People with psoriatic arthritis deserve to be informed about ways to approach disease management holistically and with a personalized approach.
Managing a chronic disease like psoriatic arthritis (PsA) can be challenging — just when one element of the disease seems under control, another can crop up. This can be a source of frustration for healthcare providers and their patients as they seek symptom relief to help improve well-being, including physical and mental health.
Given the unpredictable nature of PsA, an often debilitating immune-mediated disease characterized by swollen joints and stiffness, many patients may be disappointed with how the disease interferes with their ability to perform daily tasks or how they respond to treatment. if they experience short-term symptomatic relief, but no long-term symptomatic relief. Many patients adapt to the ebb and flow of periods when they feel better and when they experience painful symptoms.
But people with PsA earn more. They deserve to be informed about ways to approach PsA management holistically and with a personalized approach so they can relieve symptoms, slow disease progression, and feel their best.
Optimal PsA management doesn’t just include joint and spine symptom relief; it also covers patient-reported results that may not be as apparent on the surface or in test results, but affect their physical and emotional well-being. Making public health a key consideration starts with changing our understanding of PsA and then changing how we support patients along the way.
Understanding PsA. broaden
Addressing the physical symptoms of PsA, such as joint stiffness, pain, and swelling, is critical. Given the toll these symptoms can take on a person’s daily activities, it makes sense that PsA care and treatment options until now have focused on these physical aspects of the disease.
But the reality is that PsA affects much more than just the joints. For example, we know that people with PsA may experience other challenges associated with chronic illness. We also know that fatigue is a leading symptom of PsA, but one that may receive less attention. In fact, patients with PsA consistently cite fatigue as the second most reported symptom of their illness — second only to pain — and describe it as an overwhelming feeling of exhaustion, with even the smallest tasks draining all their energy. Others note the negative effects that fatigue has on their emotional and mental well-being.
It’s time for a more holistic conversation about PsA, including discussion of symptoms such as fatigue and how that might affect daily activities. It’s time to send the message that managing PsA isn’t just about reduced joint pain or smaller plaques.
It’s also about finding solutions, including medication, lifestyle changes and strategies to empower people to take control of their disease. Managing PsA can help them feel better in everyday life.
The good news is that healthcare providers and the PsA community are increasingly creating the space for patients to discuss the impact of their disease beyond inflammation and pain. In fact, a recent cross-sectional web-based study of 332 adult patients with PsA in the ArthritisPower registry found that joint pain was the most bothersome symptom for adult patients with PsA, followed by other musculoskeletal pain and fatigue.1 The study also found that adult patients with PsA were most focused on how their treatment plan could improve their ability to perform daily activities and function independently.1
The results of the study reinforce the need for PsA management to reflect each patient’s unique needs, experiences, and wellness goals, as there is no one-size-fits-all treatment plan. It’s encouraging to see how health care providers are also doing their own research to better understand how symptoms like fatigue and general well-being fit into PsA to advance care.
Change the treatment discussion
In addition to this positive shift in holistic disease management, science is also making headway. Several treatments are available to patients to address a range of symptoms, such as inflammation, stiffness, and pain. These treatments include nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and biologics. In addition, some biologics have clinical evidence for improving symptoms of fatigue.
This creates an opportunity to give patients more options, which is essential, as PsA is a chronic disease that cannot be cured. The severity of PsA can vary from patient to patient, the symptoms can feel invisible and be difficult to describe, and it is a progressive disease, so it’s important to help patients understand that it can take time to get a treatment plan exactly. get it right, and it’s not a glitch if adjustments need to be made over time. This gives patients and caregivers the chance to have an open dialogue about what works and what doesn’t to better tailor their treatment plan to their specific needs – from medication and lifestyle changes to strategies that support mental and emotional health.
Going beyond treatment and supporting the journey
To truly incorporate wellness into PsA treatment, there is one final critical component that needs to be addressed: continuing to support patients outside of the physician’s office and throughout their care journey. We can assume that a patient’s journey ends as soon as he leaves the doctor’s office with a prescription in hand.
But for many, that’s just the beginning. Often patients must go through the fulfillment process, which can be long, complicated, and overwhelming, before they can begin therapy.
At Janssen, we are committed to being there for patients throughout that entire process. After a patient is prescribed one of our products, we offer a support program to help them on their journey from finding the care they need to receiving guidance to start and stay on treatment, such as 1:1 access to a dedicated nurse, medication education and financial support.
In addition, we understand the critical role biological coordinators play in the PsA patient journey, which is why Janssen has hosted an annual National Biological Coordinators Day on November 1, 2021 to recognize the vital role these individuals play in helping patients navigate the sometimes complex process to access prescription biologic drugs. Biological coordinators are some of the foremost patient advocates in health care, but all too often their work goes unrecognized.
PSA of the future
In my view, our responsibility to empower patients with PsA is more urgent than ever before. As we continue to understand the full breadth of PsA symptoms and as more treatment options become available, we can work on making feeling just “okay” or “good enough” a thing of the past. It’s time for people with PsA to feel empowered to expect more and help them prioritize their overall well-being.
At Janssen we take up the challenge. We are building on our 20-year legacy by investing in a growing research and development program with the goal of ushering in a new era of treatment for PsA and other immune-mediated diseases. Through scientific research and efforts to support patients, we are focused on our mission to relentlessly improve care in PsA and look forward to working with the community along the way.
1. Ogdie, A., Myers, K., Mansfield, C. et al. Experiences and treatment preferences in patients with psoriatic arthritis: a cross-sectional study in the ArthritisPower registry. Rheumatol Ther 9, 735-751 (2022). https://doi.org/10.1007/s40744-022-00436-x