Rheumatology Department, CHRU Jean Minjoz, Besançon, France.
Clin Rheumatol. 2019 Feb;38(2):591-596. doi: 10.1007/s10067-018-4328-3. Epub 2018 Oct 16.
Dactylitis is a frequent disabling feature of psoriatic arthritis (PsA). Therapeutic strategy on dactylitis is not really codified. We performed a complementary literature review (since a previous one in 2014) of efficacy of new treatments recently used in PsA on this specific clinical manifestation. Eleven publications were retained (4697 patients). In the randomized double-blind placebo-controlled trials analyzed, authors declared ustekinumab, ixekizumab, adalimumab, and apremilast efficient. Secukinumab, clazakizumab, abatacept, and tofacitinib were promising. Brodalumab was ineffective. Calculations of odds ratios for residual dactylitis were significant for clazakizumab 100 mg and secukinumab in anti-TNF-naïve population. Homogenization of dactylitis assessment and use of this criterion as primary outcome are necessary to have better data on treatment efficacy in the future.
指（趾）炎是银屑病关节炎（PsA）常见的致残特征。针对指（趾）炎的治疗策略尚未明确。我们对最近用于治疗这种特定临床表现的新疗法在 PsA 中的疗效进行了补充文献复习（上次是在 2014 年）。共纳入 11 篇文献（4697 例患者）。在分析的随机双盲安慰剂对照试验中，作者报告乌司奴单抗、依奇珠单抗、阿达木单抗和阿普米司特有效。司库奇尤单抗、克拉屈滨单抗、阿巴西普和托法替布有前途。布罗达单抗无效。在抗 TNF 初治人群中，克拉屈滨单抗 100mg 和司库奇尤单抗的残余指（趾）炎计算比值比有显著意义。未来需要对指（趾）炎评估进行同质化，并将其作为主要结局指标，以获得更好的治疗效果数据。
