Etanercept and infliximab for the treatment of psoriatic arthritis: a systematic review

N F Woolacott, Z C S Khadjesari, I N Bruce, R P Riemsma

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE: To review the evidence on the clinical effectiveness of etanercept and infliximab for the treatment of active and progressive psoriatic arthritis (PsA) in patients with an inadequate response to standard treatment (including DMARD therapy). 

METHODS: A systematic review was conducted. The literature search covered a range of 13 medical databases and submissions were provided by the manufacturers of etanercept and infliximab. Randomised controlled trials (RCTs) of etanercept or infliximab that reported outcomes of disease activity in PsA were reviewed. 

RESULTS: There were two good quality double-blind, placebo-controlled RCTs each for etanercept and infliximab. The results demonstrated that after initial treatment (12 weeks for etanercept and 14 or 16 weeks for infliximab) both drugs had statistically significant beneficial effects compared with placebo on ACR 20, 50 and 70, PsARC and HAQ scores. Efficacy was not dependent upon concomitant methotrexate. Results at 24 weeks indicated that the response to treatment is maintained. Effects on psoriasis were beneficial, particularly with infliximab. Uncontrolled radiographic assessment data at one year indicated a beneficial effect of both etanercept and infliximab on the progression of joint disease. 

CONCLUSION: Our review indicates that both etanercept and infliximab are efficacious in the treatment of PsA with beneficial effects on both joint and psoriasis symptoms and on functional status. There are limited data indicating that etanercept and infliximab can delay joint disease progression. Further long-term data are required to confirm and consolidate the evidence base for both drugs.

Original languageEnglish
Pages (from-to)587-593
Number of pages7
JournalClinical and Experimental Rheumatology
Volume24
Issue number5
Publication statusPublished - Sep 2006

Keywords

  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Arthritis, Psoriatic
  • Etanercept
  • Health Status
  • Humans
  • Immunoglobulin G
  • Infliximab
  • Joints
  • Randomized Controlled Trials as Topic
  • Receptors, Tumor Necrosis Factor
  • Severity of Illness Index
  • Treatment Outcome
  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Review

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