PMID- 26660203 OWN - NLM STAT- MEDLINE DCOM- 20160620 LR - 20220410 IS - 1468-2060 (Electronic) IS - 0003-4967 (Linking) VI - 75 IP - 3 DP - 2016 Mar TI - Pharmacological treatment of psoriatic arthritis: a systematic literature review for the 2015 update of the EULAR recommendations for the management of psoriatic arthritis. PG - 490-8 LID - 10.1136/annrheumdis-2015-208466 [doi] AB - OBJECTIVE: To update the evidence on the efficacy and safety of pharmacological agents in psoriatic arthritis (PsA). METHODS: Systematic literature review of randomised controlled trials comparing pharmacological interventions in PsA: non-steroidal anti-inflammatory drugs, glucocorticoid, synthetic disease modifying antirheumatic drugs (sDMARDs) either conventional or targeted, biologicals (bDMARDs), placebo or any combination. Main outcomes were American College of Rheumatology (ACR)20-50, Psoriasis Area Severity Index 75, radiographic progression, and withdrawals due to adverse events (AEs). Multiple studies of the same intervention were meta-analysed using random effects. RESULTS: In total, 25 papers and 12 abstracts were included. The efficacy of tumour necrosis factor inhibitors (including the recently added golimumab and certolizumab pegol) was confirmed and 16 articles/abstracts focused on 3 drugs with new modes of action: ustekinumab (UST), secukinumab (SEC) and apremilast (APR). All were placebo-compared trials and met their primary end point, ACR20. In 2 studies with UST ACR20 was met by 50% and 44% of patients with UST 90 mg, 42% and 44% with UST 45 mg vs 23% and 20% with placebo, respectively. In two studies with SEC ACR20 ranged 54% (SEC 300 mg), 50-51% (SEC 150 mg), 29-51% (SEC 75 mg) and 15-17% (placebo). In four studies with APR, ACR20 ranged 32-43% (APR 30 mg), 29-38% (APR 20 mg) and 17-20% (placebo). For all three drugs, no more withdrawals due to AEs than placebo were seen and, in general, safety appeared satisfactory. A strategy trial, TIght COntrol of Psoriatic Arthritis (TICOPA), showed better ACR responses with treatment adaptations upon tight control compared with standard care. CONCLUSIONS: UST, SEC and APR are new drugs with efficacy demonstrated for the treatment of PsA. No major safety signals arise, but long-term studies are needed. This review informed about the European League Against Rheumatism recommendations for management of PsA. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ FAU - Ramiro, Sofia AU - Ramiro S AUID- ORCID: 0000-0002-8899-9087 AD - Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. FAU - Smolen, Josef S AU - Smolen JS AUID- ORCID: 0000-0002-8899-9087 AD - Division of Rheumatology, Department of Medicine, Medical University of Vienna, Hietzing Hospital, Vienna, Austria. FAU - Landewe, Robert AU - Landewe R AD - Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam and Atrium Medical Center, Heerlen, The Netherlands. FAU - van der Heijde, Desiree AU - van der Heijde D AUID- ORCID: 0000-0002-5781-158X AD - Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. FAU - Dougados, Maxime AU - Dougados M AD - Medicine Faculty, Paris Descartes University, Paris, France Rheumatology B Department, APHP, Cochin Hospital, Paris, France. FAU - Emery, Paul AU - Emery P AD - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK. FAU - de Wit, Maarten AU - de Wit M AD - EULAR past Vice President representing People with Arthritis/Rheumatism in Europe (PARE). FAU - Cutolo, Maurizio AU - Cutolo M AD - Research Laboratory and Clinical Division of Rheumatology, Department of Internal Medicine, University of Genova, Italy. FAU - Oliver, Susan AU - Oliver S AD - Independent Nurse Consultant, North Devon, UK. FAU - Gossec, Laure AU - Gossec L AUID- ORCID: 0000-0002-4528-310X AD - Sorbonne Universites, UPMC Univ Paris 06, Institut Pierre Louis d'Epidemiologie et de Sante Publique, GRC-UPMC 08 (EEMOIS), Paris, France Department of rheumatology, AP-HP, Pitie Salpetriere Hospital, Paris, France. LA - eng GR - 18475/ARC_/Arthritis Research UK/United Kingdom GR - 18475/VAC_/Versus Arthritis/United Kingdom PT - Journal Article PT - Review PT - Systematic Review DEP - 20151211 PL - England TA - Ann Rheum Dis JT - Annals of the rheumatic diseases JID - 0372355 RN - 0 (Anti-Inflammatory Agents, Non-Steroidal) RN - 0 (Antirheumatic Agents) RN - 0 (Glucocorticoids) SB - IM MH - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use MH - Antirheumatic Agents/*therapeutic use MH - Arthritis, Psoriatic/*drug therapy MH - Glucocorticoids/*therapeutic use MH - Humans MH - Practice Guidelines as Topic MH - Treatment Outcome OTO - NOTNLM OT - DMARDs (biologic) OT - DMARDs (synthetic) OT - Psoriatic Arthritis OT - Treatment EDAT- 2015/12/15 06:00 MHDA- 2016/06/21 06:00 CRDT- 2015/12/15 06:00 PHST- 2015/08/25 00:00 [received] PHST- 2015/10/30 00:00 [accepted] PHST- 2015/12/15 06:00 [entrez] PHST- 2015/12/15 06:00 [pubmed] PHST- 2016/06/21 06:00 [medline] AID - annrheumdis-2015-208466 [pii] AID - 10.1136/annrheumdis-2015-208466 [doi] PST - ppublish SO - Ann Rheum Dis. 2016 Mar;75(3):490-8. doi: 10.1136/annrheumdis-2015-208466. Epub 2015 Dec 11.