San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Rheumatology Department of Lucania, Contrada Macchia Romana, Potenza, Italy.
Expert Opin Emerg Drugs. 2010 Sep;15(3):399-414. doi: 10.1517/14728214.2010.497139.
The socioeconomic burden of psoriatic arthritis (PsA) is considerable and not different from that of rheumatoid arthritis. Current treatment options do not always allow reaching the therapeutic objectives consisting of the remission of symptoms and prevention of the appearance of damage in the early stage of PsA or the blocking of PsA progression in the established cases.
After reviewing the current treatment choices, we examine the new drugs in clinical Phase II and III trials for PsA up to January 2010. Information was mainly obtained from the network of international clinical trial registries.
The current management of PsA includes NSAIDs, corticosteroids, disease-modifying antirheumatic drugs (DMARDs) and anti-TNF-alpha blocking agents. These last drugs are more effective than traditional DMARDs on symptoms/signs of inflammation, quality of life and function and can inhibit the progression of the structural joint damage. Recent advancement in the knowledge of the immunopathogenesis of PsA has permitted the development of novel drugs including new TNF-alpha blockers, IL-1, -6, -12, -23 and -17 inhibitors, co-stimulator modulation inhibitors, B-cell depleting agents, small molecules and receptor activator of NF-kappaB/receptor activator of NF-kappaB ligand inhibitors.
The currently available anti-TNF-alpha blocking agents have revolutionized the management of PsA. However, there is a need for more effective and safer drugs.
银屑病关节炎（PsA）的社会经济负担相当大，与类风湿关节炎并无不同。目前的治疗选择并不总是能够达到治疗目标，即缓解症状和预防早期 PsA 损伤的出现，或阻止已确诊的 PsA 进展。
在审查了目前的治疗选择后，我们检查了截至 2010 年 1 月用于 PsA 的临床 II 期和 III 期试验中的新药。信息主要来自国际临床试验注册网络。
目前对 PsA 的管理包括 NSAIDs、皮质类固醇、疾病修饰抗风湿药物（DMARDs）和抗 TNF-α 阻断剂。这些最后一类药物在炎症的症状/体征、生活质量和功能方面比传统的 DMARDs 更有效，并且可以抑制结构关节损伤的进展。最近对 PsA 的免疫发病机制的认识进展使得新型药物得以开发，包括新的 TNF-α 阻断剂、IL-1、-6、-12、-23 和 -17 抑制剂、共刺激调节剂抑制剂、B 细胞耗竭剂、小分子和 NF-κB 受体激活剂/ NF-κB 配体抑制剂。
目前可用的抗 TNF-α 阻断剂彻底改变了 PsA 的治疗方法。然而，需要更有效和更安全的药物。
