Maese Jesús, Díaz Del Campo Petra, Seoane-Mato Daniel, Guerra Mercedes, Cañete Juan D
Grupo de Trabajo Reumatología Basada en la Evidencia, Sociedad Española de Reumatología, Madrid, España.
Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España.
Reumatol Clin (Engl Ed). 2018 Mar-Apr;14(2):81-89. doi: 10.1016/j.reuma.2016.10.005. Epub 2017 Jan 13.
Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA.
Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis.
Title and abstract were used to retrieve 1,662 documents for this review (Medline, n=433; EMBASE n=1,132; Cochrane, n=97), and 48 studies were selected for detailed reading; finally, 8 studies were included.
Since the studies included are not robust, and there are arguments to support the effectiveness of methotrexate, the evidence observed with the treatment of DMARDs in PsA is not conclusive.
由于银屑病关节炎（PsA）的临床异质性，国际组织已制定相关建议以指导风湿病学家的治疗决策。本系统评价（RS）的目的是评估改善病情抗风湿药（DMARDs）治疗PsA疗效的证据。
检索2008年至2014年期间Medline、EMBASE、Cochrane图书馆的文献。纳入PsA患者的RS、随机临床试验和观察性研究，并根据以下结果评估传统DMARDs（甲氨蝶呤、柳氮磺胺吡啶、来氟米特）的疗效：外周和轴向症状；外周放射学损伤；根据功率多普勒超声或磁共振成像评估的附着点炎（治疗前后附着点炎计数）；指（趾）炎；葡萄膜炎。
通过标题和摘要检索到1662篇文献用于本评价（Medline，n = 433；EMBASE，n = 1132；Cochrane，n = 97），选择48项研究进行详细阅读；最终纳入8项研究。
由于纳入的研究不够充分，且有证据支持甲氨蝶呤的有效性，因此DMARDs治疗PsA的证据并不确凿。
