Biological agents can be a better choice in the treatment of psoriatic arthritis

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Biological agents can be a better choice in the treatment of psoriatic arthritis

Psoriatic arthritis (PsA) is an autoimmune and chronic inflammatory condition, affecting mostly patients with psoriasis. It results in a broad clinical spectrum, and variable course causes joint pain, stiffness, and swelling. It can affect musculoskeletal structures as well as skin, nails, eyes, and gut. Management of PsA was quite insufficient until some years ago. From last few decades, its management had remarkably changed and improved. It’s all because of earlier diagnosis, progress in pharmacological therapies, and a wider application of a multidisciplinary approach.

The development of biological agents has increased area of possibility to control signs and symptoms of inflammation in a better way, improve quality of life (QoL) and functional status and suppress the progression of structural damage in peripheral joints. The commercialization of tumor necrosis factor inhibitors (TNFi) (Adalimumab, Certolizumab pegol, Etanercept, Golimumab, and Infliximab) as well as interleukin (IL)-12/23 (ustekinumab) and IL-17 (secukinumab) inhibitors indicated a revolution in the treatment of PsA.  However, currently, no evidence-based strategies are available to guide the rheumatologist for prescription of biological drugs. Several international and national available recommendations helped rheumatologists to manage PsA patients using biological therapy, in their day-to-day practice.

As no specific biological agent have been revealed to be more effective than others, the choice for the drug must be based on available safety data, the presence of extra-articular manifestations, the patient's preferences (e.g., administration route) and the drug price. There is much need for future studies that could directly compare different biological drugs available and evaluate the efficacy of treatment strategies specific for PsA.

Source:

Open Access Rheumatology: Research and Reviews

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28280401

The original title of the article:

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

Authors:

D'Angelo S, Tramontano G et al.

SearchTags: 
Biological agents, Psoriatic arthritis
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