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Twenty percent of patients with plaque psoriasis also have psoriatic arthritis - a disease affecting joints and entheses. Different treatment options exist but currently no succinct systematic overview exists. A systematic review of approved systemic treatments for psoriatic arthritis was conducted. We systematically searched in 3 databases (last update 09/2017). Data was extracted for ACR 20/50, HAQ-DI, SF-36 and adverse/serious adverse events after 16-24 weeks. We assessed the quality of evidence using GRADE. Twenty trials were included. Three trials compared two active substances. Results for ACR20 were infliximab+methotrexate vs. methotrexate: RR 1.40 (95%CI 1.07 to 1.84) very low quality evidence; ixekizumab Q2W vs adalimumab Q2
RR 1.08 (95%CI 0.86 to 1.36) very low quality, leflunomide vs. methotrexate: RR 1.01, (95%CI 0.84 to 1.21) low quality. Eighteen drug vs. placebo-comparisons were included. For ACR20/50, HAQ-DI and SF-36, the active treatment was efficacious and the quality of the evidence was mostly moderate to low (15 of 18 comparisons). The quality of evidence for (serious) adverse events was mostly low; differences were rare. In three placebo-controlled comparisons leflunomide, MTX and sulfasalazine failed to show statistical superiority for ACR. Besides the established treatment of anti TNF antibodies und ustekinumab for psoriatic arthritis, the newer treatment options of IL17 antibodies and apremilast are also effective for the treatment of psoriatic arthritis. Based on just one comparative trial and one drug each, the new class of anti IL 17 antibodies appears to be equally effective as the group of anti TNF antibodies, for apremilast this is yet unclear. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Journal of the European Academy of Dermatology and Venereology : JEADV
To evaluate the efficacy and safety of adalimumab in psoriatic arthritis (PsA) patients in Japan.
It is necessary to determine whether psoriasis responds to methotrexate in the same manner in patients with and without psoriatic arthritis.
Evaluate safety and efficacy of intravenous golimumab in patients with active psoriatic arthritis (PsA) through 1 year.
To describe the range and depth of perspectives and experiences of patients with psoriasis and psoriatic arthritis to inform gaps in patient centred care.
There are scarce data in Scandinavia about treatment satisfaction among patients with psoriasis (PsO) and/or psoriatic arthritis (PsA). The number of patients receiving systemic treatment is unknown.
This clinical study will test the effects of a drug called apremilast in oligoarticular psoriatic arthritis with less than 2 years of disease duration. In previous studies, apremilast has ...
The purpose of this study is to determine an optimal abatacept dosing regimen for the treatment of patients with active arthritis due to psoriatic arthritis who have had a prior inadequate...
Study BCD-085-8/PATERA is a multicentre double-blind placebo-controlled Phase 3 study in patients with psoriatic arthritis (PsA). The objective of the study is to evaluate the efficacy and...
This study is a documentation of effectiveness and safety of Humira in patients with psoriatic arthritis.
The purpose of this study is to determine whether a humanized monoclonal antibody (efalizumab) is safe and effective in the treatment of psoriatic arthritis (PsA)
Multi-step systematic review process used for improving safety by investigation of incidents to find what happened, why it happened, and to determine what can be done to prevent it from happening again.
A chimeric monoclonal antibody to TNF ALPHA that is used in the treatment of RHEUMATOID ARTHRITIS; ANKYLOSING SPONDYLITIS; PSORIATIC ARTHRITIS and CROHN'S DISEASE.
A humanized monoclonal antibody that binds specifically to TNF-ALPHA and blocks its interaction with endogenous TNF RECEPTORS to modulate INFLAMMATION. It is used in the treatment of RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS; CROHN'S DISEASE and ULCERATIVE COLITIS.
A type of inflammatory arthritis associated with PSORIASIS, often involving the axial joints and the peripheral terminal interphalangeal joints. It is characterized by the presence of HLA-B27-associated SPONDYLARTHROPATHY, and the absence of rheumatoid factor.
A recombinant version of soluble human TNF receptor that binds specifically to TUMOR NECROSIS FACTOR and inhibits its binding with endogenous TNF receptors. It prevents the inflammatory effect of TNF and is used to treat RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS and ANKYLOSING SPONDYLITIS.
A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint causes pain, stiffness, and swelling with ...
Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...