by Dr. C.H. Weaver M.D. 2/8/2019
A recent analyses of Taltz treated psoriatic arthritis (PsA) patients with enthesitis or dactylitis shows this approach to yield significant improvements in both.
Individuals with PsA often have enthesitis and dactylitis which can be painful and inhibit normal joint function. Dactylitis also referred to as “sausage digit” is inflammation of an entire digit (a finger or toe) and can be painful. The word dactyl comes from the Greek word "daktylos" meaning "finger". The places where tendons and ligaments connect to bones are called entheses. Inflammation of these areas is called enthesitis and can cause new bone tissue to form limiting mobility.
Interleukin-17 (IL-17) inhibitors
Interleukin-17 is a protein produced by immune cells that functions as a messenger between cells playing an important role in inflammation and the symptoms associated with PsA. Antibodies that target the IL-17 pathways are used for the treatment of several conditions in which the IL-17 pathway has a role, including, psoriasis and psoriatic arthritis, IL-17 therapies available for the treatment of PsA include.
- Cosentyx (secukinumab) is an anti-IL-17 monoclonal antibody that blocks the effects of IL-17 leading to an improvement in IL-17 associated symptoms.
- Taltz (ixekisumab) is an anti-IL-17 monoclonal antibody that blocks the effects of IL-17.
The SPIRIT-P1 and SPIRIT-P2 clinical trials evaluated two doses of Taltz compared to a placebo in 679 individuals with PsA. As part of the trial enthesitis was assessed using the Leeds Enthesitis Index [LEI] and dactylitis assessed using the Leeds Dactylitis Index-Basic [LDI-B].
Evaluation performed 24 weeks after initial of treatment found that there was a total resolution of enthesitis in 39% of individuals. Overall 78% experienced complete resolution of dactylitis. In addition, significant improvements in function and quality of life were reported in patient experiencing resolution of enthesitis whereas dactylitis resolution was associated with more limited improvements.