"In a randomized clinical trial conducted by researchers at Stanford and more than  other medical centers psoriatic arthritis patients given an injectable biologic drug for  weeks showed substantial improvement compared with patients who received placebo injections. May    In a pivotal phase clinical trial led by a Stanford University School of Medicine httpmed.stanford.edu investigator patients with psoriatic arthritis for whom standardofcare pharmaceutical treatments have provided no lasting relief experienced a significant reduction in symptoms including joint tenderness and swelling when they were given a new drug. The week randomized doubleblind placebocontrolled trial was conducted at  centers in  countries and involved more than  adults for whom available biologic drugs  the standard of care for this painful autoimmune condition  had lost their efficacy or lacked it in the first place. Results of the trial were published online May  in The Lancet. Left untreated or treated unsuccessfully psoriatic arthritis can progress to induce severe joint and bone damage and functional disability said Mark Genovese httpsmed.stanford.eduprofilesmarkgenovese MD professor of immunology and rheumatology at Stanford and the studys senior author. In the trial known as SPIRITP httpsclinicaltrials.govctshowNCT  patients received regular injections of either a biologic drug ixekizumab or of a placebo for  weeks. The trial was sponsored by Eli Lilly  Co. the drugs manufacturer. Treatment with ixekizumab resulted in more than  percent of the participants having at least a  percent reduction in the number of tender and swollen joints significantly outperforming the placebo said Genovese. Few serious adverse events were reported for patients receiving the drug or the placebo he said. The search for lasting relief About one in  adults in developed countries lives with psoriatic arthritis. Like the more common rheumatoid arthritis which affects nearly  percent of the population psoriatic arthritis is an inflammatory autoimmune disease whose symptoms  including stiffness pain and swelling of several joints  typically emerge between the ages of  and . The two syndromes differ though in their constellation of symptoms. For example psoriatic arthritis manifests most often in the lower extremities and is associated with the autoimmune skin condition called psoriasis in which raised red scaly patches appear on the skin. Although psoriatic rashes most often precede the onset of the arthritic stage the reverse can also be the case. Only about half of psoriatic arthritis patients who are given TNF inhibitors get better. Three of the  topselling drugs in the United States in dollar sales  adalimumab etanercept and infliximab  are biologics prescribed for psoriatic arthritis as well as for the more common rheumatoid arthritis. These three drugs share a common property They block the action of a proinflammatory substance called tumor necrosis factor. Secreted by various immune cells TNF stimulates the immune response and accompanying inflammation. However despite the availability of TNF inhibitors only about half of psoriatic arthritis patients who are given TNF inhibitors get better said Genovese. Although the ultimate cause of the disease remains unknown there was a good clinical rationale for hoping it might be responsive to ixekizumab. For the last decade or so Genovese said another proinflammatory substance called IL has been drawing the attention of immunologists focusing on psoriasis and psoriatic arthritis. Ixekizumab works by blocking IL. The drug an injectable monoclonal antibody is already commercially available for the treatment of psoriasis for which it has been remarkably effective said Genovese. And in an earlier Lillysponsored phase trial ixekizumab was shown to be effective for psoriatic arthritis patients who had not yet been treated with biologic drugs such as TNF inhibitors. Another approved monoclonalantibody that targets IL secukinumab was approved in  for psoriatic arthritis. Less pain and swelling Over the week duration of the latest trial  participants received ixekizumab every two weeks  received placebo injections every two weeks and  alternated every two weeks between getting injections of ixekizumab and the placebo. While . percent of patients who received only the placebo injections were judged to have met the trials specified clinical endpoint  at least a  percent reduction in the number of tender and swollen joints  the response rate among those getting the real drug every four weeks was . percent. Those getting the drug every two weeks didnt do any better and were slightly more prone to side effects such as a mild reaction at the injection site. Although any treatment that works by blocking the immune systems ability to mount an inflammatory response should be carefully monitored for its potential to render the body vulnerable to infectious disease there were few observed differences in this category between recipients of placebo versus active drug given every four weeks Genovese said. Lilly has filed for approval of the drug by the U.S. Food and Drug Administration. Genovese has served as a consultant to Lilly. Other coauthors of the study are affiliated with multiple institutions in diverse locations including the University of Queensland in Australia Guys  Thomas NHS Foundation Trust in London St. Lukes International University in Tokyo Memorial University in Newfoundland Canada Lapeyronie Hospital in Montpelier France Charite University Medicine Berlin in Germany and Eli Lilly and Company in Indianapolis. Stanfords Department of Medicine httpmedicine.stanford.edu also supported the work."