Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders

Figures & data

Table 1 Biological drugs currently licensed for PsA

Molecule	Mechanism of action	Route	Dosage
Infliximab	Chimeric monoclonal antibody against TNF-α	IV	5 mg/kg at weeks 0, 2, and 6 and every 6–8 weeks
Etanercept	Soluble TNF receptor p75-IgG1 fusion protein	SC	50 mg/week
Adalimumab	Fully human anti-TNF-α monoclonal antibody	SC	40 mg every 2 weeks
Golimumab	Fully human IgG1k anti-TNF-α antibody	SC	50 mg/month
Certolizumab pegol	Fab fragment of anti-TNF-α monoclonal antibody	SC	400 mg at 0, 2, and 4 weeks and then 200 mg every 2 weeks
Ustekinumab	Fully human IgG1 monoclonal antibody against the shared P40 subunit of human IL-12 and IL-23	SC	45 mg at weeks 0 and 4 and then every 12 weeks (90 mg if weight >100 kg)
Secukinumab	Monoclonal antibody against IL-17A	SC	150 (or 300) mg at weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter or directly 150 mg/month

Abbreviations: PsA, psoriatic arthritis; TNF, tumor necrosis factor; IV, intravenous; SC, subcutaneous; IL, interleukin.

Table 2 Currently approved biological drugs for PsA: efficacy data from registrative trials

Molecule	PASI 75 (at week 24)	ACR 20 (at week 24)	ACR 50 (at week 24)	ACR 70 (at week 24)
Infliximab^Citation23 (5 mg/kg at weeks 0, 2, 6, 14, and 22)	60% (1%)	54% (16%)	41% (4)	27% (2%)
Etanercept^Citation26 (25 mg twice weekly)	23% (3%)	59%* (15%*)	–	–
Adalimumab^Citation29 (40 mg every 2 weeks)	59% (1%)	57% (15%)	39% (6%)	23% (1%)
Golimumab^Citation32 (50 mg every 4 weeks)	56% (1%)	52% (12%)	–	–
Certolizumab pegol^Citation34 (400 mg at weeks 0 and 2 and then 200 mg every 4 weeks)	62% (15%)	64% (24%)	44% (13%)	28% (4%)
Ustekinumab^Citation36 (45 mg at weeks 0 and 4 and then every 12 weeks)	57% (11%)	42% (23%)	25% (9%)	12% (2%)
Secukinumab^Citation40 (150 mg at weeks 0, 1, 2, 3, and 4 and then every 4 weeks)	48% (16%)	51% (15%)	35% (7%)	21% (1%)

Notes: The percentages within the brackets refer to the related placebo values.

* At week 12. Data are only presented for an illustrative purpose but not for a direct comparison.

Abbreviations: PsA, psoriatic arthritis; PASI, Psoriasis Area and Severity Index; ACR, American College of Rheumatology improvement criteria.

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