Updated therapies for the management of Psoriatic Arthritis

Clin Immunol. 2020 Nov:220:108536. doi: 10.1016/j.clim.2020.108536. Epub 2020 Jul 16.

Abstract

Psoriatic arthritis (PsA) is a large volume of our clinical practice and its management can be challenging. Traditional DMARDs have been used over last six decades and observational studies have substantiated an effective use of many of these drugs. However, in last two decades use of anti-TNF agents has brought a new dimension in treatment of PsA and in many other autoimmune diseases. Regulatory role of the Th17 cells and its cytokines in the pathogenesis of PsA has successfully paved the foundations of anti-IL antibody based therapies in PsA. Newer therapies targeting the IL-23/IL-17 cytokines and its signaling proteins are now in development and bringing new promises for management of PsA. Herein, we provide an overview of the landscape of drug therapies, including IL-17, IL-12/23, IL-23 inhibitors, and janus kinase (JAK) inhibitors, as well as those in development, such as RORγt inhibitors, anti-NGF agents, mTOR inhibitors and T cell ion-channel blockers.

Keywords: IL-12/23; IL-17; IL-23; Psoriasis; Psoriatic arthritis; TNF inhibitor.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Psoriatic / drug therapy*
  • Arthritis, Psoriatic / epidemiology
  • Biological Products / therapeutic use
  • Comorbidity
  • Glucocorticoids / therapeutic use
  • Humans
  • Janus Kinase Inhibitors / therapeutic use
  • Phosphodiesterase 4 Inhibitors / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Biological Products
  • Glucocorticoids
  • Janus Kinase Inhibitors
  • Phosphodiesterase 4 Inhibitors