Making the next steps in psoriatic arthritis management: current status and future directions

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory condition with articular and extraarticular manifestations: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail disease. It is associated with cardiovascular comorbidities. It is now recognized as a new entity, different from rheumatoid arthritis and other spondyloarthritis in terms of clinical manifestations, pathogenesis, and response to therapies. Anti-tumor necrosis factors (antiTNFs) have demonstrated clinical efficacies exceeding that of conventional disease modifying antirheumatic drugs (DMARDs). The current treatment paradigms recommend early diagnosis and treatment, and a strategic and target orientated approach, aiming at a low disease activity status. New understanding in the immunopathogenesis of PsA has led to new treatment targets. This review addresses the evidence of current treatment for each of the domains as an aid to the clinician managing these patients in the clinic. Some new therapeutic targets are presented. We highlight the importance of development and validation in outcome measures, including that of composite scores that capture various disease domains that will facilitate future clinical trials to inform the best treatment.

Secukinumab Versus Adalimumab for Psoriatic Arthritis: Comparative Effectiveness up to 48 Weeks Using a Matching-Adjusted Indirect Comparison

“…We selected adalimumab as the comparator because of its equivalent efficacy to other anti-TNFs and widespread clinical use [19]. Anti-TNFs are established and recommended treatment options for active PsA [52][53][54][55]. Although there have been no H2H RCTs between them, indirect retrospective data suggest that they have similar efficacy and safety profiles [55,56].…”

“…Anti-TNFs are established and recommended treatment options for active PsA [52][53][54][55]. Although there have been no H2H RCTs between them, indirect retrospective data suggest that they have similar efficacy and safety profiles [55,56]. Meta-analyses have repeatedly shown no real differences in terms of ACR outcomes among anti-TNFs [54,[57][58][59][60].…”

Dynamics of Carotid Intima-Media Thickness, Parameters of Arterial Stiffness and Ambulatory Blood Pressure Monitoring during Therapy with Inhibitor of Tumor Necrosis Factor-Alpha in Patients with Early Psoriatic Arthritis

“…Псориатический артрит (ПсА) относится к заболеваниям, связанным с нарушением Т-клеточного иммунитета [1]. Ключевую роль в патогенезе ПсА играет фактор некроза опухолей альфа (ФНОα).…”

Choosing the right treatment for patients with psoriatic arthritis

“…Currently there is no biomarker that could predict treatment response, and individual therapies are chosen based on efficacy and safety data derived from clinical trials. Since our last review on this topic, 15 it is timely to update the treatment options for PsA, in particular, giving insights into choosing the appropriate treatment for PsA patients.…”