Psoriasis, a type of autoimmune disease, afflicts more than 7.5 million Americans, causing itchy or sore patches of thick, reddened skin covered with silvery scales. While this disease is most likely to develop in people 15-25 years old, after about a decade of having psoriasis, some people also develop psoriatic arthritis. Currently there are about 2 million Americans facing the chronic, painful joint inflammation of psoriatic arthritis.
Increasingly, experts suggest that early and aggressive treatment of psoriatic arthritis is the best course of action. This is an approach that has been suggested for rheumatoid arthritis, but only recently has it also been recommended for psoriatic arthritis.
British researchers published a study in The Lancet which demonstrates the benefits of early intervention. This study, called the tight control of inflammation in early psoriatic arthritis (TICOPA) study, enrolled 206 patients with early psoriatic arthritis and randomly assigned them to the standard care of seeing a doctor every 12 weeks or a “tight control” group in which patients were reviewed every four weeks and medication dosages increased if minimal disease activity criteria were not met. The primary end point at 48 weeks was the goal of achieving the American College of Rheumatology 20% (ACR20) response.
More patients in the tight control group achieved and maintained the goal of low disease activity (e.g., ACR20) than those in the standard care group. Yet, there were no more adverse effects reported from medication use in the tight control group. This study adds credence to keeping tight control on psoriatic arthritis from the early stages of this disease.
Coates LC, Moverley AR, McParland, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet 2015;386(10012):2489-98.