- A new clinical trial shows potential for the drug brepocitinib to treat psoriatic arthritis.
- The medication works by limiting the autoimmune response that causes the inflammation that is at the core of psoriatic arthritis.
- This trial is just one of many currently being undertaken to measure brepocitinib’s impact on multiple immunocompromising conditions
A phase two trial of brepocitinib, a drug being tested as a possible treatment for several immunocompromising conditions like systemic lupus erythematosus, ulcerative colitis, and dermatomyositis, has also shown positive results for the treatment of psoriatic arthritis.
The trial’s results were published
Around one in three people with psoriasis have psoriatic arthritis, according to the National Psoriasis Foundation.
They also cite data that puts the total number of Americans with psoriasis at around eight million.
Psoriatic arthritis attacks not just the joints and the skin, but the underlying inflammation can also affect bodily systems like your eyes, heart, and lungs.
Dr. Chirag Patel of Hansa Medical likens it to a relative of similar conditions like rheumatoid and osteoarthritis.
“Osteoarthritis is more of a wear and tear phenomenon, kind of like the brake pads in your car. While rheumatoid arthritis is more, ‘hey, I’m not liking your brake pads, I’m going to go attack the brake pads,'” Patel explained. “Psoriatic arthritis can affect a lot of different organs and symptoms, while rheumatoid is a little bit more related to the joints.”
The drug works by inhibiting the immune response that causes the inflammation that is at the core of psoriatic arthritis, a type of medication called a Janus kinase inhibitor or JAKi.
In the words of the researchers — who were from the US, UK, Poland, and Australia — this use of brepocitinib could fill a gap in treatment options.
“Despite a variety of treatment options, the PsA treatment goals of decreasing disease activity, inducing remission, and improving health-related quality of life (HRQoL) and function, as well as preventing structural damage and complication…remain an unmet need.”
According to a resource made available by the National Library of Medicine, the first clinical trial related to brepocitinib, which was developed by Pfizer, was in 2017.
This most recent research involved participants who received the medication for 52 weeks. The primary focus was on the data collected by the four-month mark.
This recent trial, which was placebo-controlled and also funded by Pfizer, included 218 participants, with those receiving the medication having between a 66.7% or 74.6% ACR20 response rate depending on their dosage of 10mg, 30, mg, or 60 mg per day.
This means that around two-thirds of those being given 30 milligrams of brepocitinib daily over the year-long trial had a 20% reduction in symptoms.
Those who were given a placebo had a 43.3% ACR20 response.
While there are multiple biologics on the market to treat psoriatic arthritis, many of the medications currently, like methotrexate, have significant side effects.
Patel says that looking at treatment options requires a thorough look at not just what medications a patient has already taken, but also other factors.
“How long have they had psoriasis or psoriatic arthritis? what’s worked, what hasn’t worked? Even insurance, you know, some medicines are covered by insurance, some cost tens of thousands of dollars, especially new ones on a consistent monthly basis that might be cost prohibitory for someone and we might have to be relegated to an older medication.”
Participants in the trial were allowed to take methotrexate, leflunomide, and sulfasalazine, all medications that can complicate someone’s health status because they are immunocompromising.
Patel says that, when healthcare providers are finding a suitable treatment plan for patients with psoriatic arthritis, it can take a number of team members to coordinate.
“People’s immunity can be compromised because of the disease itself, but also sometimes by the medications that are involved in the treatment…Oftentimes, there’s a rheumatologist that’s involved or following along for the benefit of the patient, but oftentimes, as a primary care doctor, we see these kind[s] of [effects on the frontlines] when we’re treating the patient.
Like with most trials and studies of this type, the recent one had some limitations that were identified by the researchers.
The vast majority of the participants were white and located in eastern Europe.
Still, the trial identified a significant reduction in symptoms and the research team stated that they see the risk factors and side effects being in line with similar work in the field.