New approved drugs for psoriatic arthritis

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory disease that possibly leads to structural damage and to a reduction of joint function and poor quality of life. Treatment of PsA has changed since its introduction of anti- TNF drugs, which have shown to reduce the symptoms and signs of the disease and slow the radiographic progression. However, recently, the discovery of new pathogenic mechanisms have made possible the development of new molecules that target pro-inflammatory cytokines involved in skin, joint and entheseal inflammation. New drugs like ustekinumab, secukinumab and apremilast inhibit interleukin axis and intracellular pathways and showed their efficacy and safety in randomized clinical trials. These drugs have been recently approved for the treatment of PsA and included in the new EULAR and GRAPPA treatment recommendations. The aim of this paper is to briefly review the clinical trials that led to their approval for PsA.

Effectiveness of Adalimumab for the Treatment of Psoriatic Arthritis: An Italian Real-Life Retrospective Study

“…TNFa is a pleiotropic cytokine which regulates several inflammatory reactions and immune functions through the control of cellular processes and plays a central role in the pathogenesis of PsA (Mantravadi et al, 2017). Anti-TNFa drugs have opened new therapeutic horizons in PsA, proving to be effective in the control of the signs/symptoms of inflammation, in improving the quality of life and the functional outcome, in inhibiting the progression of the structural damage in the peripheral joints and presenting a good safety profile (D'Angelo et al, 2012;Perrotta and Lubrano, 2016;D'Angelo et al, 2017). Treatment strategies of active, predominantly peripheral PsA recommended by International and National Guidelines suggest to use conventional diseasemodifying drugs anti-rheumatic (DMARDs), such as methotrexate (MTX).…”

“…Adalimumab has been shown to be effective and reasonably safe in reducing disease activity and controlling joint damage in patients with PsA, even in comorbid conditions (D'Angelo et al, 2012). However, despite its generally high efficacy, some patients with PsA may be refractory to adalimumab therapy, may lose response or develop drug intolerance over time (Perrotta and Lubrano, 2016;D'Angelo et al, 2017). The persistence in therapy in real-life clinical practice is increasingly recognised as a surrogate marker for the efficacy and safety of a drug (Saad et al, 2011).…”

Pharmacokinetics, Pharmacodynamics, Immunogenicity, Safety, and Tolerability of JNJ‐61178104, a Novel Tumor Necrosis Factor‐Alpha and Interleukin‐17A Bispecific Antibody, in Healthy Subjects

“…Monoclonal antibodies (mAbs) against a single target have been widely used for treatment of various autoimmune and inflammatory conditions including rheumatoid arthritis (RA), inflammatory bowel diseases, psoriatic arthritis, and psoriasis. [1][2][3][4][5][6][7][8][9] However, a significant number of patients with RA treated with singlecytokine inhibitors demonstrate a ceiling effect with inadequate clinical response to monotherapy, highlighting the need for alternative clinical strategies. 10,11 A new generation of biologic therapeutics is being developed on "alternative scaffolds" and mAb-like molecules with the potential to neutralize activities of more than one disease mediator.…”