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Stories for Reprint
Psoriatic Arthritis: Living A Fuller Life
By Ferdous Al-Faruque, MARRTC Staff
America's obsession with body image and flawless skin makes acceptance of imperfections difficult. For 7.5 million Americans who have a chronic skin disease called psoriasis, those intolerant of imperfection can make coping with symptoms like red, scaly patches of skin that much more difficult.
Dealing with just this disease alone can be a challenge, but some with psoriasis also develop an additional condition, psoriatic arthritis or PsA, which is characterized by pain, swelling and stiffness in the joints. Most people who develop PsA are between the ages of 30 and 50. In some severe cases, PsA can lead to disability.
The mortality rate for those with PsA is also higher than the average population. But a new study by the University of Toronto in Canada and Cambridge University in the United Kingdom has found that although the mortality rate of people with PsA is still higher than average, it has substantially decreased in the past three decades.
Researchers followed 680 people with PsA from 1978 to 2004, and detailed their causes of death. In most cases, people with the disease died due to problems with their circulatory system or cancer. The study found that on average people with PsA lost 3 years of their lives due to the disease. However, rheumatologists are unable to explain why people with PsA have a higher rate of mortality.
Yaser Ali, a rheumatologist with Toronto Western Hospital and the principal investigator of the study says the decrease in death rates for people with psoriatic arthritis may be due to doctors' ability to diagnose PsA earlier, and to the discovery of new and improved treatments. He says a decade ago there weren't many treatment choices for people with the disease. "But things have changed (today)," Ali added. "There are a lot of options and if one medication doesn't work we do have other options."
The most common treatments for psoriatic arthritis are non-steroidal anti-inflammatory drugs or NSAIDs and disease-modifying anti-rheumatic drugs or DMARDs. In the most severe cases, people are prescribed tumor necrosis factor inhibitors or TNF-inhibitors.
Ali says that since doctors are now better able to determine the severity of the disease, the strategy to treat PsA has changed in the past few decades. "We used to treat patients with milder medication hoping that it would treat the pain and the disease would go away," he says. However, nowadays he states that doctors treat the disease more aggressively.
Utilizing those advances in diagnosis and treatment of the disease can hopefully mean a longer and healthier life for those with PsA.
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