Department of Rheumatology, CHRU Besançon , Besançon, France.
EA 4267: "PEPITE", FHU Increase, Université Bourgogne - Franche Comte , Besançon, France.
Expert Rev Clin Pharmacol. 2020 May;13(5):505-519. doi: 10.1080/17512433.2020.1758556. Epub 2020 May 12.
The management of Psoriatic arthritis (PsA) has evolved in the last decade with a significant increase in treatment options making the choice for clinicians difficult. Thus, the different factors of good prognosis for each treatment are presented in this review.
Current available treatment and assessment tools for the response of treatment are presented. A systematic review of the literature, on Pubmed, Medline and Cochrane databases and abstracts from the last three EULAR and ACR annual conferences was performed. Factors associated with a good response to csDMARDs, tsDMARDs and bDMARDs are presented.
Dactylitis and axial involvement are associated with a poor response to methotrexate. Leflunomide has shown better efficacy in the presence of established polyarticular involvement. TNF inhibitors are to be preferred in young men with an elevated CRP while obesity, high disease activity and long disease duration are factors associated with poor response. Apremilast and ustekinumab are more effective in mono and oligo articular disease. Abatacept is more effective in patients with high CRP, high disease activity and polyarticular involvement. Finally, there are no available data with the anti IL17 These factors are some arguments to help clinicians, but comparative study are needed to conclude.
在过去的十年中，银屑病关节炎（PsA）的治疗方法有了很大的发展，治疗选择的增多使得临床医生的选择变得困难。因此，本文介绍了每种治疗方法的良好预后的不同因素。
本文介绍了目前可用于治疗银屑病关节炎的治疗方法和评估工具。在 PubMed、Medline 和 Cochrane 数据库以及过去三年的 EULAR 和 ACR 年会上的摘要中进行了文献的系统回顾。本文还介绍了与 csDMARDs、tsDMARDs 和 bDMARDs 治疗反应良好相关的因素。
掌跖关节炎和中轴关节受累与甲氨蝶呤治疗反应不佳有关。来氟米特在存在已确立的多关节受累时显示出更好的疗效。在年轻男性中，TNF 抑制剂在 CRP 升高时更为有效，而肥胖、高疾病活动度和长病程是治疗反应不佳的相关因素。阿普米司特和乌司奴单抗在单关节和寡关节疾病中更有效。阿巴西普在 CRP 高、疾病活动度高和多关节受累的患者中更有效。最后，尚无抗 IL17 的可用数据。这些因素是帮助临床医生的一些依据，但需要进行比较研究来得出结论。
