Patients with psoriatic arthritis benefit from early aggressive drug treatment, says study

People with a type of arthritis affecting the skin and joints respond significantly better to early, aggressive drug treatment compared to standard care, according to preliminary results presented by a University of Leeds lecturer to a major US conference.

Dr Philip Helliwell, who is leading an Arthritis Research UK-funded multi-centre clinical trial into psoriatic arthritis, revealed today (Monday October 28) at the prestigious American College of Rheumatology Congress in San Diego that patients benefited from a rapid escalation of medication.

Psoriatic arthritis - perhaps best known for being the condition Michael Gambon's character suffered from in the television programme, The Singing Detective - affects the joints and the skin, causing joint pain and swelling, leading to joint damage and disability over time.

Although better drugs are now available to treat the condition than in the past, Dr Helliwell and his team believe that earlier, intensive treatment of the condition can reduce joint damage more effectively, preventing disability.

"We have found that tight control of disease activity in psoriatic arthritis, using a targeted approach, significantly improves the joint and skin outcomes for newly diagnosed patients with no unexpected side-effects," said Dr Helliwell, Senior Lecturer in Rheumatology and a leading UK authority in psoriatic arthritis.

Dr Helliwell and his colleague Dr Laura Coates from the Leeds Institute of Rheumatic and Musculoskeletal Medicine, spearheaded a -550,000 national clinical trial, involving more than 200 patients, based at Chapel Allerton Hospital in Leeds.

They compared intensive early treatment carried out in specialist clinics with the kind of care patients usually receive, to find out which group of patients do better over a year.

"We predicted that a tighter, more aggressive treatment of psoriatic arthritis in which patients are given escalating dosages of drugs if their condition is not responding, and who then see a specialist every month with the aim of controlling their symptoms fully and as soon as possible, would result in a good outcome after 12 months," explained Dr Helliwell.

"That has proven to be the case. These findings could have significant implications for the way that this common type of inflammatory arthritis is treated and controlled."

Medical director of Arthritis Research UK, Professor Alan Silman, said: "Patients with psoriatic arthritis in general have fewer affected joints than those with rheumatoid arthritis, but there are sub-groups of patients who suffer a very severe form with a significant risk of irreversible, joint damage.

"Research in this disorder has lagged behind rheumatoid arthritis research, although patients have similar levels of disability and reduction in quality of life. In addition, they have to cope with often very severe skin problems and arthritis affecting the spine.

"Our trial has shown that patients with psoriatic arthritis benefit from early aggressive treatment that reduces the inflammation in the joints. Such an approach proved successful in the treatment of rheumatoid arthritis and this research could lead to a similar change in the way psoriatic arthritis patients are managed in the future."