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400,000 NHS patients suffering from psoriatic arthritis benefit from introduction of new daily pills

All NHS patients with a painful type of arthritis caused by the skin condition psoriasis will now be able to benefit from a drug that dramatically reduces symptoms in more than half of the cases.

The drug is upadacitinib, which tackles the debilitating condition by stopping the immune system’s mistaken attack on healthy tissue in the joints.

It has already been approved by the NHS to treat the 400,000 Britons with rheumatoid arthritis.

And patients with psoriatic arthritis in Scotland have been given access to upadacitinib since a review by the Scottish Medicines Consortium in April last year.

Now Britain’s prescribing watchdog, the National Institute for Health and Care Excellence, has decided that the daily pill can be extended to all NHS patients.

Professor Laura Coates, a rheumatologist at the University of Oxford, praised the move, saying: ‘This will have a major impact on this patient group.

“Living with two chronic conditions at once is extremely difficult, so it’s very welcome to have another drug that can help reduce their symptoms.”

400000 NHS patients suffering from psoriatic arthritis benefit from introduction

In September 2019, reality TV star Kim Kardashian (above) revealed that she had been diagnosed with the condition, which she described as “painful and scary.” In her case, it started with a rash on her stomach and legs, and led to severe pain in her hands that prevented her from “even being able to pick up a toothbrush.”

Patients first develop psoriasis, which causes red, scaly, and itchy patches of skin all over the body, and then—usually several years later—joint problems affect the knees, hands, feet, and lower back, getting progressively worse.  Pictured: Kim Kardashian shares news of her 2019 condition

Patients first develop psoriasis, which causes red, scaly, and itchy patches of skin all over the body, and then—usually several years later—joint problems affect the knees, hands, feet, and lower back, getting progressively worse.  Pictured: Kim Kardashian shares news of her 2019 condition

Patients first develop psoriasis, which causes red, scaly, and itchy patches of skin all over the body, and then—usually several years later—joint problems affecting the knees, hands, feet, and lower back, which get progressively worse. Pictured: Kim Kardashian shares news of her 2019 condition

Psoriatic arthritis affects about 150,000 Britons, causing joints to become painful, swollen and stiff.  The condition cannot be cured and in the worst cases, a person's joints can become permanently damaged, meaning joint replacement surgery may be needed in addition to the persistent and uncomfortable skin problems.  Pictured: Kim Kardashian in 2019

Psoriatic arthritis affects about 150,000 Britons, causing joints to become painful, swollen and stiff.  The condition cannot be cured and in the worst cases, a person's joints can become permanently damaged, meaning joint replacement surgery may be needed in addition to the persistent and uncomfortable skin problems.  Pictured: Kim Kardashian in 2019

Psoriatic arthritis affects about 150,000 Britons, causing joints to become painful, swollen and stiff. The condition cannot be cured and in the worst cases, a person’s joints can become permanently damaged, meaning joint replacement surgery may be needed in addition to the persistent and uncomfortable skin problems. Pictured: Kim Kardashian in 2019

Psoriatic arthritis affects about 150,000 Britons, causing joints to become painful, swollen and stiff.

Patients first develop psoriasis, which causes red, scaly, and itchy patches of skin all over the body, and then—usually several years later—joint problems affecting the knees, hands, feet, and lower back, which get progressively worse.

The condition cannot be cured and in the worst cases, a person’s joints can become permanently damaged, meaning joint replacement surgery may be needed in addition to the persistent and uncomfortable skin problems.

In September 2019, reality TV star Kim Kardashian revealed she had been diagnosed with the condition, which she described as “painful and scary.”

In her case, it started with a rash on her stomach and legs, and led to severe pain in her hands, leaving her “not even able to pick up a toothbrush.”

One in three people who suffer from psoriasis will develop psoriatic arthritis. Joint problems usually appear five to 10 years after the psoriasis is diagnosed, which can start at any age.

There are a number of anti-inflammatory drugs that fight the condition, including steroids.

However, for many patients these become ineffective and stronger drugs are needed.

Upadacitinib belongs to a new class of drugs known as JAK inhibitors. These work by blocking the effects of enzymes known as janus kinase, which normally help activate the immune response when the body is attacked by disease.

By blocking these enzymes in patients with so-called autoimmune diseases such as psoriatic arthritis, the drugs prevent the immune system from accidentally destroying healthy tissue.

JAK inhibitors have been very successful in treating a number of autoimmune diseases, including Crohn’s disease, in which inflammation affects the digestive tract.

One in three people who suffer from psoriasis will develop psoriatic arthritis.  Joint problems usually appear five to 10 years after the psoriasis is diagnosed, which can start at any age. [File image]

One in three people who suffer from psoriasis will develop psoriatic arthritis.  Joint problems usually appear five to 10 years after the psoriasis is diagnosed, which can start at any age. [File image]

One in three people who suffer from psoriasis will develop psoriatic arthritis. Joint problems usually appear five to 10 years after the psoriasis is diagnosed, which can start at any age. [File image]

In 2020, a large US study found that more than 70 percent of patients with psoriatic arthritis responded to upadacitinib. More than half saw their arthritis symptoms go away, while two-thirds noticed their psoriasis clearing up.

Upadacitinib pills will now be available for NHS patients who have not responded to other treatments and have arthritic symptoms in three or more joints.

Julie Morrish, 51, was one of the first psoriatic arthritis patients in Britain to receive access to upadacitinib after being given compassionate use in April due to the severity of her symptoms.

Wantage’s Oxfordshire marketing manager developed psoriasis and arthritis at the same time seven years ago.

She says: ‘The joints in my knees and ankles swelled up and I had trouble walking. It became difficult to get out of bed in the morning and at worst I literally crawled to the bathroom.’

In addition, Julie developed severe psoriasis on her hands and feet.

“The plasters got infected and it was incredibly painful. I had to be written off from work, it was that bad.’

Julie, who was a competitive weightlifter until her diagnosis, tried a number of medications, but they either became ineffective or left her with debilitating side effects.

She was started on upadacitinib last April and noticed a difference within a few days.

She says: ‘Immediately my joints were better and I had more energy. I had really stubborn psoriasis patches, but these went away, and now it doesn’t even feel like I have it.

“Sometimes I have a little pain here and there, but my arthritis is actually gone too. It’s quite astonishing.’

What Is Psoriatic Arthritis?

Psoriatic arthritis is a chronic, autoimmune form of arthritis that causes joint inflammation. It is the result of the skin condition psoriasis.

If left untreated, it can cause irreversible joint damage. It can affect large or small joints, and less commonly, the spine.

About a third of people with psoriasis develop psoriatic arthritis.

The condition causes the immune system to attack itself, primarily the joints and skin, but also organs.

Scientists believe that genes and an environmental trigger, such as trauma or virus, may play a role in the development of psoriatic arthritis.

Fingers and toes may swell and nails may become pitted or separate from the nail bed. The heel or sole of the foot can also hurt.

Psoriatic arthritis affects everyone differently. Symptoms can be mild or severe, affect only a few or many joints, and may come and go. A sudden onset of symptoms is called a flare.

Left unchecked, the condition can cause numerous health problems, including damage to the lining that covers the ends of bones in a joint and the bones themselves. This means it becomes more difficult to move joints, leading to disability.

Other side effects include redness, irritation and disturbed vision, redness and pain in tissues around the eyes, diarrhea and bloating, shortness of breath and cough, and damage to blood vessels and the heart muscle.

Source: arthritis.org

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