Thursday, December 27, 2012

Psoriatic Arthritis at the ACR 2012 in Washington

Non-anti-TNF Biologics in Psoriatic Arthritis at EULAR 2011. I hope for new results on new drugs as therapy for psoriatic arthritis still lags behind.

Actually I’ve found only data on one drug: apremilast. Apremilast is a small molecule – a phospodiesterase 4 inhibitor. About a year ago, I’ve mentioned apremilast in ankylosing spondylitis:

Juergen Rech and colleagues presented (Abstract No 272): “Interim Safety Analysis of a Phase 2, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Efficacy Study of Apremilast (CC10004) in Subjects with Erosive Hand Osteoarthritis.” Conclusion: “ … we conclude that apremilast may also be well tolerated in patients with EHOA [erosive hand arthritis]. Apremilast, if proven to be efficacious in ongoing investigations, will be an interesting treatment option for patients with EHOA.”

There has been a second study by Arthur Kavanaugh and colleagues (Abstract No. L13): “Apremilast, an Oral Phosphodiesterase 4 Inhibitor, in Patients with Psoriatic Arthritis: Results of a Phase 3, Randomized, Controlled Trial”. Conclusion: “Apremilast significantly improved signs and symptoms of PsA and resulted in statistically and clinically meaningful improvements in physical function. Apremilast was generally well tolerated and no new safety or laboratory signals were detected.” Lets look at some side effects: diarrhea (placebo: 2.4%; apremilast 20 mg BID: 11.3%; and apremilast 30 mg BID, 19.0%), nausea (high dose: 18.5%), headache (10.1%, and 10.7%), and more.

There are still some hurdles to be taken by apremilast!

There’s another study of Bremander on smoking. B. I. Bremander and colleagues presented: "Smoking Is Associated with Worse and More Widespread Pain, Worse Fatigue, General Health and Quality of Life in a Swedish Population Based Cohort of Patients with Psoriatic Arthritis" (Abstract No. 1828). Conclusion: In this population based PsA cohort, patients who were ever smokers reported worse clinical outcomes compared with never smokers. ..."

I think the message is clear. Stop smoking!

Studies on ustekinumab are here:

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