Psoriatic Arthritis Clinical Case Review

Philip Mease, MD, rheumatologist at Swedish Health Services in Washington, discusses the results of the case and important points to keep in mind when treating cases of prenatal psoriatic arthritis.

Editor’s note: The following is an automatically generated transcript of the above video.

"She gets started on certolizumab. We see her back at 1 month, which is when we typically ask mainly about any adverse effects that a person may have experienced, and there were no significant adverse effects at that point. We then saw her back at 3 months to do a full clinical efficacy evaluation. Her joint swelling, recall that it was primarily in the wrist, has resolved, and she still has four tender joints, but this is less than what she started with. Her left Achilles enthesitis pain has improved, and the plantar fascia is no longer painful. The swelling of her dactalytic digit has improved. Her psoriasis lesions have significantly improved but not quite yet the nails. They take some time. The left upper buttock area pain has resolved. She's actively trying to conceive.

Then when we saw her back at 6 months, she had just one tender joint. Enthesitis, dactylitis and nail pitting had resolved altogether. The psoriasis was limited to some lesions just adjacent to the scalp line. So we would consider her now in a state of minimal disease activity, or MDA, which is a validated target of treatment. For example, she has less than or equal to one tender joint. She has no further swollen joints. She has no longer any evidence of enthesitis on physical exam, and her skin disease has significantly diminished. Her overall evaluation of how she's doing is good, and her pain is lessened, and her physical function is just fine. So thus, we would consider this a success at this point in time in achieving a state of minimal disease activity. There's also a success for her in that she's now pregnant over the last 2 months and is feeling good about the fact that she can have control of her inflammatory arthritis during the course of pregnancy and then after pregnancy while breastfeeding. So I hope that this has been a illustrative case for you to appreciate, and thank you very much for attending this session."