Precision medicine in psoriatic arthritis: how should we select targeted therapies?

Al-Mossawi, Hussein; Taams, Leonie; Goodyear, Carl S.; Kirkham, Bruce; McInnes, Iain B.; Siebert, Stefan; Coates, Laura C.

doi:10.1016/s2665-9913(19)30008-6

Cited by 4 publications

(14 citation statements)

References 67 publications

(55 reference statements)

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“…Advances in genomics, proteomics and immunomics have allowed the development of methods to tailor medical treatments to the individual characteristics of each patient, commonly called precision medicine. 104 Precision medicine has shown promising potential in PsA. Miyagawa et al used eight-colour flow cytometry to stratify patients into Th-17 versus Th-1 patterns, for which secukinumab or anti-TNFs were offered according to the patterns.…”

Section: Current and Future Treatment Approachesmentioning

confidence: 99%

Choosing the right treatment for patients with psoriatic arthritis

Noviani

Feletar²,

Nash

et al. 2020

Therapeutic Advances in Musculoskeletal

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Psoriatic arthritis (PsA) is a chronic inflammatory condition with articular and extra-articular manifestations: peripheral arthritis, axial disease, enthesitis, dactylitis, psoriasis, inflammatory bowel disease and uveitis. Anti-tumour necrosis factors (anti-TNFs) have demonstrated clinical efficacies exceeding those of conventional disease-modifying antirheumatic drugs (DMARDs). New understanding in pathogenic pathways have led to novel therapeutic targets. The current treatment paradigms emphasize early diagnosis and treatment, and treating towards remission and low disease activity status, particularly in long-standing disease. This review addresses the evidence of current treatment options for each of the domains of PsA. We present a simple guide that weighs on clinical efficacies for each PsA domain to aid clinicians in choosing the most appropriate treatment for patients. We highlight the unmet need for biomarkers of treatment response, and future perspectives with precision medicine in PsA.

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Section: Current and Future Treatment Approachesmentioning

confidence: 99%

Choosing the right treatment for patients with psoriatic arthritis

Noviani

Feletar²,

Nash

et al. 2020

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

show abstract

“…Psoriatic arthritis (PsA) is a progressive inflammatory syndrome associated with psoriasis [1,2]. It encompasses highly variable manifestations (including inflammatory arthritis, spondylitis, enthesitis, dactylitis), occurring in up to 30% of people with psoriasis [1][2][3]. There has been a rapid expansion in therapeutic options available for PsA over recent years [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…It encompasses highly variable manifestations (including inflammatory arthritis, spondylitis, enthesitis, dactylitis), occurring in up to 30% of people with psoriasis [1][2][3]. There has been a rapid expansion in therapeutic options available for PsA over recent years [1,4]. However, different drugs with different modes of action, present new challenges when considering therapy selection for PsA and its wide-ranging clinical manifestations.…”

Section: Introductionmentioning

confidence: 99%

“…However, different drugs with different modes of action, present new challenges when considering therapy selection for PsA and its wide-ranging clinical manifestations. Evidence is lacking to guide individual therapeutic decisions and therefore how to best offer a personalized approach to PsA management [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Current practice generally follows a stepwise approach using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), followed by biologic diseasemodifying anti-rheumatic drugs (bDMARDs), if their response is inadequate [1,2]. However, newer guidelines (American College of Rheumatology (ACR) and National Psoriasis Foundation) recommend the use of bDMARDs as first-line treatment (tumor necrosis factor alpha inhibitors (TNFi)) [5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The road to personalised medicine in psoriatic arthritis

White

Coates

2021

Expert Review of Clinical Immunology

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From Science to Success? Targeting Tyrosine Kinase 2 in Spondyloarthritis and Related Chronic Inflammatory Diseases

et al. 2021

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Spondyloarthritis (SpA) is a family of inflammatory arthritic diseases, which includes the prototypes of psoriatic arthritis and ankylosing spondylitis. SpA is commonly associated with systemic inflammatory diseases, such as psoriasis and inflammatory bowel disease. Immunological studies, murine models and the genetics of SpA all indicate a pathogenic role for the IL-23/IL-17 axis. Therapeutics targeting the IL-23/IL-17 pathway are successful at providing symptomatic relief, but may not provide complete protection against progression of arthritis. Thus there is still tremendous interest in the discovery of novel therapeutic targets for SpA. Tyrosine kinase 2 (TYK2) is a member of the Janus kinases, which mediate intracellular signaling of cytokines via signal transducer and activator of transcription (STAT) activation. TYK2 plays a crucial role in mediating IL-23 receptor signaling and STAT3 activation. A plethora of natural mutations in and around TYK2 have provided a wealth of data to associate this kinase with autoimmune/autoinflammatory diseases in humans. Induced and natural mutations in murine Tyk2 largely support human data; however, key inter-species differences exist, which means extrapolation of data from murine models to humans needs to be done with caution. Despite these reservations, novel selective TYK2 inhibitors are now proving successful in advanced clinical trials of inflammatory diseases. In this review, we will discuss TYK2 from basic biology to therapeutic targeting, with an emphasis on studies in SpA. Seminal studies uncovering the basic science of TYK2 have provided sound foundations for targeting it in SpA and related inflammatory diseases. TYK2 inhibitors may well be the next blockbuster therapeutic for SpA.

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Precision medicine in psoriatic arthritis: how should we select targeted therapies?

Cited by 4 publications

References 67 publications

Choosing the right treatment for patients with psoriatic arthritis

Choosing the right treatment for patients with psoriatic arthritis

The road to personalised medicine in psoriatic arthritis

From Science to Success? Targeting Tyrosine Kinase 2 in Spondyloarthritis and Related Chronic Inflammatory Diseases

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