Literature on Psoriatic Arthritis

Anti-TNF{alpha} therapy in patients with impaired renal function.

Ann Rheum Dis. 2007 Mar 2;

Authors: Hueber AJ, Tunc A, Schett G, Manger B

Renal insufficiency is a frequent comorbidity in patients with inflammatory rheumatic diseases such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Decreased renal function is a limiting factor for the use of non-steroidal and anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). Therefore, therapeutic alternatives would be an improvement of our treatment options for these patients. For tumour necrosis factor alpha (TNFalpha) inhibitors no data about their use in patients with impaired renal function are available, because it has been an exclusion criterion in all major clinical trials.

PMID: 17337474 [PubMed - as supplied by publisher]

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Drug insight: Anti-tumor necrosis factor therapy for inflammatory arthropathies during reproduction, pregnancy and lactation.

Nat Clin Pract Rheumatol. 2007 Mar;3(3):156-64

Authors: Skomsvoll JF, Wallenius M, Koksvik HS, Rødevand E, Salvesen KA, Spigset O, Kvien TK

Tumor necrosis factor (TNF) antagonists are widely used to reduce disease activity and joint damage, and to improve health-related quality of life in patients suffering from rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis. To date, no increased risk of embryotoxicity or teratogenicity, or adverse pregnancy outcome (such as birth defects, premature birth, and low birth weight) has been reported in patients with inflammatory arthropathies treated with anti-TNF therapy, compared with the general population. However, the available data are limited, and methotrexate, which is commonly used in combination with anti-TNF drugs, is teratogenic. Until more data are available, no firm conclusions can be reached regarding the safety of anti-TNF therapy in pregnancy. Nevertheless, in selected cases where there is high disease activity, anti-TNF therapy might be recommended, depending on the results of individual risk-benefit analyses. Fully informed consent from the mother is needed in such cases. Anti-TNF agents are not usually used during lactation, although the risk of toxicity is probably negligible.

PMID: 17334338 [PubMed - indexed for MEDLINE]

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The Disease Activity Score in 28 joints in rheumatoid arthritis and psoriatic arthritis patients.

Arthritis Rheum. 2007 Mar 15;57(2):256-60

Authors: Leeb BF, Andel I, Sautner J, Fassl C, Nothnagl T, Rintelen B

OBJECTIVE: To assess the factorial structure of the Disease Activity Score including a 28-joint count (DAS28) if applied in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: DAS28 values from 85 consecutive PsA outpatients and 2 RA patient cohorts comprising 85 patients each were compared. The first RA cohort (RA1) consisted of age- and sex-matched patients seen during the same period as the patients with PsA. The first 85 RA outpatients from September 2003 were included in the second cohort (RA2). Item weighting, factor loading, and internal consistency were assessed by factor analysis, principal component analysis, and calculation of Cronbach’s alpha. RESULTS: The mean +/- SD DAS28 scores of patients in the PsA, RA1, and RA2 cohorts were 3.2 +/- 1.31, 3.21 +/- 1.45, and 3.79 +/- 1.44, respectively. A significant difference between the PsA and RA2 cohorts was found for DAS28 (P = 0.0063), swollen joint count (P = 0.007), and patient’s global assessment (P

PMID: 17330303 [PubMed - in process]

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Endothelial dysfunction in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors.

Arthritis Rheum. 2007 Mar 15;57(2):287-93

Authors: Gonzalez-Juanatey C, Llorca J, Miranda-Filloy JA, Amigo-Diaz E, Testa A, Garcia-Porrua C, Martin J, Gonzalez-Gay MA

OBJECTIVE: To determine whether endothelial dysfunction was present in a cohort of patients with psoriatic arthritis (PsA) without overt cardiovascular disease or classic cardiovascular risk factors attended to in a community hospital. METHODS: Fifty patients with PsA who fulfilled the Moll and Wright criteria were recruited from Hospital Xeral-Calde (Lugo, Spain). Patients seen during the period of recruitment who had classic cardiovascular risk factors or had experienced cardiovascular or cerebrovascular events were excluded. Fifty healthy matched controls were also studied. In all patients and controls, endothelial function was determined by measuring flow-mediated endothelial dependent vasodilatation (FMD%) and endothelial independent vasodilatation (GTN%) by brachial ultrasonography. RESULTS: FMD% was significantly impaired in patients compared with controls (mean, median [range] 6.3%, 6.1% [0.3-13.4%] versus 8.2%, 8.2% [0.0-21.2%]; P = 0.008). However, no significant difference existed between patients and controls in GTN% or baseline diameter. A significant correlation between C-reactive protein level and erythrocyte sedimentation rate at the time of disease diagnosis and FMD% was found (P

PMID: 17330278 [PubMed - in process]

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A longitudinal study of the effect of disease activity and clinical damage on physical function over the course of psoriatic arthritis: Does the effect change over time?

Arthritis Rheum. 2007 Mar;56(3):840-9

Authors: Husted JA, Tom BD, Farewell VT, Schentag CT, Gladman DD

OBJECTIVE: To investigate whether there are differential effects of disease activity and damage on physical functioning as measured by the Health Assessment Questionnaire (HAQ) over the course of psoriatic arthritis (PsA). METHODS: Between June 1993 and March 2005, 382 patients attending the University of Toronto PsA clinic had completed > or =2 HAQs on an annual basis. At the time of each HAQ assessment, clinical and laboratory measures of disease activity and damage were recorded. Generalized linear mixed-effects models were used to investigate the longitudinal relationship between disease activity, damage, and the HAQ score. To avoid floor effects that would arise in a single mixed-effects model, we adopted a 2-part model. RESULTS: The number of actively inflamed joints (measure of disease activity) and the number of clinically deformed joints (measure of damage) were positively and significantly related to the HAQ score. Furthermore, interaction terms for illness duration with the number of actively inflamed joints were statistically significant, with or without inclusion of the erythrocyte sedimentation rate and morning stiffness in the model (P = 0.029 and P

PMID: 17328058 [PubMed - in process]

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Effects of tumor necrosis factor blockade on cardiovascular risk factors in psoriatic arthritis: a double-blind, placebo-controlled study.

Arthritis Rheum. 2007 Mar;56(3):831-9

Authors: Sattar N, Crompton P, Cherry L, Kane D, Lowe G, McInnes IB

OBJECTIVE: To conduct a robust, double-blind, placebo-controlled study examining the effects of tumor necrosis factor (TNF) modulation on concentrations of traditional and novel cardiovascular disease risk factors in patients with an inflammatory condition. METHODS: In this double-blind study, 127 patients with psoriatic arthritis (PsA) and active psoriasis were randomized to 1 of 3 treatment arms (placebo, onercept 50 mg, or onercept 100 mg for 12 weeks). Traditional and novel biochemical risk factors were evaluated at baseline and at the end of the treatment period. RESULTS: At baseline, an elevated C-reactive protein (CRP) level correlated positively with lipoprotein(a) (Lp[a]), intercellular adhesion molecule 1, interleukin-6, and homocysteine levels but was inversely correlated with concentrations of all other lipid moieties and sex hormone binding globulin (SHBG). Onercept at a dose of 100 mg induced significant (P

PMID: 17328057 [PubMed - in process]

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Related ArticlesEtanercept in the treatment of rheumatoid arthritis.

Ther Clin Risk Manag. 2007 Mar;3(1):99-105

Authors: Haraoui B, Bykerk V

Etanercept (ETN) is the first anti-tumor necrosis factor (TNF) agent to be approved for the treatment of rheumatoid arthritis (RA). Over the last 8 years, several clinical trials have shown its efficacy and safety in established and early RA, as well as a monotherapy or in combination with methotrexate. ETN not only reduces the signs and symptoms of RA, but also retards the progression of radiographic damage and improves the quality of life and function of patients. Its safety profile has been predictable since the first clinical trials with no new major safety concerns. Beyond its efficacy in RA, ETN is also indicated for the treatment of psoriatic arthritis. This current report reviews the evidence and the data in RA and psoriatic arthritis (PsA).

PMID: 18360618 [PubMed - in process]

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Related ArticlesAdalimumab in the treatment of arthritis.

Ther Clin Risk Manag. 2007 Mar;3(1):133-48

Authors: Mease PJ

Tumor necrosis factor (TNF) has been implicated in a number of arthritic disease states, including rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Adalimumab is the first fully human, high-affinity, recombinant immunoglobulin G(1) (IgG(1)) anti-TNF monoclonal antibody. Adalimumab in combination with methotrexate or standard antirheumatic therapies, or as monotherapy, is effective in the treatment of adults with active rheumatoid arthritis who have had an inadequate response to disease-modifying antirheumatic drugs. Adalimumab is also effective in the treatment of patients with moderately to severely active psoriatic arthritis, improving both joint and skin manifestations of the disease as well as disability due to joint damage. In the Adalimumab Trial Evaluating Long-term Efficacy and Safety in Ankylosing Spondylitis (ATLAS), adalimumab significantly reduced the signs and symptoms of active ankylosing spondylitis and established a sustained clinical response in patients who had an inadequate response or intolerance to nonsteroidal antiinflammatory drug therapy. Overall, across these indications, adalimumab demonstrated a rapid onset of action, sustained efficacy with long-term treatment, and was well-tolerated, with few patients discontinuing treatment because of adverse events. The safety profile was similar to other TNF antagonists. Inhibition of TNF activity by adalimumab also significantly improved physical functioning and quality of life measures.

PMID: 18360621 [PubMed - in process]

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