Jesús Maese1, Petra Díaz Del Campo2, Daniel Seoane-Mato2, Mercedes Guerra2, Juan D Cañete3. 1. Grupo de Trabajo Reumatología Basada en la Evidencia, Sociedad Española de Reumatología, Madrid, España. Electronic address: jmaese@telefonica.net. 2. Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. 3. Departamento de Reumatología, Hospital Clínic de Barcelona e IDIBAPS Barcelona, España.
Abstract
BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis. RESULTS: Title and abstract were used to retrieve 1,662 documents for this review (Medline, n=433; EMBASE n=1,132; Cochrane, n=97), and 48 studies were selected for detailed reading; finally, 8 studies were included. CONCLUSIONS: Since the studies included are not robust, and there are arguments to support the effectiveness of methotrexate, the evidence observed with the treatment of DMARDs in PsA is not conclusive.
BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis. RESULTS: Title and abstract were used to retrieve 1,662 documents for this review (Medline, n=433; EMBASE n=1,132; Cochrane, n=97), and 48 studies were selected for detailed reading; finally, 8 studies were included. CONCLUSIONS: Since the studies included are not robust, and there are arguments to support the effectiveness of methotrexate, the evidence observed with the treatment of DMARDs in PsA is not conclusive.
Authors: Pedro Santos-Moreno; Fernando Gómez-De la Rosa; Devian Parra-Padilla; Nelson J Alvis-Zakzuk; Nelson R Alvis-Zakzuk; María Carrasquilla-Sotomayor; Omaira Valencia; Nelson Alvis-Guzmán Journal: Psoriasis (Auckl) Date: 2021-03-18
Authors: Michelle L M Mulder; Johanna E Vriezekolk; Nathan den Broeder; Elien A M Mahler; Philip S Helliwell; Frank H J van den Hoogen; Alfons A den Broeder; Mark H Wenink Journal: Trials Date: 2020-02-10 Impact factor: 2.279