UNMET NEEDS REMAIN IN TREATMENT1
Patients are dissatisfied with traditional oral therapies1
The MAPP survey revealed unmet needs in treatment:
*Subset of all patients surveyed. Overall, 24% of all patients said they had been prescribed a traditional oral medication for their disease (eg, cyclosporine, methotrexate, acitretin, or fumaric acid esters) at some point since their diagnosis; of these, 43% were receiving therapy and 57% had discontinued use.
- 66% of psoriatic arthritis patients report comorbidities, which may contribute to difficulties in treatment1
Patients who discontinued traditional oral therapies did so primarily due to concerns about efficacy, safety, and tolerability1
THE HETEROGENEITY OF PSORIATIC ARTHRITIS IS A MAJOR CHALLENGE IN THE TREATMENT OF DISEASE
Multiple manifestations impact physical function and contribute substantially to disease burden2-5
- Enthesitis is present in up to 78% of patients and nearly half (48%) of patients report dactylitis, both of which are associated with higher levels of physical impairment2-4
- Extra-articular domains of such as skin and nail psoriasis constitute nearly half of patient-reported burden of disease5
- There are 6 key domains recognized in psoriatic arthritis: Peripheral arthritis, enthesitis, dactylitis, skin, nail, and axial disease6
Up to 50% of psoriatic arthritis patients have an oligoarticular form of the disease7-9
- Oligoarthritis is characterized by fewer affected joints and less erosive disease9
- Despite being a less-progressive disease, patients with oligoarthritis report high disease burden10
Treatment for psoriatic arthritis should address as many of the 6 key
domains as possible, while balancing safety considerations6
|PsA - specific evidence|
|Effectivness in multiple PSA domains, including dactylitis and enthesitis|
|Evidence of long-term efficacy|
|Proven long-term safety profile|
|No label-required laboratory prescreening or ongoing monitoring|
|Warnings and precautions||
aProducts that are available as generic formulations are referred to by the active compound name.
Nearly two-thirds of patients on stable conventional DMARDs
continue to have disease activity, suggesting that a majority of
patients may benefit from treatment modification12†
†Observational, cross-sectional study (N = 152) conducted at 2 sites in Amsterdam involving patients with psoriatic arthritis on current or previous conventional DMARD, such as methotrexate or leflunomide, or TNF-inhibitor. Disease activity was defined by the treating rheumatologist (an answer of YES to the question: Do you think there is remaining disease activity in this patient, despite current treatment regimen?) based on physical examination at a routine clinical visit and collected outcome measures (VAS-PhysGlobal, VAS-PhysSkin,and BASDAI).
BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; DMARD, disease modifying antirheumatic drug; DRESS, Drug Reaction with Eosinophilia and Systemic Symptoms; VAS, visual analogue scale.
- Lebwohl MG, BachelezH, Barker J, et al. Patient perspectives in the management of psoriasis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey. J Am Acad Dermatol. 2014;70(5):871-881.
- Orbai A, Weitz J, Siegal EL, et al. Systemic review of treatment effectiveness and outcome measures for enthesitis in psoriatic arthritis. J Rheumatol. 2014;41(11):2290-2294.
- Brockbank JE, Stein M, Schentag CT, et al. Dactylitis in psoriatic arthritis: a marker for disease severity. Ann Rheum Dis. 2005;64(2):188-190.
- Kavanaugh A, Helliwell P, Ritchlin CT. Psoriatic arthritis and burden of disease: patient perspectives from the population-based multinational assessment of psoriasis and psoriatic arthritis (MAPP) survey. Rheumatol Ther. 2016;3(1):91-102.
- Dandorfer SW, Rech J, Manger B, et al. Differences in the patient’s and the physician’s perspective of disease in psoriatic arthritis. Semin Arthritis Rheum. 2012;42(1):32-41.
- Coates LC, Kavanaugh A, Mease PJ, et al. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016;68(5):1060-1071.
- Coates LC, Fitzgerald O, Gladman DD, et al. Reduced joint counts misclassify patients with oligoarticular psoriatic arthritis and miss significant numbers of patients with active disease. Arthritis Rheum. 2013;65(6):1504-1509.
- Lindqvist UR, Alenium G, Husmark T, et al. The Swedish early psoriatic arthritis register –2-year followup: a comparison with early rheumatoid arthritis. J Rheumatol. 2008;35(4):668-673.
- Nossent JC, Gran JT. Epidemiological and clinical characteristics of psoriatic arthritis in northern Norway. Scand J Rheumatol. 2009;38(4):251-255.
- Huscher D, Albrecht K, Bischoff S, et al. Patients with psoriatic arthritis and oligoarthritic subtype report higher disease burden than patients with a polyarthritic pattern –data from the German Collaborative Arthritis Centres. Presented at the ACR/ARHP Annual Meeting. November 6-11, 2015; San Francisco, CA.
- Data on file, Celgene Corporation.
- Van Mens L, van de Sande M, Fluri IA, et al. Residual disease activity and treatment adjustments in psoriatic arthritis in current clinical practice. Arthritis Research & Therapy. 2017;19(1):226.