Abstract
Psoriatic arthritis affects approximately 6-42 % of patients with psoriasis. It is useful for physicians or dermatologists managing psoriasis patients to be aware of how to concurrently manage the joint manifestations, as it is preferable and convenient to use a single agent in such patients. However, only certain therapies are effective for both. Systemic agents, which can be used for both skin and joint manifestations, include methotrexate and ciclosporin. For the group of biologic agents, the tumor necrosis factor inhibitors such as adalimumab, etanercept, infliximab, golimumab and certolizumab are effective. Ustekinumab is a more recently developed agent belonging to the group of anti-IL-12p40 antibodies and has been shown to be efficacious. Newer drugs in the treatment armamentarium that have shown efficacy for both psoriasis and psoriatic arthritis consist of the anti-IL-17 agent, secukinumab, and a phosphodiesterase-4 inhibitor, apremilast. The other anti-IL-17 agents, ixekizumab and brodalumab, as well as the oral Jak inhibitor, tofacitinib, have very limited but promising data. This review paper provides a good overview of the agents that can be used for the concurrent management of skin and joint psoriasis.
MeSH terms
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / genetics
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Antibodies, Monoclonal / pharmacology
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Antibodies, Monoclonal / therapeutic use
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Antirheumatic Agents / adverse effects
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Antirheumatic Agents / pharmacology
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Antirheumatic Agents / therapeutic use
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Arthritis, Psoriatic / drug therapy
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Arthritis, Psoriatic / etiology
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Arthritis, Psoriatic / immunology
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Arthritis, Psoriatic / prevention & control*
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Biological Products / adverse effects
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Biological Products / pharmacology
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Biological Products / therapeutic use*
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Dermatologic Agents / adverse effects
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Dermatologic Agents / pharmacology
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Dermatologic Agents / therapeutic use
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Humans
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / pharmacology
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Immunosuppressive Agents / therapeutic use*
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Interleukin-12 Subunit p40 / antagonists & inhibitors
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Interleukin-12 Subunit p40 / metabolism
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Interleukin-17 / antagonists & inhibitors
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Interleukin-17 / metabolism
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Janus Kinases / antagonists & inhibitors
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Janus Kinases / metabolism
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Joints / drug effects*
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Joints / immunology
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Joints / metabolism
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Phosphodiesterase 4 Inhibitors / adverse effects
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Phosphodiesterase 4 Inhibitors / pharmacology
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Phosphodiesterase 4 Inhibitors / therapeutic use
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Protein Kinase Inhibitors / adverse effects
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Protein Kinase Inhibitors / pharmacology
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Protein Kinase Inhibitors / therapeutic use
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Psoriasis / drug therapy*
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Psoriasis / immunology
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Psoriasis / metabolism
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Psoriasis / physiopathology
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Recombinant Fusion Proteins / adverse effects
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Recombinant Fusion Proteins / pharmacology
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Recombinant Fusion Proteins / therapeutic use
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Skin / drug effects*
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Skin / immunology
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Skin / metabolism
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Tumor Necrosis Factor Inhibitors
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Tumor Necrosis Factors / metabolism
Substances
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Antibodies, Monoclonal
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Antirheumatic Agents
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Biological Products
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Dermatologic Agents
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IL12B protein, human
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Immunosuppressive Agents
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Interleukin-12 Subunit p40
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Interleukin-17
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Phosphodiesterase 4 Inhibitors
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Protein Kinase Inhibitors
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Recombinant Fusion Proteins
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Tumor Necrosis Factor Inhibitors
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Tumor Necrosis Factors
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Janus Kinases