Biologics for Psoriatic Arthritis Overview

Psoriatic arthritis is a type of arthritis that patients with psoriasis suffer from that affects larger joints like the knees or shoulders.

Psoriatic arthritis is a type of arthritis that patients with psoriasis suffer from that affects larger joints like the knees or shoulders. Without treatment psoriatic arthritis can cause joint damage, skin damage and lead to depression or coronary artery disease.

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This video features Bobby Buka, MD. Dr. Buka is a section chief at Mount Sinai School of Medicine. Dr. Buka is also a diplomate of the American Board of Dermatology and the Society for Pediatric Dermatology.

Duration: 2:52. Last Updated On: March 24, 2019, 2:31 p.m.

Reviewed by: Mera Goodman, MD, Preeti Parikh, MD . Review date: March 24, 2019

00:00 [MUSIC]
00:02 I'm Doctor Boby Buka, section chief of the Mount Sinai School of Medicine.
00:05 Psoriatic arthritis is a type of arthritis that patients with psoriasis suffer from.
00:10 And it affects the joint spaces, typically large joints like knees and shoulders.
00:14 And it affects that synovial space, the space where two bones connect.
00:19 Not everyone that has psoriasis gets psoriatic arthritis, but
00:22 the percentage is about 25 to 30%.
00:24 Though we do know that the more severe the psoriasis is,
00:26 the more likely that patient will suffer from psoriatic arthritis.
00:30 If you have psoriatic skin disease, and
00:32 you have some joints that don't feel right, that's psoriatic arthritis.
00:36 The reason we have to get in front of psoriatic arthritis is to prevent it from
00:39 progressing.
00:40 All of that inflammation in the synovial joint space will wear down that
00:44 synovial lining and that causes a rubbing of bone to bone.
00:48 So getting in front of it early means joints that will stay healthier much
00:52 longer.
00:53 We think psoriasis is an autoimmune condition.
00:55 We know that there are two magnets, a T cell that's part of our body's innate
00:59 immune system, and an unknown antigen that that T cell is attacking.
01:03 Now, we figure that that unknown antigen is a part of our own body and
01:06 that it's present more commonly in certain families, and in certain genetic makeup.
01:11 What that antigen is we haven't figure out.
01:13 We know it's in the joint space.
01:15 We know it's in the skin.
01:16 We know it's in the coronary arteries.
01:18 But what the magnet, this t-cell it's attracted to, we still don't know.
01:22 But it's loosely considered under the autoimmune umbrella.
01:26 Autoimmune simply means that the body's attacking itself.
01:28 The body's immune system has found something
01:30 within ourselves that it doesn't like, that it considers external,
01:35 that it considers a threat so the immune system attacks it.
01:39 We wish that we could block those two magnets from colliding.
01:42 We wish that we could figure out that antigen and get in the way
01:45 between the T cell and whatever it's attacking that's part of our own bodies.
01:49 Right now, we're doing the next best thing.
01:50 So, once those magnets collide and
01:53 all these inflammatory proteins are released, we want to sponge those up.
01:56 We want to get all of those inflammatory proteins out of the way so
02:00 that innocent tissue doesn't get damaged in the mix.
02:03 The body's not meant to live in a state of continued inflammation.
02:07 And if we have these magnets connecting and
02:09 we don't get in the way of treating psoriasis or psoriatic arthritis and we're
02:13 living in this state of heightened immune response, it starts to wear the body down.
02:18 It wears the body down in the joints, it wears the body down in the skin,
02:21 and also some unknown areas that we may not think about.
02:24 Like, depression is linked to psoriasis and
02:27 coronary artery disease linked to psoriasis.
02:30 So, it's really critical to get in the way of that inflammatory cascade and
02:34 start sucking up those inflammatory mediators to prevent this heightened state
02:38 of attack that's going on day to day without us even knowing it.
02:42 So, if you have marginal symptoms that you may not
02:45 think are related to your psoriatic skin disease, ask your doctor about it.