Tremfya improved fatigue in patients with psoriatic arthritis

[Fred]

Janssen will present data showing Tremfya (guselkumab) improved fatigue in patients with psoriatic arthritis.

Quote:

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The Janssen Pharmaceutical Companies of Johnson & Johnson today announced data from two Phase 3 clinical trials, DISCOVER-1 and DISCOVER-2, which showed TREMFYA® (guselkumab) improved fatigue in adult patients with active psoriatic arthritis (PsA) and maintained response through 52 weeks of active treatment, as measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale. TREMFYA improved fatigue during the placebo-controlled periods of both studies at week 24, and through one year of active treatment. In both studies, TREMFYA had positive effect on fatigue, in addition to other clinical outcomes, including ACR20 response. TREMFYA is FDA-approved for administration as a 100 mg subcutaneous (SC) injection every eight weeks (q8w), following two starter doses at weeks 0 and 4.

Data assessing fatigue outcomes of the studies will be presented as a poster presentation (Abstract #0347) on Friday, November 6 from 9:00 - 11:00 a.m. EST during ACR Convergence 2020, the American College of Rheumatology (ACR) virtual annual meeting.

Fatigue is considered one of the three most important symptoms by patients with active PsA, and moderate to severe fatigue occurs in up to 50 percent of these patients. Fatigue is defined as an overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work. It includes a range of experiences, from tiredness to exhaustion, which can interfere with normal daily function and reduce health-related quality of life. Fatigue is ranked high by patients regarding impact on life and priority for improvement.

"Fatigue associated with psoriatic arthritis can have a serious impact on patients' health-related quality of life and can lead to social isolation and loss of employment," said Proton Rahman,i M.D., Professor of Medicine, Rheumatology, Memorial University in Newfoundland, Canada and presenting author of the study. "These findings from the DISCOVER-1 and DISCOVER-2 studies showing an improvement in fatigue a full year into treatment with TREMFYA add to the previously presented 52-week data demonstrating an improvement in joint and skin symptoms. Considered together, the data are encouraging for active psoriatic arthritis patients who struggle with multiple symptoms."

Source: janssen.com

Tremfya (guselkumab)

[KatT]

In terms of PSA, if a treatment is working, that means less pain and better sleep which would result in less fatigue no?

Regardless of the treatment?

[Caroline]

In terms of PSA, if a treatment is working, that means less pain and better sleep which would result in less fatigue no?

Regardless of the treatment?

Hi KatT,
I would indeed think like you on this thing. Better sleep — more energy.
But.... it seems that this kind of fatigue is far more reaching. If you don’t have that it is very hard to imagine. The also state this in the information that 50% of the sufferers seem to have it, which means that 50% also doesn’t
It probably has to do with some kind of unbalance that is cause by the disease, that also causes the Psoriatic Arthritis.
They say that it is a side effect of the Psoriatic Arthritis, but I think that it is different. I think we have a disease that has several effects, which can be psoriasis and/or Psoriatic Arthritis and/or chronic fatigue.
The real disease is deeper in our system, what we experience are only the manifestations of it.

Often it is stated: Psoriasis is a skin disease.... obviously not true... it is a system disease that manifests on the skin.

Luckily I myself do not suffer from this fatigue. Always plenty of energy.

[KatT]

I feel tired all the time but always associated it to lack of sleep because of the pain 

[Caroline]

I feel tired all the time but always associated it to lack of sleep because of the pain 

Ah... how awful for you.
So you have the strong feeling, that it is tiredness because of the lack of sleep.
And if you take a strong painkiller before you go to sleep, do you feel less exhausted then the next morning?

P.s... will check this thread tomorrow morning again... going to bed now.. I do have a few remarks perhaps then, as my sleep is not always the best.

[KatT]

Yes I feel better after the fogginess goes away....but I take the painkillers only once in a while..... once or twice a month on average (was trying to save what I had left from two years ago).  I did get a prescription for the same really good ones a few weeks ago so now I have tons (too much) but I have a tendency to endure aaaaand I don't want to get addicted aaaand I want to wake up in the morning.

I have a high tolerance to pain....except when I am exhausted. 
  
But my sleeping or lack of has gotten worse as the PSA progressed.  And if for example I  have a sleepless night (happens frequently), the pain is so much worse the next day.  

All this to say I linked it mostly to the pain caused by inflammation.....basically when there is pain due to PSA, there's inflammation, your body is fighting all the time, you're in pain and lack sleep thus you are more tired and get exhausted.

I think if the conclusion of this study would be the same for other biologics.

I totally agree that it's not a skin disease.  It's an auto immune disease that causes arthritis and psoriasis and other ailments (not sure this is the correct term).

Hope you sleep well 

PS.  Tell the hamster to stop spinning the wheel.  You might sleep better 

[Fred]

I usually feel very tired on Tuesdays as I don't drink on a Monday and that means I don't sleep well because of the pain, but the other days are fine as plenty of Merlot puts me to sleep.

Merlotosed I know isn't good for me, but it does stop the pain in the night. Day time is not so bad as along as it's not too damp, as you can move around to ease the pain.

Yes Caroline put some oil on that hamster wheel

[Caroline]

Yes I feel better after the fogginess goes away....but I take the painkillers only once in a while..... once or twice a month on average (was trying to save what I had left from two years ago).  I did get a prescription for the same really good ones a few weeks ago so now I have tons (too much) but I have a tendency to endure aaaaand I don't want to get addicted aaaand I want to wake up in the morning.

I have a high tolerance to pain....except when I am exhausted. 
  
But my sleeping or lack of has gotten worse as the PSA progressed.  And if for example I  have a sleepless night (happens frequently), the pain is so much worse the next day.  

All this to say I linked it mostly to the pain caused by inflammation.....basically when there is pain due to PSA, there's inflammation, your body is fighting all the time, you're in pain and lack sleep thus you are more tired and get exhausted.

I think if the conclusion of this study would be the same for other biologics.

I totally agree that it's not a skin disease.  It's an auto immune disease that causes arthritis and psoriasis and other ailments (not sure this is the correct term).

Hope you sleep well 

PS.  Tell the hamster to stop spinning the wheel.  You might sleep better 

Later than I expected, this answer, had a busy day with the family, but you are still awake.
Yes, I understand that the pain is caused by the inflammation and I recognise that, only with me it is less and up to now under control.
I get your statement that tiredness can be the result of lack of sleep. And I do believe that for many people that is so.
That would indeed also imply that, no matter what medication you use, if a medication works, the pain will reduce, your sleep will get better and you will be less tired. Certainly logical so must be true.

But I also think that there is a certain part of the PSA sufferers, who have a more fundamental form of tiredness, called fatigue, which is not the result of lack of sleep, but is another side effect of our disease. So the cause of our psoriasis or PSA is also the cause of a phenomenon called fatigue.

You state that you agree that it is no skin disease.   So on there we are on the same level.
Then you say that it is an auto immune disease........   Here I begin to hesitate.
You know why?

Well “The” essential aspect of auto immune diseases, you see this with all of them, Rheum, MS, you name them, is that you can find anti-bodies belonging to those diseases in the blood. That is used as a proof that you indeed have that specific disease.
And now it appears that..... you cannot find anti-bodies in the blood of us Psoriasis or PSA sufferers. This is also seen with the diagnosis of PSA, that is extremely difficult as you cannot find anything in the blood.
So.... I am very much hesitating myself to call it an auto immune disease.
But it is a disease that is somewhere hidden in our system.

I have an idea of what it is caused by, handed to me by a doctor over here, who has studied it and treated a few thousand sufferers.

Cheers and I hope you sleep well tonight..

.....
And again I don’t really get your remark about the hamster. hihi... that is probably my lack of understanding very subtle English proverbs... 

[Bill]

There are adaptive immune pathways that don't involve antibodies Caroline, but I am tending to agree with you about controlling the disease by keeping the lymphocyte count down, at least in part. Elimination of disease is an ideal, so sufferers are always living with some disease. Personally I cannot distinguish one cause of fatigue from another. I didn't get much sleep when my disease was out of control, but was the fatigue due to lack of sleep or my body at war with itself and producing a heap of useless skin? Probably both.

Cheers

[Caroline]

Thanks for your comment Bill. As always very knowledged.
I am not so familiar with adaptive pathways, but the essence is that I think that Psoriasis is quite different from common auto immune diseases. Therefore perhaps cannot be called an auto immune disease.