RT Journal Article
SR Electronic
T1 Management of Dactylitis in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 265
OP 278
DO 10.3899/jrheum.220311
VO 50
IS 2
A1 Penélope Esther Palominos
A1 Daniel G. Fernández-Ávila
A1 Laura C. Coates
A1 Adewale Adebajo
A1 Adrien Nzeusseu Toukap
A1 Ahmed Abogamal
A1 Ari Polachek
A1 Arno W.R. van Kuijk
A1 Francesco Caso
A1 Gabriele de Marco
A1 Gurjit S. Kaeley
A1 Ingrid Steinkoenig
A1 Jeffrey Chau
A1 Marie Feletar
A1 Marijn Vis
A1 Ori Elkayam
A1 Philipp Sewerin
A1 Salvatore d’Angelo
A1 Sibel Zehra Aydin
A1 Waleed AlShehhi
A1 Philip S. Helliwell
YR 2023
UL http://www.jrheum.org/content/50/2/265.abstract
AB Objective This literature review aimed to identify the most efficacious current interventions for dactylitis and provide up-to-date scientific evidence to support the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommendations on the management of psoriatic arthritis.Methods Original articles published from 2013 to 2020, registered in MEDLINE, Embase, and Cochrane Library, describing interventional trials and reporting dactylitis-related outcomes were included. The 20 members of the GRAPPA dactylitis group were divided into 9 subgroups according to treatment, and members of each group independently extracted data from articles/abstracts corresponding to their group by using a standardized data extraction form.Results Forty-nine publications were analyzed, representing 40 randomized clinical trials (RCTs) and including 16,752 patients. Dactylitis was assessed as a secondary outcome in 97.5% of these trials and more than 40% of RCTs did not employ a specific dactylitis measure or instrument.Conclusion The emergence of agents with novel mechanisms of action in recent years, such as interleukin 17 (IL-17), IL-12/23, IL-23, and Janus kinase inhibitors, has significantly expanded the available treatment options for dactylitis. This article points out the lack of consensus regarding dactylitis assessment and the paucity of data concerning the effect of local steroid injections, nonsteroidal antiinflammatory drugs, and conventional disease-modifying antirheumatic drugs. Clinical trials evaluating the effect of these traditional and low-cost medications used to treat dactylitis should be encouraged.