A new research study is enrolling for adults with Psoriatic Arthritis at ForCare. If you are struggling with this condition, a clinical research study may be an option for you. Reimbursement may be available for time and travel.
Qualified participants are:
- Age 18 or above
- Diagnosed with Psoriatic Arthritis
- Not diagnosed with any other forms of Autoimmune Arthritis (Rheumatoid Arthritis, Ankylosing Spondylitis)
- Participants aged 18 or above are needed and compensated for a clinical trial for Psoriatic Arthritis.
All study related tests, visits and investigational product are at no cost to the participant.
Facts about Psoriatic Arthritis
Approximately two percent (2%) of the population is affected by Psoriatic Arthritis. There are about two hundred thousand new cases diagnosed a year. Psoriatic Arthritis generally presents in a person’s early twenties. The condition may appear in children; however, it is less common.
Spondylitis: Inflammation of the spinal column. This occurs in some individuals with psoriatic arthritis. The main symptoms are inflammation with stiffness of the neck, lower back and sacroiliac joints. Spinal arthritis makes joint motion in these areas painful and difficult.
Enthesitis: Inflammation of entheses, the site where ligaments or tendons insert into the bones. Common locations for Enthesitis include the bottoms of the feet, the Achilles’ tendons, and the places where ligaments attach to the ribs, spine and pelvis. It is unique to Psoriatic Arthritis and does not occur with other forms of arthritis like Rheumatoid Arthritis or Osteoarthritis. Enthesitis can make the tissues in the affected area become ropey (known as fibrosis) or solid (known as ossification or calcification).
Dactylitis: Also known as “sausage digits,” refers to inflammation/swelling of an entire finger or toe. It happens when the small joints and Entheses of the surrounding tendons become inflamed. Dactylitis is another distinguishing indicator of Psoriatic Arthritis. Usually Dactylitis involves a few fingers and/or toes, but not in a symmetrical pattern (different toes and fingers are affected on different sides of the body).
Approximately forty percent (40%) of patients with Plaque Psoriasis are affected with Psoriatic Arthritis.
Type of Psoriatic Arthritis
Symmetric Psoriatic Arthritis: This makes up about 50 percent of PsA cases. Symmetric means it affects joints on both sides of the body at the same time. This type of arthritis is similar to Rheumatoid Arthritis.
Asymmetric Psoriatic Arthritis: Often mild, this type of PsA appears in 35 percent of people with the condition. It’s called asymmetric because it doesn’t appear in the same joints on both sides of the body.
Distal Psoriatic Arthritis: This type causes inflammation and stiffness near the ends of the fingers and toes, along with changes in toenails and fingernails such as pitting, white spots and lifting from the nail bed.
Spondylitis: Pain and stiffness in the spine and neck are hallmarks of this form of PsA.
Arthritis Mutilans: Although considered the most severe form of PsA, arthritis mutilans affects only 5 percent of people who have the condition. It causes deformities in the small joints at the ends of the fingers and toes, and can destroy them almost completely.
Effects of Psoriatic Arthritis
Psoriatic Arthritis affects far more than just the joints. It can have a severe and measurable affect on the quality of life. Patients affected with the condition may experience the following:
- Sleep loss from joint pain
- Work Loss
- Sexual Dyspareunia (uncomfortable sexual relations)
- Decreased physical activity
- Permanent Joint Damage and Deformity
- Permanent Disability
Symptoms of Psoriatic Arthritis
- Plaque Psoriasis
- Generalized fatigue
- Tenderness, pain and swelling over tendons
- Swollen fingers and toes that look like sausages (Sausage Digits)
- Stiffness, pain, throbbing, swelling and tenderness in one or more joints
- A reduced range of motion
- Morning stiffness and tiredness
- Nail changes—for example, the nail separates from the nail bed and/or becomes pitted and mimics fungus infections
- Redness and pain of the eye, such as conjunctivitis
There is no cure at this time. Treatments aim to reduce inflammation, scale development, slow the accumulation of skin cells, and remove plaques. Treatments fall into three categories: topical treatments, systemic medications, and light therapy.
Treatment of Psoriatic Arthritis
Creams and ointments applied directly to the skin can be helpful for reducing mild to Psoriatic Arthritis.
- Diclofenac Cream and/ointment (Voltaren)
- Capsaicin Cream (Capzacin-HP)
- Methyl Salicylate Cream (Ben-Gay
People with moderate to severe Psoriatic Arthritis, and those who have not responded well to other treatment types, may need to use oral, subcutaneously injected or intravenously infused medications. The medications include:
- Biologic therapy
- TNF-α inhibition
- Infliximab (Remicade)
- Adalimumab (Humira)
- Certolizumab pegol (Cimzia)
- Golimumab (Simponi)
- Etanercept (Enbrel)
- IL-12/23 Inhibition – Ustekinumab (Stelara)
- IL-17 Inhibition –
- Secukinumab (Cosentyx)
- Ixekizumab (Taltz
- CD-20 Antibody – Rituximab (Rituxan)
- IL-1 receptor – Anakinra (Kineret)
- TNF-α inhibition
- DMARDS (Disease Modfying Anti-Rheumatic Drugs) – Methotrexate, Cyclopsporine, Dapsone, Mycophenolate Mofetil, Leflunomide, etc
- Phosphodiesterase-4 Inhibition – Apremilast (Otezla)
Psoriatic Arthritis – Other Considerations
Psoriatic Arthritis is a multi-systemic condition that requires a multidisciplinary approach. The therapeutic team may consist of:
- Orthopedic Surgeon
- Physiatrist (Physical Medicine and Rehabilitation)
- Physical Therapist