Study: Biologic Treatments Lessen Pain Before MRIs Show Results


Gina Garippo

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A healthy diet, regular exercise, and relaxation are great ways to take care of your skin with psoriasis.

Psoriasis Appointment Guide

Ask the right questions at your next doctor's appointment.

If you’re like many people with psoriatic arthritis, you and your doctor have used a “trial and error” approach to finding the right drug to treat your condition. That’s because what works for one person may not work for another.

If you’ve tried a number of treatment options and your doctor recommends a biologic response modifier (or biologic) drug, what can you expect? Published clinical research provides insight into how quickly patients may feel the results.

Researchers Compare Pain Levels with Actual Inflammation

Biologic drugs are designed to decrease inflammation, reducing or preventing long-term joint damage. However, new research shows that these drugs may also offer dramatic pain relief to patients even before their inflammation levels are greatly reduced. 

In a small study reported at the 2011 meeting of the American College of Rheumatology, researchers analyzed 29 men and women with psoriatic arthritis who responded to the biologic drug treatment adalimumab (Humira). The researchers then compared the patients’ self-estimated pain level with actual joint inflammation, which was measured using magnetic resonance imaging (MRI).

Drug Shows Early Effect on Pain

After 48 weeks of taking adalimumab, patients’ perception of pain dropped from an average of 62 at baseline to only 12 on a number scale used to rank pain levels. However, their actual joint inflammation was only slightly reduced during the same time frame. The drop in perceived pain was much greater than the drop in actual inflammation.

Actual joint inflammation was studied by imaging the joints using MRI technology. The level of inflammation was then ranked using the Psoriatic Arthritis Magnetic Resonance Imaging Scale (PsAMRIS). Imaging showed a reduction in inflammation only from 9 to 6 (on a 0 to 36 scale).

The study shows that the biologic drug worked quickly to reduce psoriatic arthritis pain even before MRIs showed significant improvement in inflammation.

Talk with Your Doctor About Drug Options

As with all medications, biologics, including adalimumab, work in different ways for different people. More research is needed to determine the overall effects of biologics on pain and inflammation. However, this study confirms that biologics can provide significant benefits to some people with moderate to severe psoriatic arthritis.

If you have uncontrolled symptoms of psoriatic arthritis, talk with your doctor about the benefits of biologics and other disease-modifying antirheumatic drugs (DMARDs). You may be able to reduce long-term joint damage as well as achieve pain relief.

Key Takeaways:

  • Biologic drugs are designed to decrease inflammation, reducing or preventing long-term joint damage.

  • New research shows that biologics may also offer dramatic pain relief to patients even before their inflammation levels are greatly reduced. 

  • As with all medications, biologics work in different ways for different people. Talk with your doctor about whether they’re a good choice for you.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Mar 25, 2016

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Medical References

  1. Poggenborg R, et al. Reduction in MRI inflammation during adalimumab therapy in patients with psoriatic arthritis -- implementation of the OMERACT PsAMRIS scoring method in a follow-up study. Arth Rheum ACR. 2011; Abstract 953.
  2. Psoriatic Arthritis. Arthritis Foundation
  3. Disease-modifying Anti-rheumatic Drugs (DMARDs). The Psoriasis and Psoriatic Arthritis Alliance.
  4. About Psoriatic Arthritis. National Psoriasis Foundation.
  5. Disease-modifying Antirheumatic Drugs (DMARDs). National Psoriasis Foundation.
  6. Moderate to Severe Psoriasis and Psoriatic Arthritis: Biologic Drugs. National Psoriasis Foundation.
  7. Psoriatic Arthritis. American College of Rheumatology.

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