Why we produced our PsA Report: too few clinical trials, diagnostic tools or programs to help patients stay on therapy

When we first started selecting the reports for Drug Market Info we naturally chose psoriasis. We had done extensive work in the field and also I was very actively involved with psoriasis patients. We did not really plan to do an entirely separate report on psoriatic arthritis. Initially, I wanted to include it as a part of the Psoriasis Market Info™ Report. However, as we did more research and talked with patients it became pretty clear that psoriatic arthritis (PsA) is a very different disease than psoriasis.

Although the National Psoriasis Foundation estimates that up to a third of psoriasis patients have PsA, we believe these estimates are a little high. However, for patients with psoriatic arthritis the stakes are definitely higher with joint involvement. What I mean by that is that unlike psoriasis, where patients can take drug holidays or just stop therapy for a while, PsA patients can’t and indeed shouldn’t do this.  A couple of things came out when we talked to patients. One is that the earlier PsA is treated the better—before joint damage occurs. The other is that treatment can indeed be disease modifying and taking drug holidays with PsA is probably not a good idea. What patients told us is that if they don’t stay on therapy, fatigue sets in and all of the arthritic aspects of the disease become worse.  There is a message here for companies marketing drugs to design programs to help psoriatic arthritis patients utilize and stay on therapy.

The other thing about PsA is that most patients are treated by rheumatologists and see dermatologists to manage their psoriasis.  Although this goes smoothly for a lot of patients, it might be possible to help the coordination and communication with these two specialists so that patients can benefit. Again, we are hoping that Psoriatic Arthritis Market Info™ will bring about more awareness and potentially help PsA patients.

We were also amazed by the entire diagnosis process surrounding PsA. Many psoriasis patients don’t know they have it and chalk it up to sports or just being tired. Even when they finally end up at a doctor the diagnosis is one of exclusion. Clearly, more could be done in the area of diagnostic tools for psoriatic arthritis.

The lack of a definitive diagnosis is probably one of the reasons that there aren’t enough clinical trials conducted with PsA.  It is shocking that there are almost ten times more clinical trials going on for Rheumatoid Arthritis (RA) and three times more trials in psoriasis than PsA.  We are hoping that our report, Psoriatic Arthritis Market Info™, will draw attention to this destructive disease and encourage more companies to pursue this indication.