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Related Experiment Videos

Interventions for psoriatic arthritis.

G Jones1, M Crotty, P Brooks

  • 1Department of Rheumatology, Menzies Centre for Population Health Res, GPO Box 252C, Hobart, Tasmania, Australia, 7001. G.Jones@Menzies.utas.edu.au

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Salazopyrin and parenteral high-dose methotrexate show proven efficacy for psoriatic arthritis. Further trials are needed for other agents, and uncontrolled studies should be avoided.

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Area of Science:

  • Rheumatology
  • Clinical Pharmacology

Background:

  • Psoriatic arthritis is a chronic inflammatory condition affecting joints and skin.
  • Several disease-modifying antirheumatic drugs (DMARDs) are used to manage psoriatic arthritis.
  • Evidence for the efficacy of these treatments in psoriatic arthritis requires systematic evaluation.

Purpose of the Study:

  • To systematically review randomized controlled trials evaluating the efficacy of various agents in psoriatic arthritis.
  • To compare the effectiveness of salazopyrin, auranofin, etretinate, fumaric acid, IMI gold, azathioprine, and methotrexate.

Main Methods:

  • Comprehensive literature search of Medline and Excerpta Medica databases up to 1995.
  • Inclusion of all randomized trials assessing the specified agents in psoriatic arthritis.

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  • Outcome measures included OMERACT variables such as joint counts, pain, and global assessments; trials of 1 year or longer were prioritized.

    • Main Results:

    • Eleven randomized trials with 777 subjects were included in the quantitative analysis.
    • Salazopyrin, azathioprine, and etretinate demonstrated statistically significant improvement in a global disease activity index.
    • Significant improvement was observed in the placebo group, highlighting the need for controlled trials.

    Conclusions:

    • Parenteral high-dose methotrexate and salazopyrin are the most well-demonstrated effective treatments for psoriatic arthritis based on published data.
    • Azathioprine, etretinate, and oral low-dose methotrexate may be effective, but require further multicenter trials for confirmation.
    • The substantial placebo effect underscores the importance of using controlled trials to guide psoriatic arthritis management.