Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

Abstract

Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for psoriatic arthritis include nonsteroidal anti-inflammatory drugs followed by disease modifying antirheumatic drugs and/or tumor necrosis factor (TNF)-α inhibitors and interleukin-12/23p40 inhibitors. Treatment of both diseases is typically driven by disease severity. In the past decade, major advances in the understanding of the immunopathogenesis of psoriasis and psoriatic arthritis have led to the development of numerous biological therapies, which have revolutionized the treatment for moderate to severe plaque psoriasis and psoriatic arthritis. Anti-TNF-α agents are currently considered as first line biological therapies for the treatment of moderate to severe psoriasis and psoriatic arthritis. Currently approved anti-TNF-α agents include etanercept, adalimumab, and infliximab for psoriasis and psoriatic arthritis as well as golimumab and certolizumab for psoriatic arthritis. In this article, we aim to evaluate the long term safety and efficacy of etanercept in psoriasis and psoriatic arthritis.

Phagocytosed Clofazimine Biocrystals Can Modulate Innate Immune Signaling by Inhibiting TNFα and Boosting IL-1RA Secretion

“…These drugs are used to treat inflammatory bowel diseases, 48 rheumatoid arthritis, 49,50 and psoriasis. 51,52 Furthermore, recombinant human IL-1RA is also clinically used as a drug (anakinra/Kineret; Sobi, Sweden) to treat rheumatoid arthritis. It has also been shown to reduce airway inflammation 53 and is being considered for the treatment of inflammatory lung diseases, including acute respiratory distress syndrome, 54 acute lung injury, 55–57 allergic airway inflammation, 58 and bronchopulmonary dysplasia.…”

Inhibition of IL-17 and IL-23 in Human Keratinocytes by the A3 Adenosine Receptor Agonist Piclidenoson

“…Activation of NF- κ B and TNF- α induces IL-23 production [ 26 , 27 ], therefore suggesting that the inhibitory effect of piclidenoson on NF- κ B and TNF- α may result in deregulation of IL-23 and IL-17. Monoclonal antibodies against TNF- α , IL-17, and IL-23 were found to mediate a strong anti-inflammatory effect that has been already implemented for the treatment of psoriasis patients and proved to be highly efficacious [ 25 , 27 – 31 ].…”

Targeted therapy of psoriatic disease

“…Препарат хорошо переносится больными даже в течение длительного периода лечения. Из нежелательных последствий изредка отмечают местные реакции в виде гиперемии и инфильтрата, инфекционные осложнения, инфаркт миокарда, депрессию и базально-клеточную карциному [8,40].…”

“…Одним из наиболее тяжелых клинических проявлений является псориатический артрит (ПсА). Частота артрита у больных псориазом, по данным разных авторов, составляет от 13,5 до 47% [8]. ПсА представляет собой хронический прогрессирующий системный воспалительный процесс, ассоциированный с псориазом, который характеризуется преимущественной локализацией в тканях опорно-двигательного аппарата и приводит к развитию эрозивного артрита, внутрисуставного остеолиза и спондилоартрита [9].…”