Choosing the right treatment for patients with psoriatic arthritis

Noviani, Maria; Feletar, Marie; Nash, Peter; Leung, Ying Ying

doi:10.1177/1759720x20962623

Cited by 15 publications

(9 citation statements)

References 110 publications

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“…Several therapies are available for PsA with differing mechanisms of action, and treatment guidelines have focused on individualized treatment to address as many relevant disease domains as possible [ 2 , 4 , 5 ]. Conventional and biologic disease-modifying antirheumatic drug (DMARD) options for PsA include methotrexate and inhibitors of tumor necrosis factor, interleukin-17A (IL-17A), IL-12/23p40, IL-23p19, phosphodiesterase 4, T cell activation, and the Janus kinase pathway [ 1 , 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Collagen Turnover Biomarkers Associate with Active Psoriatic Arthritis and Decrease with Guselkumab Treatment in a Phase 3 Clinical Trial (DISCOVER-2)

et al. 2022

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Introduction Guselkumab, a novel interleukin-23p19 subunit monoclonal antibody, has been shown to effectively improve the diverse manifestations of active psoriatic arthritis (PsA) in two phase 3 trials (DISCOVER-1, DISCOVER-2). Serum concentrations of extracellular matrix (ECM) biomarkers at baseline and following treatment with guselkumab were evaluated in patients with active PsA, and the relationship of these biomarkers with baseline PsA characteristics and clinical response to guselkumab treatment was explored. Methods Serum samples were collected at weeks 0, 4, 24, and 52 from a selected subset ( N = 260) of the 739 biologic-naïve patients with PsA treated with guselkumab 100 mg every 4 or 8 weeks or placebo in DISCOVER-2. Demographically matched healthy controls ( N = 76) were used for comparison. The samples were analyzed for ECM biomarkers associated with collagen degradation (C1M, C2M, C3M, C4M, C6M, C10C) and collagen formation (PRO-C1, PRO-C2, PRO-C3, PRO-C4, PRO-C6). Results Baseline concentrations of collagen degradation biomarkers C1M, C3M, C4M, and C6M and collagen formation biomarkers PRO-C3 and PRO-C6 were significantly higher (i.e., ≥ 1.25-fold and false discovery rate adjusted p < 0.05) in PsA patients than in healthy controls. Serum C1M, C3M, C4M, and C6M levels declined from baseline in guselkumab-treated patients in both dosing regimens. In addition, guselkumab-treated ACR20 responders (≥ 20% improvement in American College of Rhematology response criteria) had significantly lower C1M levels than ACR20 nonresponders. Conclusion These data demonstrate that serum collagen biomarkers are elevated in patients with PsA compared with healthy controls and that treatment with guselkumab decreases levels of C1M, C3M, C4M, and C6M. Importantly, C1M serves as a biomarker that associates with improvement of joint signs and symptoms. Trial Registration ClinicalTrials.gov identifier: NCT03158285. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-022-00444-x.

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Section: Introductionmentioning

confidence: 99%

Collagen Turnover Biomarkers Associate with Active Psoriatic Arthritis and Decrease with Guselkumab Treatment in a Phase 3 Clinical Trial (DISCOVER-2)

et al. 2022

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“…In particular, it is difficult to distinguish PsA from RA or osteoarthritis, because, in some cases, skin symptoms and arthritis develop simultaneously, and in other cases, arthritis precedes skin symptoms [ 40 ]. Since PsA is a disease that can cause serious damage to joints if diagnosis is delayed, a BM that can rapidly diagnose and predict the onset of PsA is required [ 42 , 61 ]. A previous report on PsA showed that the expression levels of high-sensitivity CRP, osteoprotegerin, MMP-3, and the ratio CPII of C2C differ between patients with psoriasis alone and those with PsA [ 62 ].…”

Section: Psoriasismentioning

confidence: 99%

Current Status, Issues and Future Prospects of Personalized Medicine for Each Disease

Yamamoto

Kanayama

Nakayama

et al. 2022

JPM

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In recent years, with the advancement of next-generation sequencing (NGS) technology, gene panel tests have been approved in the field of cancer diseases, and approaches to prescribe optimal molecular target drugs to patients are being developed. In the field of rare diseases, whole-genome and whole-exome analysis has been used to identify the causative genes of undiagnosed diseases and to diagnose patients’ diseases, and further progress in personalized medicine is expected. In order to promote personalized medicine in the future, we investigated the current status and progress of personalized medicine in disease areas other than cancer and rare diseases, where personalized medicine is most advanced. We selected rheumatoid arthritis and psoriasis as the inflammatory disease, in addition to Alzheimer’s disease. These diseases have high unmet needs for personalized medicine from the viewpoints of disease mechanisms, diagnostic biomarkers, therapeutic drugs with diagnostic markers and treatment satisfaction. In rheumatoid arthritis and psoriasis, there are many therapeutic options; however, diagnostic methods have not been developed to select the best treatment for each patient. In addition, there are few effective therapeutic agents in Alzheimer’s disease, although clinical trials of many candidate drugs have been conducted. In rheumatoid arthritis and psoriasis, further elucidation of the disease mechanism is desired to enable the selection of appropriate therapeutic agents according to the patient profile. In the case of Alzheimer’s disease, progress in preventive medicine is desired through the establishment of an early diagnosis method as well as the research and development of innovative therapeutic agents. To this end, we hope for further research and development of diagnostic markers and new drugs through progress in comprehensive data analysis such as comprehensive genomic and transcriptomic information. Furthermore, new types of markers such as miRNAs and the gut microbiome are desired to be utilized in clinical diagnostics.

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“…The extra-articular manifestations of PsA include inflammatory bowel disease (IBD) and uveitis ( 5 ). In recent years, there are advancements in therapeutic options to treat musculoskeletal manifestations of PsA ( 6 ), but research to understand the pathogenesis of extra-articular manifestations and their treatment options is still in infancy. The purpose of this review is to summarize the current understanding of pathogenesis of PsA and the extra-articular manifestations and their treatment options.…”

Section: Introductionmentioning

confidence: 99%

Managing Psoriatic Arthritis With Inflammatory Bowel Disease and/or Uveitis

et al. 2021

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Psoriatic arthritis (PsA) is a chronic inflammatory disease that presents with psoriasis (PsO), peripheral and axial arthropathy. The heterogeneity of disease presentation leads to the term “psoriatic disease (PsD)” which is thought to better encompass the range of clinical manifestations. PsA is associated with several comorbidities such as cardiovascular diseases, metabolic syndrome and other extra-articular manifestations including uveitis, and inflammatory bowel disease (IBD). While novel therapeutics are being developed following advances in our understanding of the pathogenesis of the disease, the diverse combinations of PsA with its various comorbidities still pose a clinical challenge in managing patients with PsA. This article reviews our current understanding of the pathogenesis of PsA and how various pathways in the pathogenesis lead to the two comorbid extra-articular manifestations – uveitis and IBD. We also review current evidence of treatment strategies in managing patients with PsA with comorbidities of uveitis and/or IBD.

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Choosing the right treatment for patients with psoriatic arthritis

Cited by 15 publications

References 110 publications

Collagen Turnover Biomarkers Associate with Active Psoriatic Arthritis and Decrease with Guselkumab Treatment in a Phase 3 Clinical Trial (DISCOVER-2)

Collagen Turnover Biomarkers Associate with Active Psoriatic Arthritis and Decrease with Guselkumab Treatment in a Phase 3 Clinical Trial (DISCOVER-2)

Current Status, Issues and Future Prospects of Personalized Medicine for Each Disease

Managing Psoriatic Arthritis With Inflammatory Bowel Disease and/or Uveitis

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