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Interventions for psoriatic arthritis
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
|July 25, 2000
Summary
Parenteral high dose methotrexate and salazopyrin show proven efficacy for psoriatic arthritis. Other treatments may be effective, but require further trials due to limited data and significant placebo effects.
Area of Science:
- Rheumatology
- Clinical Pharmacology
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory condition.
- Effective therapeutic options for PsA are crucial for managing disease activity and improving patient outcomes.
Purpose of the Study:
- To systematically review the efficacy of various medications in treating psoriatic arthritis.
- To identify treatments with demonstrated effectiveness based on randomized controlled trials.
Main Methods:
- A comprehensive literature search was conducted in Medline and Excerpta Medica databases.
- Randomized trials comparing salazopyrin, auranofin, etretinate, fumaric acid, IMI gold, azathioprine, and methotrexate were included.
- Outcome measures included disease activity indices, joint counts, pain, disability, and radiographic changes.
Main Results:
- Thirteen trials involving 1022 subjects were quantitatively analyzed.
- Salazopyrin, azathioprine, and etretinate showed statistically significant improvements in a global disease activity index.
- Parenteral high-dose methotrexate and salazopyrin demonstrated the most robust published efficacy.
Conclusions:
- Parenteral high-dose methotrexate and salazopyrin are recommended for psoriatic arthritis based on current evidence.
- Azathioprine, etretinate, and low-dose methotrexate may be effective but require further investigation.
- The significant placebo response highlights the need for controlled trials in psoriatic arthritis management.