I read an article pertaining to psoriatic arthritis and how it is overlooked initially.  This cliché popped into my head “which came first the chicken or the egg”.  You laugh, but this is what’s happening in the psoriasis community.  Psoriatic’s dismiss their joint pain for something other then psoriatic arthritis.  Plus doctors are not properly surveying the patient and therefore not connecting the two diseases. 

Why is this a problem?  Psoriatic arthritis, when not treated can have irreversible effects on bones and joints.  PsA can contribute to bone loss and deformities.  Swelling of certain joints can lead to temporarily or long term disabilities.   Psoriasis patients are at fault for not educating themselves about psoriatic arthritis.  Doctors are at fault for not asking the patient if they are experiencing any joint pain or swelling.  The difference of evaluation could mean more specific medications as opposed to the patient walking out with a tube of cortisone.

Timely Treatment Decisions
Here is a excerpt written by Thomas G. Ciccone a Staff Writer at Practical Pain Management

Treatment decisions need to be timely, precise—perhaps even pragmatic—to improve outcomes and inhibit the disease’s radiographic progression. However, this may be a more perplexing task than it was in the past. For decades, methotrexate (Trexall, Rasuvo, others) was the proverbial drug-of-choice for PsA, but in the last few years, the practice has seen a ballooning inventory of pharmaceutical options.

“It’s unbelievable the amount of new treatments that are available for psoriatic arthritis today,” said Elaine Husni, MD, MPH, of the Cleveland Clinic Foundation in Ohio. The litany of TNFi, phosphodiesterase-4 inhibitors (PDE4i), and emerging investigational interleukin inhibitors present a bevy of therapeutic approaches to assess.

The article brings up some critical points for both the patient and the doctors initial evaluation.  I like what Dr. Mease says here, “We now are able to treat to target—meaning treat to a target of either low disease activity or even remission. In addition, we now have quantitative measures that can be employed in rheumatology to quantitate disease response.”

I encourage patients to see their doctor.  New treatment options are proving to be safe and effective.  If you don’t have insurance you can register for a clinical trial. Review the studies being conducted at clinicaltrials.gov.  If you want to be proactive then I would suggest registering for one of our events at National Psoriasis Foundation If you want to sponsor a rider, namely me, go to Hamptons NY Bike Ride Have a wonderful day.  Remember to have your pets spade or neutered.

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