Update in treatment options for psoriatic arthritis

Abstract

Psoriatic arthritis is a chronic inflammatory joint disease in patients with psoriasis and has a varying disease course. The majority of patients develop important disability and joint destruction within a few years of disease onset, necessitating the initation of disease-modifying therapy. Treatment options for peripheral disease, enthesitis and dactylitis include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), local steroids and TNF-blocking agents. Axial disease is treated with NSAIDS and TNF blockade. Major clinical response is seen in approximately 30% of patients with methotrexate or leflunomide but no structural effect has yet been documented. Anti-TNF treatment has the best number-needed- to-treat/number-needed-to harm ratio of all DMARDs in psoriatic arthritis and is able to induce clinical remission in at least 30% of patients. TNF-blocking agents have also been demonstrated to slow down or halt radiographic progression.

Keywords::

• biologicals
• psoriatic arthritis
• remission
• TNF-blocking agents

Financial and competing interests disclosure

Kurt de Vlam received fees for consulting and expert boards from Shering Plough, UCB and Wyeth, and is a member of the speaker’s board of Shering Plough. Rik J Lories is also a member of the speaker’s board of Shering Plough. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

^*Current psoriasis scores 2; all other scores 1.

Data taken from [5].