Psoriatic Arthritis: Tight Control Improves Arthritis, Skin Disease

Dr. Laura Coates Division of Rheumatic and Musculoskeletal Disease Chapel Allerton Hospital Chapeltown Road Leeds NIHR Clinical Lecturer at the University of LeedsMedicalResearch.com Interview with:
Dr. Laura Coates
Division of Rheumatic and Musculoskeletal Disease
Chapel Allerton Hospital Chapeltown Road Leeds
NIHR Clinical Lecturer at the University of Leeds


MedicalResearch.com: What are the main findings of the study?

Answer: The TICOPA study showed that treating patients with early psoriatic
arthritis to an objective target with regular review improved
patient’s clinical outcome both in terms of arthritis and skin
psoriasis.  There was an increase in adverse events in the tight
control arm but only 4 serious infections seen in the tight control
arm that were thought to be related to treatment (2 cases of
cellulitis, 2 cases of chest infection).

MedicalResearch.com: Were any of the findings unexpected?

Answer: The findings are not totally unexpected as previous observational
studies have suggested that inflammation in joints is linked to long-
term outcome.  However this is the first study to assess treatment to
target in PsA and show such a direct improvement in outcome.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: The study suggests that clinicians should be more aggressive with
treatment of psoriatic arthritis and assess all of the different
facets of the disease when considering treatment options.  Using the
minimal disease activity (MDA) criteria to assess patients can assist
in treatment decisions ensuring that both the physician’s and
patient’s opinions are taken into account.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Further studies are now needed to test alternative treatment
strategies with different therapies as we have little evidence in PsA
about which drugs to use in which order.  We also need to do further
research about predictors of response and disease severity so that we
can personalise treatment and identify which patients need more
aggressive therapy.

Citation:

ACR 2013 presentation:
Results of a randomized controlled trial comparing tight control of
early psoriatic arthritis (TICOPA) with standard care: Tight control
improves outcome

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