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Update on the treatment of peripheral arthritis in psoriatic arthritis

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Abstract

Psoriatic arthritis is a chronic, disabling disease for which therapies have been borrowed from rheumatoid arthritis and spondylitis. Traditional disease-modifying antirheumatic drugs (DMARDs) remain the first choice for the treatment of peripheral arthritis despite scarce evidence of their efficacy or ability to halt radiographic progression. Tumor necrosis factor antagonists have the greatest level of evidence for symptom control and radiographic progression. They are currently used after the failure of DMARDs to effectively treat peripheral arthritis, enthesitis, and dactylitis, and are the first choice when axial disease predominates. Despite the use of these treatments, 30% to 40% of patients will still have active disease. Among new drugs, evidence of efficacy has already been published with regard to anti-IL12/23 monoclonal antibody (ustekimumab) and golimumab. Results are forthcoming from trials with certolizumab pegol, abatacept, and rituximab. As knowledge of the pathogenesis of psoriatic arthritis evolves and differences among other arthritis conditions become evident, therapies targeting these distinct features are needed.

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References and Recommended Reading

  1. Alamanos Y, PV Voulgari A, A Drosos: Incidence and prevalence of psoriatic arthritis: a systematic review. J Rheumatol 2008, 35:1354–1358.

    PubMed  Google Scholar 

  2. Gladman DD, Antoni C, Mease P, et al.: Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005, 64:ii14–ii17.

    Article  PubMed  Google Scholar 

  3. Wilson FC, Icen M, Crowson CS, et al.: Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum 2009, 61:233–239.

    Article  PubMed  CAS  Google Scholar 

  4. McHugh NJ, Balachrishnan C, Jones SM: Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology (Oxford) 2003, 42:778–783.

    Article  CAS  Google Scholar 

  5. Queiro-Silva R, Torre-Alonso JC, Tinture-Eguren T, Lopez-Lagunas I: A polyarticular onset predicts erosive and deforming disease in psoriatic arthritis. Ann Rheum Dis 2003, 62:68–70.

    Article  PubMed  CAS  Google Scholar 

  6. Gladman DD, Mease PJ: Towards international guidelines for the management of psoriatic arthritis. J Rheumatol 2006, 33:1228–1230.

    PubMed  Google Scholar 

  7. Soriano ER, McHugh NJ: Therapies for peripheral joint disease in psoriatic arthritis. A systematic review. J Rheumatol 2006, 33:1422–1430.

    PubMed  Google Scholar 

  8. Gladman DD, Mease PJ, Ritchlin CT, et al.: Adalimumab for long-term treatment of psoriatic arthritis: forty-eight week data from the adalimumab effectiveness in psoriatic arthritis trial. Arthritis Rheum 2007, 56:476–488.

    Article  PubMed  CAS  Google Scholar 

  9. Kavanaugh A, Antoni CE, Gladman D, et al.: The Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT): results of radiographic analyses after 1 year. Ann Rheum Dis 2006, 65:1038–1043.

    Article  PubMed  CAS  Google Scholar 

  10. Mease PJ, Gladman DD, Ritchlin CT, et al.: Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum 2005, 52:3279–3289.

    Article  PubMed  CAS  Google Scholar 

  11. Mease PJ, Kivitz AJ, Burch FX, et al.: Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum 2004, 50:2264–2272.

    Article  PubMed  CAS  Google Scholar 

  12. Ravindran V, Scott DL, Choy EH: A systematic review and meta-analysis of efficacy and toxicity of disease modifying anti-rheumatic drugs and biological agents for psoriatic arthritis. Ann Rheum Dis 2008, 67:855–859.

    Article  PubMed  CAS  Google Scholar 

  13. Gottlieb A, Korman NJ, Gordon KB, et al.: Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol 2008, 58:851–864.

    Article  PubMed  Google Scholar 

  14. Ritchlin CT, Kavanaugh A, Gladman DD, et al.: Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2008, Oct 24 (Epub ahead of print).

  15. Salvarani C, Olivieri I, Pipitone N, et al.: Recommendations of the Italian Society for Rheumatology for the use of biologic (TNF-alpha blocking) agents in the treatment of psoriatic arthritis. Clin Exp Rheumatol 2006, 24:70–78.

    PubMed  CAS  Google Scholar 

  16. Pham T, Fautrel B, Dernis E, et al.: Recommendations of the French Society for Rheumatology regarding TNFalpha antagonist therapy in patients with ankylosing spondylitis or psoriatic arthritis: 2007 update. Joint Bone Spine 2007, 74:638–646.

    Article  PubMed  CAS  Google Scholar 

  17. Kyle S, Chandler D, Griffiths CE, et al.: Guideline for anti-TNF-alpha therapy in psoriatic arthritis. Rheumatology (Oxford) 2005, 44:390–397.

    Article  CAS  Google Scholar 

  18. Maksymowych WP, Gladman D, Rahman P, et al.: The Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondyloarthritis: a national multidisciplinary stakeholder project. J Rheumatol 2007, 34:2273–2284.

    PubMed  Google Scholar 

  19. McCarey D, McInnes IB: Psoriatic arthritis: current topics. Curr Rheumatol Rep 2007, 9:442–448.

    Article  PubMed  CAS  Google Scholar 

  20. Scarpa R, Peluso R, Atteno M, et al.: The effectiveness of a traditional therapeutical approach in early psoriatic arthritis: results of a pilot randomised 6-month trial with methotrexate. Clin Rheumatol 2008, 27:823–826.

    Article  PubMed  Google Scholar 

  21. Chandran V, Schentag CT, Gladman DD: Reappraisal of the effectiveness of methotrexate in psoriatic arthritis: results from a longitudinal observational cohort. J Rheumatol 2008, 35:469–471.

    PubMed  CAS  Google Scholar 

  22. Rahman P, Gladman DD, Cook RJ, et al.: Radiological assessment in psoriatic arthritis. Br J Rheumatol 1998, 37:760–765.

    Article  PubMed  CAS  Google Scholar 

  23. Abu-Shakra M, Gladman DD, Thorne JC, et al.: Long-term methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. J Rheumatol 1995, 22:241–245.

    PubMed  CAS  Google Scholar 

  24. Kaltwasser JP, Nash P, Gladman D, et al.: Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: a multinational, double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum 2004, 50:1939–1950.

    Article  PubMed  CAS  Google Scholar 

  25. Malesci D, Tirri T, Buono R, La Montagna G: Leflunomide in psoriatic arthritis: a retrospective study of discontinuation rate in daily clinical practice compared with methotrexate. Clin Exp Rheumatol 2007, 25:881–884.

    PubMed  CAS  Google Scholar 

  26. Jones G, Crotty M, Brooks P: Psoriatic arthritis: a quantitative overview of therapeutic options. The Psoriatic Arthritis Meta-Analysis Study Group. Br J Rheumatol 1997, 36:95–99.

    Article  PubMed  CAS  Google Scholar 

  27. Marzo-Ortega H, Green MJ, Keenan AM, et al.: A randomized controlled trial of early intervention with intraarticular corticosteroids followed by sulfasalazine versus conservative treatment in early oligoarthritis. Arthritis Rheum 2007, 57:154–160.

    Article  PubMed  CAS  Google Scholar 

  28. Spadaro A, Riccieri V, Sili-Scavalli A, et al.: Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clin Exp Rheumatol 1995, 13:589–593.

    PubMed  CAS  Google Scholar 

  29. Salvarani C, Macchioni P, Olivieri I, et al.: A comparison of cyclosporine, sulfasalazine, and symptomatic therapy in the treatment of psoriatic arthritis. J Rheumatol 2001, 28:2274–2282.

    PubMed  CAS  Google Scholar 

  30. Grimshaw JM, Winkens RA, Shirran L, et al.: Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database Syst Rev 2005: CD005471.

  31. Kavanaugh A, Tutuncu Z, Catalan-Sanchez T: Update on anti-tumor necrosis factor therapy in the spondyloarthropathies including psoriatic arthritis. Curr Opin Rheumatol 2006, 18:347–353.

    Article  PubMed  CAS  Google Scholar 

  32. Antoni CE, Kavanaugh A, Kirkham B, et al.: Sustained benefits of infliximab therapy for dermatologic and articular manifestations of psoriatic arthritis: results from the infliximab multinational psoriatic arthritis controlled trial (IMPACT). Arthritis Rheum 2005, 52:1227–1236.

    Article  PubMed  CAS  Google Scholar 

  33. Antoni CE, Kavanaugh A, van der Heijde D, et al.: Two-year efficacy and safety of infliximab treatment in patients with active psoriatic arthritis: findings of the Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT). J Rheumatol 2008, 35:869–876.

    PubMed  CAS  Google Scholar 

  34. Mease PJ, Kivitz AJ, Burch FX, et al.: Continued inhibition of radiographic progression in patients with psoriatic arthritis following 2 years of treatment with etanercept. J Rheumatol 2006, 33:712–721.

    PubMed  CAS  Google Scholar 

  35. Mease PJ, Ory P, Sharp JT, et al.: Adalimumab for long-term treatment of psoriatic arthritis: 2-year data from the Adalimumab Effectiveness in Psoriatic Arthritis Trial (ADEPT). Ann Rheum Dis 2009, 68:702–709.

    Article  PubMed  CAS  Google Scholar 

  36. Anandarajah AP, Ory P, Salonen D, et al.: Effect of adalimumab on joint disease features of patients with psoriatic arthritis detected by Magnetic Resonance Imaging. Ann Rheum Dis 2009 Feb 9 (Epub ahead of print).

  37. Delaunay C, Farrenq V, Marini-Portugal A, et al.: Infliximab to etanercept switch in patients with spondyloarthropathies and psoriatic arthritis: preliminary data. J Rheumatol 2005, 32:2183–2185.

    PubMed  CAS  Google Scholar 

  38. Conti F, Ceccarelli F, Marocchi E, et al.: Switching tumour necrosis factor alpha antagonists in patients with ankylosing spondylitis and psoriatic arthritis: an observational study over a 5-year period. Ann Rheum Dis 2007, 66, 1393–1397.

    Article  PubMed  CAS  Google Scholar 

  39. Conti F, Ceccarelli F, Priori R, et al.: Intra-articular infliximab in patients with rheumatoid arthritis and psoriatic arthritis with monoarthritis resistant to local glucocorticoids. Clinical efficacy extended to patients on systemic anti-tumour necrosis factor alpha. Ann Rheum Dis 2008, 67:1787–1790.

    Article  PubMed  CAS  Google Scholar 

  40. Kavanaugh A, McIness I, Mease P, et al.: Golimumab, a new human tumor necrosis factor alpha antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: twenty-four-week efficacy and safety results of a randomized, placebo-controlled study. Arthritis Rheum 2009, 60:976–986.

    Article  PubMed  CAS  Google Scholar 

  41. Ko JM, Gottlieb AB, Kerbleski JF: Induction and exacerbation of psoriasis with TNF-blockade therapy: a review and analysis of 127 cases. J Dermatolog Treat 2009, 20:100–108.

    Article  PubMed  CAS  Google Scholar 

  42. Collamer AN, Guerrero KT, Henning JS, Battafarano DF: Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: a literature review and potential mechanisms of action. Arthritis Rheum 2008, 59:996–1001.

    Article  PubMed  CAS  Google Scholar 

  43. Bansback NJ, Ara R, Barkham N, et al.: Estimating the cost and health status consequences of treatment with TNF antagonists in patients with psoriatic arthritis. Rheumatology (Oxford) 2006, 45:1029–1038.

    Article  CAS  Google Scholar 

  44. Bravo Vergel Y, Hawkins NS, Claxton K, et al.: The cost-effectiveness of etanercept and infliximab for the treatment of patients with psoriatic arthritis. Rheumatology (Oxford) 2007, 46:1729–1735.

    Article  CAS  Google Scholar 

  45. Olivieri I, de Portu S, Salvarani C, et al.: The psoriatic arthritis cost evaluation study: a cost-of-illness study on tumour necrosis factor inhibitors in psoriatic arthritis patients with inadequate response to conventional therapy. Rheumatology (Oxford) 2008, 47:1664–1670.

    Article  CAS  Google Scholar 

  46. Mease PJ, Gladman DD, Keystone EC: Alefacept in combination with methotrexate for the treatment of psoriatic arthritis: results of a randomized, double-blind, placebocontrolled study. Arthritis Rheum 2006, 54:1638–1645.

    Article  PubMed  CAS  Google Scholar 

  47. Mease PJ, Reich K: Alefacept with methotrexate for treatment of psoriatic arthritis: open-label extension of a randomized, double-blind, placebo-controlled study. J Am Acad Dermatol 2009, 60:402–411.

    Article  PubMed  Google Scholar 

  48. Turkiewicz AM, Moreland LW: Psoriatic arthritis: current concepts on pathogenesis-oriented therapeutic options. Arthritis Rheum 2007, 56:1051–1066.

    Article  PubMed  CAS  Google Scholar 

  49. Papp KA, Caro I, Leung HM, et al.: Efalizumab for the treatment of psoriatic arthritis. J Cutan Med Surg 2007, 11:57–66.

    PubMed  CAS  Google Scholar 

  50. Abrams JR, Lebwohl MG, Guzzo CA, et al.: CTLA4Ig-mediated blockade of T-cell costimulation in patients with psoriasis vulgaris. J Clin Invest 1999, 103:1243–1252.

    Article  PubMed  CAS  Google Scholar 

  51. Gottlieb A, Menter A, Mendelsohn A, et al.: Ustekinumab, a human interleukin 12/23 monoclonal antibody, for psoriatic arthritis: randomised, double-blind, placebo-controlled, crossover trial. Lancet 2009, 373:633–640.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Enrique R. Soriano.

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Soriano, E.R., Rosa, J. Update on the treatment of peripheral arthritis in psoriatic arthritis. Curr Rheumatol Rep 11, 270–277 (2009). https://doi.org/10.1007/s11926-009-0038-9

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