Advertisement

Optimal Biologic Selection for Treatment of Psoriatic Arthritis: the Approach to Precision Medicine

  • Ippei Miyagawa
  • Shingo Nakayamada
  • Yoshiya TanakaEmail author
Spondyloarthritis (M Khan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Spondyloarthritis

Abstract

Purpose of Review

This review describes previously reported findings on optimal biologic agent selection for psoriatic arthritis (PsA) treatment and outlines our approach to developing precision medicine techniques for targeted treatment of this disease.

Recent Findings

Clinical trials have reported the effectiveness of numerous biologics with different targets, such as tumor necrosis factor-α, interleukin (IL)-17A, IL-17 receptor, IL-12/23(p40), and IL-23(p19) for the treatment of PsA. Although several studies have suggested specific predictors of treatment responses to each biologic, how biologics are differentially chosen in each patient remains unclear. Recent reports indicate the possibility of treating PsA using precision medicine based on individual immunological phenotypes.

Summary

Because PsA exhibits numerous symptoms, selecting an optimal biologic for each patient may be important. The establishment of appropriate selection guidelines will require further clinical trials.

Keywords

Psoriatic arthritis Biologics Treatment T cells Precision medicine 

Notes

Funding

This work was supported in part by Research on rare and intractable diseases and Research Grant-In-Aid for Scientific Research by the Ministry of Health, Labor and Welfare of Japan, the Ministry of Education, Culture, Sports, Science and Technology of Japan, the Japan Agency for Medical Research and Development, and the University of Occupational and Environmental Health, Japan, and UOEH Grant for Advanced Research.

Compliance with Ethical Standards

Conflict of Interest

Y. Tanaka received speaking fees and/or honoraria from Daiichi-Sankyo, Astellas, Eli Lilly, Chugai, Sanofi, AbbVie, Pfizer, YL Biologics, Bristol-Myers, Glaxo-SmithKline, UCB, Mitsubishi-Tanabe, Novartis, Eisai, Takeda, Janssen, and Asahi-kasei, and research grants from Mitsubishi-Tanabe, Bristol-Myers, Eisai, Chugai, Takeda, Abbvie, Astellas, Daiichi-Sankyo, Ono, MSD, Taisho-Toyama. S. Nakayamada received speaking fees and/or honoraria from Bristol-Myers, Sanofi, Abbvie, Eisai, Eli Lilly, Chugai, Asahi-kasei and Pfizer (less than $10,000 each), and also research grants from Mitsubishi-Tanabe, Takeda, Novartis and MSD.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Greb JE, Goldminz AM, Elder JT, et al. Psoriasis. Nat Rev Dis Primers. 2016;2:16082.CrossRefGoogle Scholar
  2. 2.
    McGonagle D, Lories RJ, Tan AL, et al. The concept of a “synovio-entheseal complex” and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum. 2017;56:2482–91.CrossRefGoogle Scholar
  3. 3.
    McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. 1998;352:1137–40.CrossRefGoogle Scholar
  4. 4.
    Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401–7.CrossRefGoogle Scholar
  5. 5.
    Mease PJ. Psoriatic arthritis: update on pathophysiology, assessment and management. Ann Rheum Dis. 2011;70:i77–84.CrossRefGoogle Scholar
  6. 6.
    Roubille C, Richer V, Starnino T, McCourt C, McFartane A, Fleming P, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74:480–9.CrossRefGoogle Scholar
  7. 7.
    Mease PJ, Kivitz AJ, Burch FX, Siegel EL, Cohen SB, Ory P, et al. Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum. 2004;50:2264–72.CrossRefGoogle Scholar
  8. 8.
    Mease PJ, Ory P, Sharp JT, Ritchlin CT, Van den Bosch F, Wellborne F, et al. Adalimumab for long-term treatment of psoriatic arthritis: 2-year data from the Adalimumab Effectiveness in Psoriatic Arthritis Trial (ADEPT). Ann Rheum Dis. 2019;68:702–9.CrossRefGoogle Scholar
  9. 9.
    Antoni CE, Kavanaugh A, van der Heijde D, Beutler A, Keenan G, Zhou B, et al. Two-year efficacy and safety of infliximab treatment in patients with active psoriatic arthritis: findings of the Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT). J Rheumatol. 2008;35:869–76.PubMedGoogle Scholar
  10. 10.
    Kavanaugh A, Krueger GG, Beutler A, Guzzo C, Zhou B, Dooley LT, et al. Infliximab maintains a high degree of clinical response in patients with active psoriatic arthritis through 1 year of treatment: results from the IMPACT 2 trial. Ann Rheum Dis. 2007;66:498–505.CrossRefGoogle Scholar
  11. 11.
    Kavanaugh A, McInnes IB, Mease P, Krueger GG, Gladman D, van der Heijde D, et al. Clinical efficacy, radiographic and safety findings through 5 years of subcutaneous golimumab treatment in patients with active psoriatic arthritis: results from a long-term extension of a randomised, placebo-controlled trial (the GO-REVEAL study). Ann Rheum Dis. 2014;73:1689–94.CrossRefGoogle Scholar
  12. 12.
    Mease PJ, Fleischmann R, Deodhar AA, Wollenhaupt J, Khraishi M, Kielar D, et al. Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Ann Rheum Dis. 2014;73:48–55.CrossRefGoogle Scholar
  13. 13.
    McInnes IB, Kavanaugh A, Gottlieb AB, Puig L, Rahman P, Ritchlin C, et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double-blind, placebo-controlled PSUMMIT 1 trial. Lancet. 2013;31:780–9.CrossRefGoogle Scholar
  14. 14.
    Ritchlin C, Rahman P, Kavanaugh A, McInnes IB, Puig L, Li S, et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial. Ann Rheum Dis. 2014;73:990–9.CrossRefGoogle Scholar
  15. 15.
    Kavanaugh A, Puig L, Gottlieb AB, Ritchlin C, You Y, Li S, et al. Efficacy and safety of ustekinumab in psoriatic arthritis patients with peripheral arthritis and physician-reported spondylitis: post-hoc analyses from two phase III, multicentre, double-blind, placebo-controlled studies (PSUMMIT-1/PSUMMIT-2). Ann Rheum Dis. 2016;75:1984–8.CrossRefGoogle Scholar
  16. 16.
    Deodhar A, Gottlieb AB, Boehncke WH, Dong B, Wang Y, Zhuang Y, et al. Efficacy and safety of guselkumab in patients with active psoriatic arthritis: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet. 2018;2:2213–24.CrossRefGoogle Scholar
  17. 17.
    McInnes IB, Mease PJ, Kirkham B, Kavanaugh A, Ritchlin CT, Rahman P, et al. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;386:1137–46.CrossRefGoogle Scholar
  18. 18.
    Strand V, Mease P, Gossec L, Elkayam O, van den Bosch F, Zuazo J, et al. Secukinumab improves patient-reported outcomes in subjects with active psoriatic arthritis: results from a randomised phase III trial (FUTURE 1). Ann Rheum Dis. 2017;76:203–7.CrossRefGoogle Scholar
  19. 19.
    Kavanaugh A, McInnes IB, Mease PJ, Hall S, Chinoy H, Kivitz AJ, et al. Efficacy of subcutaneous secukinumab in patients with active psoriatic arthritis stratified by prior tumor necrosis factor inhibitor use: results from the Randomized Placebo-controlled FUTURE 2 Study. J Rheumatol. 2016;43:1713–7.CrossRefGoogle Scholar
  20. 20.
    Mease PJ, van der Heijde D, Ritchlin CT, Okada M, Cuchacovich RS, Shuler CL, et al. Ixekizumab, an interleukin-17A specific monoclonal antibody, for the treatment of biologic-naive patients with active psoriatic arthritis: results from the 24-week randomised, double-blind, placebo-controlled and active (adalimumab)-controlled period of the phase III trial SPIRIT-P1. Ann Rheum Dis. 2017;76:79–87.CrossRefGoogle Scholar
  21. 21.
    Nash P, Kirkham B, Okada M, Rahman P, Combe B, Burmester GR, et al. Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors: results from the 24-week randomised, double-blind, placebo-controlled period of the SPIRIT-P2 phase 3 trial. Lancet. 2017;389:2317–27.CrossRefGoogle Scholar
  22. 22.
    van der Heijde D, Gladman DD, Kishimoto M, Okada M, Rathmann SS, Moriarty SR, et al. Efficacy and safety of ixekizumab in patients with active psoriatic arthritis: 52-week results from a Phase III Study (SPIRIT-P1). J Rheumatol. 2018;45:367–77.CrossRefGoogle Scholar
  23. 23.
    Coates LC, Kishimoto M, Gottlieb A, Shuler CL, Lin CY, Lee CH, et al. Ixekizumab efficacy and safety with and without concomitant conventional disease-modifying antirheumatic drugs (cDMARDs) in biologic DMARD (bDMARD)-naïve patients with active psoriatic arthritis (PsA): results from SPIRIT-P1. RMD Open. 2017;3:e000567.CrossRefGoogle Scholar
  24. 24.
    Mease PJ, Genovese MC, Greenwald MW, Ritchlin CT, Beaulieu AD, Deodhar A, et al. Brodalumab, an anti-IL17RA monoclonal antibody, in psoriatic arthritis. N Engl J Med. 2014;370:2295–306.CrossRefGoogle Scholar
  25. 25.
    Gossec L, Smolen JS, Ramiro S, de Wit M, Cutolo M, Dougados M, et al. European league against rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis. 2016;75:499–510.CrossRefGoogle Scholar
  26. 26.
    Coates LC, Kavanaugh A, Mease PJ, Soriano ER, Laura Acosta-Felquer M, Armstrong AW, et al. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol. 2016;68:1060–71.PubMedGoogle Scholar
  27. 27.
    Coates LC, Moverley AR, McParland L, Brown S, Navarro-Coy N, O'Dwyer JL, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386:2489–98.CrossRefGoogle Scholar
  28. 28.
    Coates LC, FitzGerald O, Merola JF, Smolen J, van Mens LJJ, Bertheussen H, et al. Group for research and assessment of psoriasis and psoriatic arthritis/outcome measures in rheumatology consensus-based recommendations and research agenda for use of composite measures and treatment targets in psoriatic arthritis. Arthritis Rheumatol. 2018;70:345–55.CrossRefGoogle Scholar
  29. 29.
    Gossec L, Coates LC, de Wit M, Kavanaugh A, Ramiro S, Mease PJ, et al. Management of psoriatic arthritis in 2016: a comparison of EULAR and GRAPPA recommendations. Nat Rev Rheumatol. 2016;12:743–50.CrossRefGoogle Scholar
  30. 30.
    Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, et al. Special article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019;71:5–32.CrossRefGoogle Scholar
  31. 31.
    Nash P, McInnes IB, Mease PJ, Thom H, Hunger M, Karabis A, et al. Secukinumab versus adalimumab for psoriatic arthritis: comparative effectiveness up to 48 weeks using a matching-adjusted indirect comparison. Rheumatol Ther. 2018;5:99–122.CrossRefGoogle Scholar
  32. 32.
    Mease PJ, Kavanaugh A, Coates LC, McInnes IB, Hojnik M, Zhang Y, et al. Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial. RMD Open. 2017;3:e000415.CrossRefGoogle Scholar
  33. 33.
    Stober C, Ye W, Guruparan T, Htut E, Clunie G, Jadon D. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford). 2018;57:158–63.CrossRefGoogle Scholar
  34. 34.
    Maneiro JR, Souto A, Salgado E, Mera A, Gomez-Reino JJ. Predictors of response to TNF antagonists in patients with ankylosing spondylitis and psoriatic arthritis: systematic review and meta-analysis. RMD Open. 2015;1:e000017.CrossRefGoogle Scholar
  35. 35.
    Naik GS, Ming WK, Magodoro IM, Akinwunmi B, Dar S, Poulsen HE, et al. Th17 inhibitors in active psoriatic arthritis: a systematic review and meta-analysis of randomized controlled clinical trials. Dermatology. 2017;233:366–77.CrossRefGoogle Scholar
  36. 36.
    Furie R, Khamashta M, Merrill JT, Werth VP, Kalunian K, Brohawn P, et al. Anifrolumab, an anti-interferon-α receptor monoclonal antibody, in moderate-to-severe systemic lupus erythematosus. Arthritis Rheumatol. 2017;69:376–86.CrossRefGoogle Scholar
  37. 37.
    •• Miyagawa I, Nakayamada S, Nakano K, Kubo S, Iwata S, Miyazaki Y, et al. Precision medicine using different biological DMARDs based on characteristic phenotypes of peripheral T helper cells in psoriatic arthritis. Rheumatology (Oxford). 2018.  https://doi.org/10.1093/rheumatology/key069 This report demonstrates the possibility of precision medicine based on the peripheral lymphocytic phenotypes in patients with psoriatic arthritis.
  38. 38.
    Nakayamada S, Kubo S, Yoshikawa M, Miyazaki Y, Yunoue N, Iwata S, et al. Differential effects of biological DMARDs on peripheral immune cell phenotypes in patients with rheumatoid arthritis. Rheumatology (Oxford). 2018;57:164–74.CrossRefGoogle Scholar
  39. 39.
    Maecker HT, McCoy JP, Nussenblatt R. Standardizing immunophenotyping for the human immunology project. Nat Rev Immunol. 2012;12:191–200.CrossRefGoogle Scholar
  40. 40.
    Haroon M, Winchester R, Giles JT, Heffernan E, FitzGerald O. Certain class I HLA alleles and haplotypes implicated in susceptibility play a role in determining specific features of the psoriatic arthritis phenotype. Ann Rheum Dis. 2016;75:155–62.CrossRefGoogle Scholar
  41. 41.
    Jadon DR, Sengupta R, Nightingale A, Lindsay M, Korendowych E, Robinson G, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis. 2017;76:701–7.CrossRefGoogle Scholar
  42. 42.
    Bowes J, Ashcroft J, Dand N, Jalali-Najafabadi F, Bellou E, Ho P, et al. Cross- phenotype association mapping of the MHC identifies genetic variants that differentiate psoriatic arthritis from psoriasis. Ann Rheum Dis. 2017;76:1774–9.CrossRefGoogle Scholar
  43. 43.
    Allen RL, O'Callaghan CA, McMichael AJ, Bowness P. Cutting edge: HLA- B27 can form a novel β2-microglobulin- free heavy chain homodimer structure. J Immunol. 1999;162:5045–8.PubMedGoogle Scholar
  44. 44.
    DeLay ML, Turner MJ, Klenk EI, Smith JA, Sowders DP, Colbert RA. HLA- B27 misfolding and the unfolded protein response augment interleukin-23 production and are associated with Th17 activation in transgenic rats. Arthritis Rheum. 2009;60:2633–43.CrossRefGoogle Scholar
  45. 45.
    Colbert RA, DeLay ML, Klenk EI, Layh-Schmitt G. From HLA- B27 to spondyloarthritis: a journey through the ER. Immunol Rev. 2010;233:181–202.CrossRefGoogle Scholar
  46. 46.
    Bowness P, Ridley A, Shaw J, Chan AT, Wong-Baeza I, Fleming M, et al. Th17 cells expressing KIR3DL2+ and responsive to HLA-B27 homodimers are increased in ankylosing spondylitis. J Immunol. 2011;186:2672–80.CrossRefGoogle Scholar
  47. 47.
    • Taams LS, Steel KJA, Srenathan U, Burns LA, Kirkham BW. IL-17 in the immunopathogenesis of spondyloarthritis. Nat Rev Rheumatol. 2018;14:453–66 This review discuss the immunopathogenesis of spondyloarthrits including psoriatic arthritis.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ippei Miyagawa
    • 1
  • Shingo Nakayamada
    • 1
  • Yoshiya Tanaka
    • 1
    Email author
  1. 1.The First Department of Internal MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan

Personalised recommendations