Switching Between Biological Treatments in Psoriatic Arthritis: A Review of the Evidence

Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy. Therapy with anti-tumor necrosis factor (TNF)-α agents represents the first therapeutic choice for moderate and severe forms; however, PsA patients can experience anti-TNFα failure, lack of efficacy, or adverse events. Several evidence...

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Published in:Drugs in R&D 2017-12, Vol.17 (4), p.509-522
Main Authors: Costa, Luisa, Perricone, Carlo, Chimenti, Maria Sole, Del Puente, Antonio, Caso, Paolo, Peluso, Rosario, Bottiglieri, Paolo, Scarpa, Raffaele, Caso, Francesco
Format: Article
Language:English
Subjects:
Arthritis
Internal Medicine
Medicine
Medicine & Public Health
Monoclonal antibodies
Pharmacology/Toxicology
Pharmacotherapy
Psoriatic arthritis
Review
Review Article
Tumor necrosis factor-TNF
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creator Costa, Luisa
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Scarpa, Raffaele
Caso, Francesco
description Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy. Therapy with anti-tumor necrosis factor (TNF)-α agents represents the first therapeutic choice for moderate and severe forms; however, PsA patients can experience anti-TNFα failure, lack of efficacy, or adverse events. Several evidences exist on the effectiveness of switching among different TNFα inhibitors, and we reviewed the published data on the effectiveness of anti-TNFα first-, second- and third-line. Most of the studies report that the main reason for switching to a second anti-TNFα agent is represented by lack of efficacy (primary or secondary) and, more rarely, adverse events. Switchers receiving their second anti-TNFα agent have considerably poorer responses compared with non-switchers. Survival of anti-TNFα treatment appears to be superior in PsA patients when compared with rheumatoid arthritis patients. Switching from anti-TNF agents to ustekinumab or secukinumab or apremilast can represent a valid alternative therapeutic strategy.
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subjects Arthritis
Internal Medicine
Medicine
Medicine & Public Health
Monoclonal antibodies
Pharmacology/Toxicology
Pharmacotherapy
Psoriatic arthritis
Review
Review Article
Tumor necrosis factor-TNF
title Switching Between Biological Treatments in Psoriatic Arthritis: A Review of the Evidence
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