New therapy avenue approved for psoriatic arthritis

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New therapy avenue approved for psoriatic arthritis

Psoriatic arthritis is the a seronegative oligoarthritis found in patients with psoriasis with less common but characteristic, differentiating features of distal joint involvement and arthritis mutilans. Psoriatic arthritis causes swelling, stiffness and pain in the joints, changes in nail and overall fatigue. Recently, treatment with tumor necrosis factor inhibitors (TNFi) or anti-TNF drugs have shown significantly improved of psoriatic arthritic patients.

Clinical and laboratory indices from two indirect comparison meta-analyses have showed the similar favorable outcomes for all the TNFi drugs. In those meta-analyses, adalimumab, etanercept, golimumab and infliximab showed no significant differences in the efficacy and safety. Treatment regimen has shifted after the introduction of TNFi drugs, owing to their ability to reduce the signs and symptoms of the disease and slow down the radiographic progression. The recent discovery of new pathogenic mechanisms have made this development of new molecules possible that targets pro-inflammatory cytokines involved in skin, joint and entheseal inflammation.  Blocking of these cytokines and cellular pathways involved in the pathogenesis is now possible using the biotechnological drugs and small molecules approved for the treatment of psoriatic arthritis.  

Various new drugs that have been introduced such as ustekinumab, secukinumab and apremilast that inhibits the interleukin axis and intracellular pathways and have also been showed their efficacy and safety in different randomized clinical trials. These drugs have been recently approved for the treatment of psoriatic arthritis and were included in the new Annual European Congress of Rheumatology (EULAR) and Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations.

After the analysis, TNFi therapy has showed its efficacy and safety in different rheumatic diseases and now a state of remission or low disease activity are achievable targets even in the spondyloarthritis and psoriatic arthritis. However, about 40% of the patients didn’t respond to the TNFi drugs. Fortunately, the treatment of psoriatic arthritis is rapidly evolving beyond the TNFi therapy which is among rising novel therapies that targets new molecules.

Source:

Rheumatismo

Link to the source:

http://www.reumatismo.org/index.php/reuma/article/view/873/714

Original title of article:

New approved drugs for psoriatic arthritis

Authors:

F.M. Perrotta, E. Lubrano

 

Rheumatismo
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