Top

Drugs

Published in:

01-06-2005 | Review Article

Traditional and Newer Therapeutic Options for Psoriatic Arthritis

An Evidence-Based Review

Author: Professor Dafna D. Gladman

Published in: Drugs | Issue 9/2005

Abstract

Psoriatic arthritis (PsA) is a destructive form of inflammatory arthritis that occurs in about one-third of patients with psoriasis. The pathogenesis of PsA includes genetic and immunological factors. A review of the currently available therapies reveals that traditional disease-modifying medications have provided only marginal relief from joint inflammation in patients with PsA, and have not been successful in controlling the disease and preventing joint damage. On the basis of current understanding of the pathogenesis of joint destruction in PsA, several new medications have been introduced, including anti-tumour necrosis factor (TNF) agents and agents that interfere with T-cell function. Most of these medications have been found to be effective in both psoriasis and PsA. Recent randomised controlled trials suggest that at least anti-TNF agents may help prevent progression of joint destruction.

Gladman DD, Rahman P. Psoriatic arthritis. In: Ruddy S, Harris ED, Sledge CB, et al., editors. Kelly’s textbook of rheumatology. 6th ed. Philadelphia (PA): WB Saunders, 2001: 1071–9

Bruce IN. Psoriatic arthritis clinical features. In: Hochberg M, Silman A, Smolen J, et al., editors. Rheumatology. Edinburgh: Mosby, 2003: 1241–53

Zachariae H. Prevalence of joint disease in patients with psoriasis: implications for therapy. Am J Clin Dermatol 2003: 4: 441–7PubMedCrossRef

Brockbank J, Stein M, Schentag CT, et al. Dactylitis in psoriatic arthritis: a marker for disease severity? Ann Rheum Dis 2005 Feb; 64(2): 188–90. Epub 2004 Jul 22PubMedCrossRef

Gladman DD, Brubacher B, Buskila D, et al. Differences in the expression of spondyloarthropathy: a comparison between ankylosing spondylitis and psoriatic arthritis: genetic and gender effects. Clin Invest Med 1993; 16: 1–7PubMed

Gladman DD, Stafford-Brady F, Chang CH, et al. Longitudinal study of clinical and radiological progression in psoriatic arthritis. J Rheumatol 1990; 17: 809–12PubMed

Torre-Alonso JC, Rodrigues-Perez A, Arribas-Castrillom JM, et al. Psoriatic arthritis (PA): a clinical immunologic and radiological study. Br J Rheumatol 1991; 30: 245–50PubMedCrossRef

McHugh NJ, Balachrishnan C, Jones SM. Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology (Oxford) 2003; 42: 778–83CrossRef

Gladman DD, Farewell VT. Progression in psoriatic arthritis: role of time varying clinical indicators. J Rheumatol 1999; 26: 2409–13PubMed

10.

Sokoll KB, Helliwell PS. Comparison of disability and quality of life in rheumatoid and psoriatic arthritis. J Rheumatol 2001; 28: 1842–6PubMed

11.

Husted JA, Gladman DD, Farewell VT, et al. Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Arthritis Care Res 2001; 45: 151–8CrossRef

12.

Wong K, Gladman DD, Husted J, et al. Mortality studies in psoriatic arthritis: results from a single centre. iI: risk and causes of death. Arthritis Rheum 1997; 40: 1873–7CrossRef

13.

Gladman DD, Farewell VT, Wong K, et al. Mortality studies in psoriatic arthritis: results from a single centre. II: prognostic indicators for mortality. Arthritis Rheum 1998; 41: 1103–10PubMedCrossRef

14.

Moll JM, Wright V. Familial occurrence of PsA. Ann Rheum Dis 1973; 32: 181–201PubMedCrossRef

15.

Eastmond CJ. Genetics and HLA antigens. In: Wright V, Helliwell P, editors. Baillière’s clinical rheumatology. Psoriatic arthritis. London: Baillière’s Tindall, 1994: 263–76

16.

Gladman DD, Farewell VT, Pellett F, et al. HLA is a candidate region for psoriatic arthritis: evidence for excessive HLA sharing in sibling pairs. Hum Immunol 2003; 64: 887–9PubMedCrossRef

17.

Elder JT, Nair RP, Henseler T, et al. The genetics of psoriasis 2001: the Odyssey continues. Arch Dermatol 2001; 137: 1447–54PubMed

18.

Karason A, Gudjonsson JE, Upmanyu R, et al. A susceptibility gene for psoriatic arthritis maps to chromosome 16q: evidence for imprinting. Am J Hum Genet 2003; 72: 125–31PubMedCrossRef

19.

Gladman DD, Farewell VT, Kopciuk K, et al. HLA antigens and progression in psoriatic arthritis. J Rheumatol 1998; 25: 730–3PubMed

20.

Gladman DD. Toward unraveling the mystery of psoriatic arthritis. Arthritis Rheum 1993; 36: 881–4PubMedCrossRef

21.

Veale D, Yanni G, Rogers S, et al. Reduced synovial membrane macrophage numbers, ELAM1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis. Arthritis Rheum 1993; 36: 893–900PubMedCrossRef

22.

Ritchlin C, Haas-Smith SA, Hicks D. Patterns of cytokine production in psoriatic synovium. J Rheumatol 1998; 25(8): 1544–52PubMed

23.

Espinoza LR, Aguilar JL, Espinoza CG, et al. Fibroblast function in psoriatic arthritis: I. Alteration of cell kinetics and growth factor responses. J Rheumatol 1994; 21: 1502–6

24.

Espinoza LR, Aguilar JL, Espinoza CG, et al. Fibroblast function in psoriatic arthritis: II. Increased expression of PDGF receptors and increased production of GF and cytokines. J Rheumatol 1994; 21: 1507–11

25.

Panayi G. Immunology of psoriasis and psoriatic arthritis. Baillieres Clin Rheumatol 1994; 8: 419–27PubMedCrossRef

26.

Veale DJ, Barnes L, Rogers S, et al. Immunohistochemical markers for arthritis in psoriasis. Ann Rheum Dis 1994; 53: 450–4PubMedCrossRef

27.

Costello P, Bresnihan B, O’Farrell C, et al. Predominance of CD8+ T lymphocytes in psoriatic arthritis. J Rheumatol 1999; 26: 1117–24PubMed

28.

Nakashima T, Wada T, Penninger JM. RANKL and RANK as novel therapeutic targets for arthritis. Curr Opin Rheumatol 2003; 15: 280–7PubMedCrossRef

29.

Lacey DL, Timms E, Tan HL, et al. Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell 1998; 93: 165–76PubMedCrossRef

30.

Suda T, Takahashi N, Udagawa N, et al. Modulation of osteoclast differentiation and function by the new members of the tumor necrosis factor receptor and ligand families. Endocr Rev 1999; 20: 345–57PubMedCrossRef

31.

Ritchlin CT, Haas-Smith SA, Li P, et al. Mechanisms of TNF-alpha- and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis. J Clin Invest 2003; 111: 821–31PubMed

32.

Neumüller J, Dunky A, Burtscher H, et al. Interaction of monocytes from patients with psoriatic arthritis with cultured microvascular endothelial cells. Clin Immunol 2001; 98: 143–52PubMedCrossRef

33.

Dayer JM, Burger D. Interleukin-1, tumor necrosis factor and their specific inhibitors. Eur Cytokine Netw 1994; 5: 563–71PubMed

34.

Fraser A, Fearon U, Reece R, et al. Matrix metalloproteinase 9, apoptosis, and vascular morphology in early arthritis. Arthritis Rheum 2001; 44: 2024–8PubMedCrossRef

35.

Hitchon CA, Danning CL, Illei GG, et al. Gelatinase expression and activity in the synovium and skin of patients with erosive psoriatic arthritis. J Rheumatol 2002; 29: 107–17PubMed

36.

Ribbens C, Porras M, Franchimont N, et al. Increased matrix metalloproteinase-3 serum levels in rheumatic diseases: relationship with synovitis and steroid treatment. Ann Rheum Dis 2002; 61: 161–6PubMedCrossRef

37.

Myers A, Lakey R, Cawston TE, et al. Serum MMP-1 and TIMP-1 levels are increased in patients with psoriatic arthritis and their siblings. Rheumatology (Oxford) 2004 Mar; 43(3): 272–6CrossRef

38.

Cohen MR, Reda DJ, Clegg DO. Baseline relationships between psoriasis and psoriatic arthritis: analysis of 221 patients with active psoriatic arthritis. J Rheumatol 1999; 26: 1752–6PubMed

39.

Gladman DD, Helliwell P, Mease PJ, et al. Assessment of patients with psoriatic arthritis: a review of currently available measures. Arthritis Rheum 2004; 50: 24–35PubMedCrossRef

40.

Gladman DD, Farewell V, Buskila D, et al. Reliability of measurements of active and damaged joints in psoriatic arthritis. J Rheumatol 1990; 17: 62–4PubMed

41.

Gladman DD, Cook RJ, Schentag C, et al. The clinical assessment of patients with psoriatic arthritis: results of a validation study of the SpondyloArthritis Research Consortium of Canada (SPARCC). J Rheumatol 2004 Jun; 31(6): 1126–31PubMed

42.

Gladman DD, Strand V, Mease PJ, et al. OMERACT 7 psoriatic arthritis workshop: synopsis. Ann Rheum Dis 2005 Mar; 64 Suppl. 2: ii115–6PubMedCrossRef

43.

Griffith CEM. Therapy for psoriatic arthritis: sometimes a conflict for psoriasis. Br J Rheumatol 1997; 36: 409–12CrossRef

44.

Black RL, O’Brien WM, Van Scott EJ, et al. Methotrexate therapy in psoriatic arthritis: double blind study on 21 patients. JAMA 1964; 189: 743–7PubMedCrossRef

45.

Willkens RF, Williams HJ, Ward JR, et al. Randomized, double-blind, placebo controlled trial of low-dose pulse methotrexate in psoriatic arthritis. Arthritis Rheum 1984; 27: 376–81PubMedCrossRef

46.

Kragballe K, Zachariae E, Zachariae H. Methotrexate in psoriatic arthritis: a retrospective study. Acta Derm Venereol 1983: 63: 165–7PubMed

47.

Espinoza LR, Zakraoui L, Espinoza CG, et al. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J Rheumatol 1992; 19: 872–7PubMed

48.

Abu-Shakra M, Gladman DD, Thorne JC, et al. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiologic outcome. J Rheumatol 1995; 22: 241–5PubMed

49.

Salvarani C, Macchioni P, Olivieri I, et al. A comparison of cyclosporine, sulfasalazine, and symptomatic therapy in the treatment of psoriatic arthritis. J Rheumatol 2001; 28: 2274–82PubMed

50.

Spadaro A, Riccieri V, Sili-Scavalli A, et al. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clin Exp Rheumatol 1995; 13: 589–93PubMed

51.

Ellis CN, Fradin MS, Messana JM, et al. Cyclosporin for plaque-type psoriasis: results of a multidose, double-blind trial. N Engl J Med 1991; 324: 277–84PubMedCrossRef

52.

Hopkins R, Bird HA, Jones H, et al. A double-blind controlled trial of etretinate (Tigason) and ibuprofen in psoriatic arthritis. Ann Rheum Dis 1985; 44: 189–93PubMedCrossRef

53.

Ciompi ML, Bazzichi L, Marotta G, et al. Tigason (etretinate) treatment in psoriatic arthritis. Int J Tissue React 1988; 10: 25–7PubMed

54.

Klinkhoff AV, Gertner E, Chalmers A, et al. Pilot study of etretinate in psoriatic arthritis. J Rheumatol 1989; 16: 789–91PubMed

55.

Perlman SG, Gerber LH, Roberts RM, et al. Photochemotherapy and psoriatic arthritis: a prospective study. Ann Intern Med 1979; 91: 717–22PubMed

56.

de Misa RF, Azana JM, Harto A, et al. Psoriatic arthritis: one year of treatment with extracorporeal photochemotherapy. J Am Acad Dermatol 1994; 30: 1037–8PubMedCrossRef

57.

Farr M, Kitas GD, Waterhouse L, et al. Sulphasalazine in psoriatic arthritis: a double-blind placebo-controlled study. Br J Rheumatol 1990; 29: 46–9PubMedCrossRef

58.

Fraser SM, Hopkins R, Hunter JA, et al. Sulphasalazine in the management of psoriatic arthritis. Br J Rheumatol 1993; 32: 923–5PubMedCrossRef

59.

Gupta AK, Grober JS, Hamilton TA, et al. Sulfasalazine therapy for psoriatic arthritis: a double blind, placebo controlled trial. J Rheumatol 1995; 22: 894–8PubMed

60.

Combe B, Goupille P, Kuntz JL, et al. Sulphasalazine in psoriatic arthritis: a randomized, multicentre, placebo-controlled study. Br J Rheumatol 1996; 35: 664–8PubMedCrossRef

61.

Clegg DO, Reda DJ, Mejias E, et al. Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis: a Department of Veterans Affairs Cooperative Study. Arthritis Rheum 1996; 39: 2013–20PubMedCrossRef

62.

Rahman P, Gladman DD, Zhou Y, et al. The use of sulfasalazine in psoriatic arthritis: a clinic experience. J Rheumatol 1998: 25: 1957–61PubMed

63.

Levy JJ, Paulus HE, Barnett EV, et al. A double-blind controlled evaluation of azathioprine treatment in rheumatoid arthritis and psoriatic arthritis. Arthritis Rheum 1972; 15: 116–7

64.

Lee JCT, Gladman DD, Schentag CT, et al. The long-term use of azathioprine in patients with psoriatic arthritis. J Clin Rheumatol 2001; 7: 160–5PubMedCrossRef

65.

Gladman DD, Blake R, Brubacher B, et al. Chloroquine therapy in psoriatic arthritis. J Rheumatol 1992; 19: 1724–6PubMed

66.

Carrette S, Calin A. Evaluation of auranofin in psoriatic arthritis: a double blind placebo controlled trial. Arthritis Rheum 1989; 32: 158–65CrossRef

67.

Palit J, Hill J, Capell HA, et al. A multicentre double-blind comparison of auranofin, intramuscular gold thiomalate and placebo in patients with psoriatic arthritis. Br J Rheumatol 1990; 29: 280–3PubMedCrossRef

68.

Mader R, Gladman DD, Long J, et al. Does injectable gold retard radiologic evidence of joint damage in psoriatic arthritis. Clin Invest Med 1995; 18: 139–43PubMed

69.

Jones G, Crotty M, Brooks P. Interventions for treating psoriatic arthritis (Cochrane Review). In: The Cochrane Library. Issue 3. Oxford: Update Software, 2001: 1–18

70.

Kaltwasser JP, Nash P, Gladman D, et al. Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis. Arthritis Rheum 2004; 50: 1939–50PubMedCrossRef

71.

Mease PJ, Goffe BS, Metz J, et al. Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 2000; 356: 385–90PubMedCrossRef

72.

Mease PJ, Kivitz AJ, Burch FX, et al. Etanercept treatment of psoriatic arthritis: safety, efficacy and effect on disease progression. Arthritis Rheum 2004; 50: 2264–72PubMedCrossRef

73.

Antoni C, Kavanaugh A, Kirkham B, et al. The Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT) [abstract]. Arthritis Rheum 2002; 46: S381

74.

Antoni CE, Kavanaugh A, Kirkham B, et al. Sustained benefits of infliximab therapy for dermatologic and articular manifestations of psoriatic arthritis: results from the Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT). Arthritis Rheum 2005; 52: 1227–36PubMedCrossRef

75.

Kavanaugh A, Krueger GG, De Vlam K, et al. Infliximab improves arthritis and psoriasis in patients with active polyarticular psoriatic arthritis: results of the IMPACT 2 trial [abstract]. Ann Rheum Dis 2004; 63 Suppl. 1: 402

76.

Mease PJ, Gladman DD, Ritchlin CT, et al. Adalimumab therapy in patients with psoriatic arthritis: 24-week results of a phase II study [abstract]. Arthritis Rheum 2004; 50: 4097CrossRef

77.

Sharp JT, Strand V, Leung H, et al. Treatment with leflunomide slows radiographie progression of rheumatoid arthritis: results from three randomized controlled trials of leflunomide in patients with active rheumatoid arthritis. Leflunomide Rheumatoid Arthritis Investigators Group. Arthritis Rheum 2000: 43: 495–505PubMedCrossRef

78.

Breedveld FC, Dayer J-M. Leflunomide: mode of action in the treatment of rheumatoid arthritis. Ann Rheum Dis 2000; 59: 841–9PubMedCrossRef

79.

Liang GC, Barr WG. Open trial of leflunomide for refractory psoriasis and psoriatic arthritis. J Clin Rheumatol 2001; 7: 366–70PubMedCrossRef

80.

Reich K, Hummel KM, Beckmann I, et al. Treatment of severe psoriasis and psoriatic arthritis with leflunomide. Br J Dermatol 2002; 146: 335–6PubMedCrossRef

81.

Cuchacovich M, Soto L. Leflunomide decreases joint erosions and induces reparative changes in a patient with psoriatic arthritis. Ann Rheum Dis 2002; 61: 942–3PubMedCrossRef

82.

Fredriksson T, Pettersson U. Severe psoriasis: oral therapy with a new retinoid. Dermatologica 1978; 157: 238–44PubMedCrossRef

83.

84.

Finlay AY, Khan GK. Dermatology life quality index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210–6PubMedCrossRef

85.

Ransom JT. Mechanism of action of mycophenolate mofetil. Ther Drug Monit 1995; 17: 681–4PubMedCrossRef

86.

Schrader P, Mooser G, Peter RU, et al. Preliminary results in the therapy of psoriatic arthritis with mycophenolate mofetil [in German]. Z Rheumatol 2002; 61: 545–50PubMedCrossRef

87.

Grundmann-Kollmann M, Mooser G, Schraeder P, et al. Treatment of chronic plaque-stage psoriasis and psoriatic arthritis with mycophenolate mofetil. J Am Acad Dermatol 2000; 42: 835–7PubMedCrossRef

88.

Specner-Green G. Etanercept (Enbrel): update on therapeutic use. Ann Rheum Dis 2000; 59 Suppl. 1: i46–9CrossRef

89.

Mease P. Psoriatic arthritis: the role of TNF inhibition and the effect of its inhibition with etanercept. Clin Exp Rheumatol 2002; 20 (6 Suppl. 28): S116–21PubMed

90.

Remicade® [manufacturer’s prescribing information]. Malvern (PA): Centocor Inc., 2002

91.

Feletar M, Brockbank JB, Schentag C, et al. Treatment of refractory psoriatic arthritis with infliximab: a 12 month observational study of 16 patients. Ann Rheum Dis 2004; 63: 156–61PubMedCrossRef

92.

Serono web page: media [online]. Available from URL: http://www.serono.com/media/stories2003/20030622 [Accessed 2004 Sep 01]

93.

Serono announces discontinuation of onercept in moderate-to-severe psoriasis and Canvaxin™ in stage IV melanoma. Press release; 2005 Apr 6 [online]. Available from URL: http://www.serono.com/media/stories2005/archive2005.jsp?major=4=1 [Accessed 2005 Apr 14]

94.

Keystone ED, Kavanaugh AF, Sharp JT, et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy. Arthritis Rheum 2004; 50: 1400–11PubMedCrossRef

95.

Ritchlin C, Anandarajaha A, Totterman S, et al. Preliminary data from a study of adalimumab in the treatment of psoriatic arthritis [abstract]. Ann Rheum Dis 2004; 63 Suppl. 1: 403

96.

Langley R, Leonardi C, Toth D, et al. Long-term safety and efficacy of adalimumab in the treatment of moderate to severe chronic plaque psoriasis [abstract]. J Am Acad Dermatol 2005; 52 (3 Suppl.): 2

97.

Grakoui A, Bromley SK, Sumen C, et al. The immunological synapse: a molecular machine controlling T cell activation. Science 1999; 285: 221–7PubMedCrossRef

98.

Leonardi CL. Treatment of psoriasis using efalizumab. In: Weinstein G, Gottlieb A, editors. Therapy of moderate-tosevere psoriasis. New York: Marcel Dekker, 2003: 333–50

99.

Lebwohl M, Tyring SK, Hamilton TK, et al. A novel targeted T-cell modulator, efalizumab, for plaque psoriasis. N Engl J Med 2003; 349(21): 2004–13PubMedCrossRef

100.

Gordon KB, Papp KA, Hamilton TK, et al. Efalizumab for patients with moderate to severe plaque psoriasis: a randomized controlled trial. JAMA 2003; 290(23): 3073–80PubMedCrossRef

101.

Genentech and Xoma announce results of phase II study of Raptiva™ in psoriatic arthritis patients [news release; online]. Available from URL: http://www.xoma.com/pdf/nr_04.03.21.pdf [Accessed 2004 Sep 01]

102.

Kraan MC, van Kuijk AW, Dinant HJ, et al. Alefacept treatment in psoriatic arthritis: reduction of the effector T cell population in peripheral blood and synovial tissue is associated with improvement of clinical signs of arthritis. Arthritis Rheum 2002; 46: 2776–84PubMedCrossRef

103.

Krueger G, Callis K. Alefacept to treat psoriasis. In: Weinstein G, Gottlieb A, editors. Therapy of moderate-to-severe psoriasis. New York: Marcel Dekker, 2003: 287–306

104.

Ellis CN, Krueger GG. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med 2001; 345: 248–55PubMedCrossRef

Title: Traditional and Newer Therapeutic Options for Psoriatic Arthritis
An Evidence-Based Review
Author: Professor Dafna D. Gladman
Publication date: 01-06-2005
Publisher: Springer International Publishing
Published in: Drugs / Issue 9/2005
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200565090-00004

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Traditional and Newer Therapeutic Options for Psoriatic Arthritis

An Evidence-Based Review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2005

Infliximab in Ankylosing Spondylitis

Short-Course Therapy for Community-Acquired Pneumonia in Paediatric Patients

Pharmacological Management of Acute Agitation

Subcutaneous Recombinant Interferon-β-1a (Rebif®)

Infliximab

Use of Antipsychotics in the Management of Schizophrenia during Pregnancy