Pharmacy and Wellness Review


Psoriasis is an autoimmune disease characterized by painful skin lesions. When joints and connective tissue also become involved, the condition is referred to as psoriatic arthritis (PsA). Current treatments for moderate to severe PsA include therapies used to treat rheumatoid arthritis (RA) despite differences in disease presentation which includes factors such as peripheral disease, sacroiliitis, stiffness, presence of rheumatoid factor and psoriasis. Treatment out-comes for PsA are measured by the American College of Rheumatology (ACR) Responder Index (ACR20) and the Dis-ease Activity Score for 28 joints (DAS28). First-line treatment includes disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine or leflunomide in con-junction with symptomatic therapy including nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections. Oftentimes these treatments do not provide adequate management for PsA which has led to recent studies that have looked at using additional therapies in this patient population. Patients who do not experience relief from first-line options often require the use of a second DMARD added to their treatment regimen. Interleukin (IL)-12/23 inhibitors, IL-17A inhibitors, phosphodiesterase 4 (PDE4) inhibitors, janus kinase (JAK) inhibitors and tumor necrosis factor (TNF)-alpha inhibitors are discussed in this article and their benefits were examined in recent clinical trials.



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