Psoriatic arthritis: current therapy and future approaches

Rheumatology (Oxford). 2015 Jan;54(1):20-8. doi: 10.1093/rheumatology/keu237. Epub 2014 Aug 14.

Abstract

PsA is a systemic inflammatory condition that affects 20-30% of patients with psoriasis. It is characterized by potential involvement of diverse tissues, including peripheral and axial joints, enthesitis, dactylitis and skin and nail disease. The degree of involvement in each domain can vary over time in individual patients and can differ substantially between PsA patients. The clinical heterogeneity along with the varying extent of severity and activity can pose significant challenges to treatment. Although some studies had suggested immunopathophysiological similarities between PsA and RA, more recently important distinctions have been defined. Similarly, although some immunomodulatory therapies have proved effective for both PsA and RA, recent data suggest distinct responses to certain targeted therapies. Herein, current DMARDs and biologic agents as well as the potential role of emerging therapeutics will be reviewed.

Keywords: IL-17 inhibitor; apremilast; disease-modifying anti-rheumatic drug; methotrexate; psoriatic arthritis; review; rituximab; treatment; tumour necrosis factor inhibitors; ustekinumab.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Psoriatic / diagnosis*
  • Arthritis, Psoriatic / drug therapy*
  • Biological Products / therapeutic use
  • Disease Management*
  • Humans
  • Immunologic Factors / therapeutic use
  • Practice Guidelines as Topic
  • Severity of Illness Index*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antirheumatic Agents
  • Biological Products
  • Immunologic Factors
  • Tumor Necrosis Factor-alpha