Q&A: Common Misconceptions About Psoriatic Arthritis

Psoriatic arthritis, a chronic skin condition that affects patients on physically and mentally — often impacts patients’ mobility in their daily lives. Healthcare professionals across all specialties have experience when dealing with these patients in different capacities.

MD Magazine interviewed Jason Faller, MD, rheumatologist at Mount Sinai hospital, NY, NY, to shed light on this condition.

1. With so much buzz lately of celebrities diagnosed with psoriasis/PsA, how would you describe the current disease landscape?

More than one million people in the US live with PsA, but the number may be higher given that the disease is so often misdiagnosed and underreported. It is certainly good to see public figures come forward to talk about how they are impacted by these conditions, and help shed light on the community as a whole. We see that PsA affects both men and women equally, with symptoms usually appearing between the ages of 30 and 50. Additionally, up to 30% of psoriasis patients develop psoriatic arthritis.

2. How has the conversation and action for treatment/prevention shifted? What triggered the birth of the Be Counted! campaign?

PsA is commonly confused with other types of arthritis, most often osteoarthritis or degenerative arthritis. Patients have expressed difficulty getting others to understand the nature of their PsA, a distinct disease, impacting their ability to function and manage social interactions. It doesn’t only affect a person’s ability to perform daily activities — such as work, hobbies, and exercise – but it may also affect their relationships with others. At the most basic level, some people living with psoriatic arthritis find their mobility is affected, making it difficult to walk easily or climb stairs. It’s important to understand that there is no cure for PsA, nor is it preventable. It is, however, important for people living with the condition to work with their doctors to understand the condition and develop a treatment plan that is right for them.

Be Counted! aims to combat misunderstandings about the disease, by uniting patients, advocates, and doctors to raise awareness of PsA, educate the public, and rally support for this chronic, autoimmune condition.

At the campaign website, PsACounts.com, you can watch videos that highlight different perspectives on the disease. I encourage everyone to help spread the word about the program and PsA by sharing the videos via your social media channels.

3. What is your role in this campaign or in other education-focused platforms?

I have partnered with Celgene on Be Counted! to help provide my perspective as a rheumatologist on the condition, and to help educate the public about PsA. On PsACounts.com, you’ll see that I have been included in a video where I’ve discussed tips for healthy living and how PsA impacts the patients I work with every day.

4. Since rheumatologists aren’t the only healthcare professionals dealing with these patients, what do you suggest primary care physicians need to know?

Primary care physicians, who may see PsA patients first, include a range of health care providers, like general practitioners, podiatrists, orthopedists, and physiatrists. Patients visit these physicians because of a variety of symptoms that range from swollen fingers and toes to back pain, foot pain, or other joint symptoms. These providers should be aware of the potential link between these symptoms and psoriatic arthritis. Clues to the diagnosis include prior history of psoriasis as well as other markers that can be found on x-rays and lab test results. By working closely with patients, these physicians can help make an accurate diagnosis and optimize a treatment regimen for those patients recommend an appropriate individualized treatment plan for the patient.

One treatment option for adult patients with active psoriatic arthritis is a prescription pill called Otezla, also known as apremilast.

5. For the more severe cases, how would you consider patients’ quality of life?

People with PsA can appear to be healthy “on the outside,” but their condition may actually impact their mobility and daily life. At the most basic level, some lose dexterity in their hands and some are unable to walk easily or climb stairs. In my experience, patients often shared how PsA impacts day-to-day activities, such as caring for their families, performing their jobs, as well as driving a car or doing laundry. This can be particularly difficult because PsA generally impacts individuals in their 30s-50s.

6. What is the future of PsA treatment? Are there new indications in the pipeline?

As I mentioned, there is no cure for PsA, however there are several ways to help manage the disease including lifestyle changes and medical treatment. People with psoriatic arthritis should work closely with their physicians to create a treatment plan that works for them.

Rheumatologists have several options for the treatment of psoriatic arthritis. Otezla, also known as apremilast, is the first and only oral prescription medicine approved by the FDA for the treatment of adult patients with active psoriatic arthritis.