Good news for the approximately two million Americans withpsoriatic arthritis (PsA). Those with active disease now have two new treatment options: the U.S. Food and Drug Administration (FDA) in December approved both ixekizumab (Taltz) and tofacitinib (Xeljanz) for thetreatment of PsA.
This is the second approved indication for ixekizumab. Thebiologic, which is injected, was approved in March 2016 to treat moderate-to-severe plaque psoriasis in adults. It can be taken alone or in combination with a traditionaldisease-modifying antirheumatic drug (DMARD), such as methotrexate.
This is also the second approved indication for tofacitinib, a so-called targeted DMARD that is taken orally. Tofacitinib was first approved in 2012 to treatrheumatoid arthritis. It, too, can be taken alone or in combination with certain traditional DMARDs.
“It’s nice for patients to have options,” says M. Elaine Husni, MD, MPH, vice chair and director of the Arthritis Center at the Department of Immunologic and Rheumatic Diseases at Cleveland Clinic in Ohio. “People respond to drugs differently. What is wonderful is we get to be more personalized about our care. We don’t have to treat one-size-fits-all; we can be more tailored. So it’s important to havemedications that work through different mechanisms.”
Ixekizumab inhibits interleukin-17A (IL-17A), a molecule involved in inflammatory and immune responses. It’s the second IL-17 inhibitor on the market for PsA. Additionally, there are other biologics approved to treat PsA that work through different mechanisms, including five tumor necrosis factor (TNF) inhibitors, and one that blocks IL-12 and IL-23. Tofacitinib is a JAK inhibitor; it works by blocking precise pathways inside immune cells.
Like other medications that interfere with the immune system, both ixekizumab and tofacitinib can increase the risk of infection. Before starting either one, patients need to be tested for tuberculosis. Additionally, ixekizumab could worsen symptoms of inflammatory bowel disease.
Author: Jennifer Davis for the Arthritis Foundation
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This all great that there are these new medications if you can afford them. I’m on medicare and anyone of these would wipe out my part d in one month. And because I’m on medicare I don’t qualify for help from the drug co.