Targeted synthetic pharmacotherapy for psoriatic arthritis: state of the art.

Targeted synthetic pharmacotherapy for psoriatic arthritis: state of the art. Expert Opin Pharmacother. 2020 Feb 14;:1-12 Authors: Caso F, Navarini L, Ruscitti P, Chimenti MS, Girolimetto N, Del Puente A, Giacomelli R, Scarpa R, Costa L Abstract Introduction: In recent years, different studies regarding psoriatic arthritis (PsA) have shown the pathogenetic role of dysfunction of signaling pathways involving the phosphodiesterase-4 enzyme and transcription factors or enzymes belonging to the kinase (JAK)-signal family pathway. These also represent the target of several drugs known as targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs).Areas covered: The authors performed a systematic literature search using the PubMed database, as well as through retrieving data from randomized controlled trials, their post-hoc analysis, and pooled data analysis on the efficacy and safety profile of the PDE4 inhibitor (PDE4i), apremilast, and the inhibitors of JAK (JAKis), tofacitinib, filgotinib, baricitinib, and upadacitinib, in PsA.Expert opinion: In PsA, the PDE4i, apremilast, and the JAKi, tofacitinib, are effective across multiple clinical domains and have an acceptable tolerability profile, thus expanding the treatment options available for PsA patients. Apremilast and tofacitinib show several advantages mainly represented by their oral administration, a fast onset of action, and a short half-life. Data on tsDMARDs in PsA are still limited,...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

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Authors: Chandran V Abstract Introduction: Biomarkers may help influence long-term outcomes of psoriatic disease by improving the objective assessment of the presence and severity of psoriatic arthritis (PsA) and by guiding treatment selection. However, there are no validated biomarkers for PsA.Areas covered: Beginning with a brief overview of the clinical features of PsA and concepts about biomarkers and risk prediction in medicine, this narrative review covers the recent developments in the field of PsA biomarker research including biomarkers for identifying patients with psoriasis who are at high risk for develo...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research
ConclusionsThe prevalence and impact of medical comorbidity on PROs are very high in patients with PsA.
Source: Rheumatology and Therapy - Category: Rheumatology Source Type: research
AbstractObjectivesTransforming growth factor beta (TGF β) inhibitor Bone Morphogenetic Protein and Activin Membrane‐Bound Inhibitor (BAMBI) has been shown to control CD4+ T lymphocytes differentiation into either tolerogenic regulatory T (Tregs) or pathogenic TH17 cells through the regulation of TGF β and IL‐2 signaling strength. In the present study, we explore the potential beneficial effects of its pharmacological inhibition with new anti‐BAMBI monoclonal antibodies (mAbs) in different skin and joint experimental chronic‐inflammatory/autoimmune diseases.MethodsDevelopment ofsaccharomyces cerevisiae man...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Authors: Girolimetto N, Macchioni P, Tinazzi I, Costa L, Peluso R, Tasso M, Bottiglieri P, Marchetta A, Possemato N, Salvarani C, McGonagle D, Scarpa R, Caso F Abstract OBJECTIVES: The aim of this study was to explore the link between specific sonographic findings and Leeds Dactylitis Index basic (LDI-b) score in psoriatic arthritis (PsA) patients with hand dactylitis. METHODS: Ninety-one hand dactylitis were evaluated in a multicentre study for the presence of pain, functional limitation and tenderness (2-point scale) and LDI-b score. Dactylitic fingers were investigated using high-frequency US in grey scale (...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
This study examined weight reduction as well as smoking as potential modifiable risk factors for PsA.The British Journal of Dermatology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Dermatology Journal Article Source Type: news
ABSTRACTObjectiveInterleukin ‐17A (IL‐17A) and TNFα contribute to the pathogenesis of psoriatic arthritis (PsA). However, their functional relationship in PsA synovitis has not been fully elucidated. In addition, although CD8+ T‐cells in PsA have been recognized as a source of IL‐17A using flow cytometry, it is not cle ar whether CD8+ T‐cells secrete IL‐17A under more physiological conditions. Clarifying these issues are the objectives of this study.MethodsIL ‐17A+ T‐cells were identified in PsA synovial fluid (SF, n=20), treatment‐naïve PsA blood and healthy blood (n=22 each) by flow cytometry...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Psoriasis (Pso), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are inflammatory diseases. PsA and RA are characterized by bone and muscle loss. In RA, bone loss has been extensively characterized, bu...
Source: BMC Musculoskeletal Disorders - Category: Orthopaedics Authors: Tags: Research article Source Type: research
AbstractBackgroundPsoriatic arthritis (PsA) patients are often affected by numerous comorbidities. However, contrasting results have been reported with regard to the respiratory involvement in PsA patients. The aim of this study was to evaluate the presence of subclinical airway inflammation in non-smoking PsA patients compared to patients with only psoriasis using the fraction of exhaled nitric oxide (FeNO) as an indirect marker of airway inflammation.MethodsThe study included 164 non-smoking psoriatic patients (Psoriasis Area of Severity Index or PASI score>  10): 82 with and 82 without PsA, who underwent FeNO ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
In this study, we examined whether raised CRP over the disease course is associated with worse outcome measures in a well-characterised PsA cohort with a long-term follow up.MethodsA cohort of 283 PsA patients (fulfilling CASPAR criteria) was evaluated. All underwent detailed skin and rheumatologic assessments. Moreover, we documented the presence/absence of comorbidities using Charlson Comorbidity Index (CCI). CRP at first visit to a rheumatologist was documented. Cumulative inflammation over time was represented by the cumulative averages of CRP (ca-CRP). Multiple linear regression modelling CRP was used.ResultsTwo hundr...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Abstract Psoriatic arthritis (PsA) is a heterogeneous disease that affects multiple organ systems including the peripheral and axial joints, entheses and nails. PsA is associated with significant comorbidities including cardiovascular, metabolic, and psychiatric diseases. The pathogenesis of PsA is complex and involves genetic, immunologic and environmental factors. Recent evidence suggests that the heritability for PsA to be stronger and distinct from that of PsC. Prominent genes identified via GWAS for PsA include HLA-B/C, HLAB, IL12B, IL23R, TNP1, TRAF3IP3, and REL. We review the genetics of psoriatic arthritis...
Source: Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Clin Immunol Source Type: research
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