Elaine Husni, MD: Choosing Between Treatments in Psoriatic Arthritis

While there are many subgroups and patient populations within rheumatology seeking novel effective treatments, for conditions like psoriatic arthritis(PsA) there are a dozen approved treatments.

With evidence of methotrexate providing relief of PsA symptoms dating back to the 1980s, the larger challenge for rheumatologists is often choosing between which of treatment is most appropriate for a patient.

With 10 biologic disease-modifying antirheumatic drugs approved by the US FDA for the treatment of PsA, selecting a therapy that fits well into a patient’s current treatment algorithm can be a daunting task. For more on how clinicians choose between treatment options, MD Magazine® sat down with Elaine Husni, MD, MPH, vice chair of rheumatology at the Cleveland Clinic for how she goes about making that decision.

MD Mag: With so many treatment options available for patients with psoriatic arthritis, how do you go about choosing which is most appropriate?

Husni: Whenever we have a lot of therapies, then the question becomes Well, how do we sort of cycle through them? How do we see clinically use them? And I think what we need to do is understand better some of the nuances amongst the treatment options. So what I mean by that is how do we personalize care? How do we be able to pick the right drug rather than a trial and error sort of regimen, which is sort of what we're doing now.

So, I think it's important to understand how these drugs can have benefits in different areas and different domains of treatment. So whether it might be a little bit better for the skin versus a little bit better for the joints are better for fatigue or other health related quality of life. I think knowing how these medicines can treat a patient can help us personalize the ways that we choose them. In addition It's mechanism of action.