Psoriatic arthritis: latest treatments and their place in therapy

Abstract

Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease that may affect peripheral and axial joints, entheses, skin and nails, and other organs. Treatment with nonsteroidal anti-inflammatory drugs, steroid and disease-modifying antirheumatic drugs had been the backbone of traditional management of PsA for many years. However, improvement in our understanding of immunopathogenesis of PsA has led to new immunomodulatory therapies. Introduction of novel agents has raised the bar for treatment and helped drive research into additional therapeutic options.

New Interleukins in Psoriasis and Psoriatic Arthritis Patients: The Possible Roles of Interleukin-33 to Interleukin-38 in Disease Activities and Bone Erosions

“…In addition, we investigated IL-12/23p40, of which the antibody, Ustekinumab, has yielded impressive results in clinical treatment [1,18] .…”

“…Pro-inflammatory cytokines play critical roles in Ps and PsA by promoting systemic inflammation, tumor necrosis factor α (TNF-α), interleukin (IL)-1, and IL-12 families. From bench to bedside, treatment methods of Ps and PsA have changed dramatically due to the development and introduction of biologic agents, particularly inhibitors of the pro-inflammatory cytokines [1] . The successes achieved by TNF-α inhibitors (TNFi) and IL-12/IL-23p40 inhibitors have also been instrumental in carrying out additional re- A range of bone pathologies was observed in patients with PsA including aberrant bone loss and new bone formation [6,7] .…”

Targeting IL-17 in psoriatic arthritis

“…Blockade of IL-17 has resulted in remarkable success in the treatment of psoriatic disease (47). In particular, IL-17 antagonists in the setting of psoriasis have been shown to achieve higher PASI 75, 90, 100 response rates (48).…”

How can the key findings from the GO-REVEAL study be translated to the clinic?

“…These studies were published prior to the approval of certolizumab in 2013 for the treatment of PsA [21,22]. All TNF-Is were comparable in efficacy as measured by PsARC response, HAQ and ACR20/50/70.…”

“…All TNF-Is were comparable in efficacy as measured by PsARC response, HAQ and ACR20/50/70. Certolizumab had similar ACR response to other TNF-Is when compared with placebo with ACR 20/50/70 of 58/42/26% at week 24 [22]. All TNF-Is also were equally effective in delaying radiographic progression [23,24].…”