Thousands living with forms of arthritis that affect younger people will soon benefit from a new drug which has been approved by NHS health chiefs.
Pivotal studies have found that the drug, bimekizumab, can dramatically reduce joint pain and swelling for those with a type of arthritis linked to the skin condition psoriasis, known as psoriatic arthritis.
Separate research has found it can also improve the debilitating symptoms of axial spondyloarthritis, known as axial SpA, another type of arthritis that causes pain and stiffness in the lower back when the joints become swollen.
Bimekizumab is particularly effective for those who are resistant to other treatments, offering a crucial solution to patients who have run out of options.
Arthritis, which causes stiff and painful joints, affects around ten million people in the UK. Most have osteoarthritis, which is caused by age-related wear and tear on the protective tissue inside knee, hip and ankle joints. Other forms, such as rheumatoid arthritis, are caused by an over-reaction of the immune system in which the body attacks its own healthy tissue, causing inflammation and pain.
PAINFUL: Reality star Kim Kardashian’s psoriasis patches on her face
Psoriatic arthritis – which affects 100,000 people and develops in one in five with psoriasis – causes swollen, stiff and painful joints, well as the characteristic patches of red, flaky skin. Both psoriatic arthritis – and axial SpA, which affects a further 220,000 people, have the same immune system trigger and can emerge as early as childhood.
One famous patient is reality star Kim Kardashian, who was diagnosed with psoriatic arthritis in 2019 and last year revealed it affected movement in her hands.
Patients with both conditions start on drugs that suppress the immune system, such as methotrexate. But some struggle with side effects such as nausea and headaches, and the medicines often stop working.
Next, patients can try biologics – drugs that block an immune protein that triggers inflammation. But in around half of cases these drugs also stop working after a couple of years. In one in ten patients they do not work at all.
Bimekizumab is already approved as a treatment for psoriasis but last week the UK drug watchdog, the Medicines and Healthcare Products Regulatory Agency, gave it the green light for both psoriatic arthritis and axial SpA. And last night, health chiefs agreed to fund it for NHS patients within the next few weeks.
Given as a monthly injection, bimekizumab blocks two inflammatory proteins simultaneously.
‘It’s a much smarter drug,’ says Professor Laura Coates, a rheumatologist at the University of Oxford. ‘We expect patients to do better if more inflammation is blocked. If you’re young, and you’re facing having this condition for the rest of your life, that’s really important.’
Prof Coates says the data so far shows bimekizumab is, on average, as effective as the other drugs but it worked particularly well in patients who failed to respond to other treatments.
‘Normally harder-to-treat patients respond less well,’ Prof Coates adds. ‘So while it needs to be looked at further, it is encouraging and suggests that blocking both proteins might be particularly important for these patients.’
Pivotal studies have found that the drug, bimekizumab, can dramatically reduce joint pain and swelling for those with a type of arthritis linked to the skin condition psoriasis, known as psoriatic arthritis
Laura Hoskin, 38, from Oxfordshire, was running out of options when she started taking bimekizumab as part of a trial in 2021.
The business consultant has suffered psoriasis since her early 20s, and developed agonising psoriatic arthritis eight years ago. But none of the treatments were working, and she was getting desperate.
‘I was in a terrible state,’ Laura says. ‘I was newly married but we decided not to have children because I kept dropping things – I was haunted by the idea I might drop the baby. The chronic pain is like a fire in your joints.’
Bimekizumab kicked in within a month of starting the trial.
‘I was in less pain and there was less swelling,’ she says. ‘I’ve now been on it for two years and, honestly, it’s been life-changing. I might not be doing ten-mile runs, but I no longer have to second-guess how I’m going to feel every day.’
- Prof Coates is seeking volunteers for a study into the links between psoriasis and arthritis. To take part, visit hpos.study.