Caso Francesco, Lubrano Ennio, Del Puente Antonio, Caso Paolo, Peluso Rosario, Foglia Francesca, Benigno Carolina, Girolimetto Nicolò, Bottiglieri Paolo, Scarpa Raffaele, Costa Luisa
a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy.
Expert Rev Clin Immunol. 2016;12(3):315-31. doi: 10.1586/1744666X.2016.1117941. Epub 2015 Dec 9.
The improved recognition of pathogenetic molecular mechanisms has led to the use of drugs targeting cytokines in different inflammatory arthropathies as well psoriatic arthritis (PsA). In particular, the progress in knowledge on tumor necrosis factor (TNF)-α in the pathogenesis of PsA has changed the therapeutic approach by use of direct and receptor cytokine antagonists. Currently, infliximab (IFX), adalimumab, etanercept, golimumab and certolizumab pegol represent the five anti-TNF-α available for the treatment of PsA. This review describes evidence on treatment aimed at neutralizing TNF-α in PsA patients, from the first study in 2000 until today, mainly derived from randomized clinical trials. In comparison with traditional therapies, anti-TNF-α agents have shown to have more efficacy both in treating clinical aspects, including enthesitis, dactylitis, joint pain and swelling, axial involvement, nail and skin lesions, and in reducing radiographic progression. Moreover, anti-TNF-α agents have been demonstrated to be reasonably safe in PsA, as confirmed by data derived by different registries.
对致病分子机制认识的提高，已促使针对细胞因子的药物应用于包括银屑病关节炎（PsA）在内的不同炎性关节病。特别是，对PsA发病机制中肿瘤坏死因子（TNF）-α的认识进展，已通过使用直接细胞因子拮抗剂和受体细胞因子拮抗剂改变了治疗方法。目前，英夫利昔单抗（IFX）、阿达木单抗、依那西普、戈利木单抗和赛妥珠单抗聚乙二醇是可用于治疗PsA的五种抗TNF-α药物。本综述描述了自2000年的第一项研究至今，主要来自随机临床试验的、针对PsA患者中和TNF-α治疗的证据。与传统疗法相比，抗TNF-α药物在治疗包括肌腱端炎、指（趾）炎、关节疼痛和肿胀、中轴受累、指甲和皮肤病变等临床症状方面，以及在减少影像学进展方面，均显示出更高的疗效。此外，不同注册研究的数据证实，抗TNF-α药物在PsA中已被证明具有合理的安全性。
