UO of Rheumatology, S. Pietro Fatebenefratelli Hospital, Via cassia 600, 00189 Rome, Italy.
Clin Rheumatol. 2012 Jan;31(1):133-7. doi: 10.1007/s10067-011-1790-6. Epub 2011 Jun 24.
Psoriatic arthritis (PsA) is a chronic inflammatory joint disorder that is commonly associated with skin psoriatic lesions and can lead to severe disability. Current pharmacologic therapy for PsA includes TNFα-blocking agents for patients who are intolerant of or have an inadequate response to conventional disease-modifying antirheumatic drugs. Currently, there are no published randomized controlled trials providing a head-to-head comparison of the effectiveness of the three TNFα-blocking agents used most often to treat patients with PsA (adalimumab, etanercept, and infliximab). In this study, we have performed the first indirect comparison among these biologic agents, in this setting, using a mixed treatment comparison analysis of the data from pivotal trials regarding efficacy profiles of adalimumab, etanercept, and infliximab evaluated as American College of Rheumatology (ACR) 20 response. Our results suggest that etanercept is expected to provide the greatest ACR20 response among the anti-TNFα agents compared with placebo in the treatment of patients with PsA unresponsive to conventional treatments. This analysis may be relevant for clinical decision-making, hence improving the management of PsA patients.
银屑病关节炎（PsA）是一种慢性炎症性关节疾病，通常与皮肤银屑病病变有关，并可导致严重残疾。目前针对 PsA 的药物治疗包括 TNFα 阻断剂，适用于对传统疾病修饰抗风湿药物不耐受或反应不足的患者。目前，尚无发表的随机对照试验提供最常用于治疗 PsA 患者的三种 TNFα 阻断剂（阿达木单抗、依那西普和英夫利昔单抗）的有效性的头对头比较。在这项研究中，我们使用关键试验中关于阿达木单抗、依那西普和英夫利昔单抗的疗效特征的混合治疗比较分析，首次在这一背景下对这些生物制剂进行了间接比较，评估为美国风湿病学会（ACR）20 反应。我们的结果表明，与安慰剂相比，依那西普有望在治疗对常规治疗无反应的 PsA 患者中提供最大的抗 TNFα 药物 ACR20 反应。这种分析可能与临床决策相关，从而改善 PsA 患者的管理。
