 58.1% and 53.6%, respectively, achieved an ACR50 response, and 38.6% and 33.9%, respectively, achieved an ACR70 response. Among patients with ≥3% body surface area affected, 71.9% in the golimumab group and 60.6% in the placebo-crossover group achieved a PASI75 response at week 52. Mean change from baseline in total SHS at week 52 was -0.5 in the golimumab group and 0.8 in the placebo-crossover group. Through week 60, 50.9% of all golimumabtreated patients had ≥1 AE, and 5.2% had ≥1 serious AE. There were no opportunistic infections, 2 malignancies, and 1 death in patients treated with golimumab.Conclusion. Sustained improvements in joint and skin disease in patients with PsA were maintained through 1 year in the GO-VIBRANT study. No new safety signals for IV golimumab were identified.
“…The physical and psychosocial disability associated with PsA places a substantial burden on patients due to its diverse clinical spectrum. In addition to debilitating joint damage, the presence of psoriatic skin disease can cause patients embarrassment, self-consciousness, and depression [40]. The substantial burden of PsA on patient quality of life has been reported in studies carried out in North America and Europe [41].…”
Section: Physical and Psychosocial Disease Impact Of Psa In Africa Anmentioning
Psoriatic arthritis (PsA) is a chronic, inflammatory arthropathy occurring in up to 30% of patients with psoriasis, and is characterized by multiple manifestations including peripheral arthritis, enthesitis, dactylitis, spondylitis, and psoriatic skin and nail disease. This complex and heterogeneous disease is poorly understood and its diagnosis and treatment are suboptimal, particularly in Africa and the Middle East, where very few studies into the impact of PsA have been carried out. This article aims to highlight the disease burden of PsA in the region as well as to identify unmet clinical needs. A non-systematic review was carried out in the PubMed database and the most relevant publications were selected. Expert rheumatologists practicing in Africa and the Middle East provide an insight into the challenges of treating PsA in daily practice, along with recommendations for improvements.
“…[5][6][7] The psychosocial burden in PsA further affects the HRQoL, and is much worse than in patients with rheumatoid arthritis (RA). [7][8][9] It is evident that this disease is associated with substantial clinical burden and cost to both the patient and society. show conflicting results.…”
Aim
There have been major advances in biologic treatment options for psoriatic arthritis (PsA) since the publication of the 2015 consensus recommendations by the Chapter of Rheumatologists, College of Physicians, Academy of Medicine, Singapore, for government‐assisted funding, thus warranting a revision of this guideline.
Methods
Recent trials and nine published guidelines on the use of biologic therapy for PsA were reviewed. Based on the synthesized evidence, a task force panel (TFP), consisting of 10 practicing rheumatologists in Singapore, rated the statements pertaining to the use of biologic therapy, using a modified Delphi approach. Consensus was obtained if >70% agreed on a statement.
Results
The TFP agreed on 10 recommendations pertaining to the initiation, choice and continuation of biologic therapy. A biologic is indicated in patients with PsA: (a) with at least three swollen and tender joints, digits or entheses; and (b) who have failed at least two conventional synthetic disease‐modifying anti‐rheumatic drug (csDMARD) strategies for a minimum of 3 months each. Any approved drug class including tumor necrosis factor inhibitors, interleukin‐17 inhibitors (IL‐17i), IL‐12/23i or targeted synthetic DMARDs may be considered as first‐line treatment, and continued only if a response is achieved by 6 months.
Conclusion
These recommendations developed through a formal consensus method may be useful to guide funding considerations for appropriate and equitable use of biologic therapy for eligible patients with PsA.
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