s28_ab15

Disease-modifying antirheumatic drug therapy for psoriatic arthritis

C. Salvarani¹, F. Cantini², I. Olivieri³

¹Rheumatic Disease Unit, Arcispedale Santa Maria Nuova, Reggio Emilia; ²Rheumatic Disease Unit, 2nd Division of Medicine, Ospedale di Prato, Prato; and ³Rheumatology Department of Lucania, Ospedale S Carlo, Potenza, Italy.

ABSTRACT
As erosive and deforming arthritis is present in 40% of patients with psoriatic arthritis (PsA), early and aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) may be as effective in controlling the progression of the disease as it is for rheumatoid arthritis (RA).
Methotrexate (MTX), sulfasalazine (SSZ), and cyclosporine (CsA) are the most widely used DMARDs in the treatment of PsA and are safe and effective in patients with active peripheral arthritis, although they do not appear to be effective on axial manifestations. No controlled study has evaluated the efficacy of these drugs on the progression of radiological damage.
It has recently been demonstrated that leflunomide and anti-tumor necrosis factor (TNF) agents are effective in PsA and psoriasis. The symptomatic improvement has been important and sustained and side effects minimal. In particular, inhibitors of TNF appear to have excellent potential to treat PsA. These agents are able to slow joint damage in rheumatoid arthritis and they are effective on spinal symptoms in ankylosing spondylitis. Hopefully, these findings will prove true in PsA as well

Key words
Psoriatic arthritis, disease-modifying antirheumatic drugs, biological agents, leflunomide.

Please address correspondence to: Dr. Carlo Salvarani, Servizio di Reumatologia, Arcispedale S.Maria Nuova, Viale Umberto I no. 50, 42100 Reggio Emilia, Italy.
E-mail: salvarani.carlo@asmn.re.it