Biologics Reduce Pain But Not Inflammation in PsA

Dr. Nathan Wei had another interesting short video this week where he announced that at the annual meeting of the American College of Rheumatologists a study was presented showing that psoriatic arthritis patients on biologics report a decrease in pain, however MRI studies show that inflammation and disease activity continues in joints.

Since I am a psoriatic arthritis patient on a biologic (remicade) this is a little concerning to me on two levels.  Firstly if disease activity continues in the joints even though I am pain free then does this predispose me to a higher risk of needing joint replacement in the future?  I will continue to wolf down my fish oil, devil’s claw and cat’s claw bark pills daily (which supposedly help with joint maintenance).  Interestingly I recently read an article on LEF that tart cherry reduces inflammation and ordered some tart cherry pills – so hopefully that will help too.

Dr. Wei did not mention if there was an increase in inflammation or disease markers in blood tests and I couldn’t find a copy of the report on the web.  I would be interested to know if the MRIs showed disease activity with blood tests such as ESR and CRP negative.  I have blogged before about the usual blood tests for arthritis and all my recent blood work has been negative for inflammation.  However if the study shows that an MRI could be positive for disease in the midst of a negative blood test, then I’ll probably ask my doc if I can get an MRI of my hips to compare with CT scans I had back in 2004.

The second concern I have is that if there is inflammation occurring even though I do not have any joint pain, does that increase my risk of heart disease?  Although there is no evidence that inflammation causes heart attacks there is evidence that inflammation is common in patients with heart disease and strokes.  I’ve blogged before that people with psoriasis have an increased risk of metabolic syndrome (which includes heart disease), so I’m wondering if that increased risk is due to this prevalence of disease even though there is no pain, or is the prevalence of disease in the absence of pain something additional which I should be worried about?

Either way it is healthy to have a diet which lowers the amount of inflammation in your body.

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