(Department of Rheumatology andRehabilitation, Barking Havering andRedbridge University Hospitals NHSTrust, King George Hospital, Barley Lanes,London, UK)
Euthalia ROUSSOU
(Department of Rheumatology andRehabilitation, Barking Havering andRedbridge University Hospitals NHSTrust, King George Hospital, Barley Lanes,London, UK)
Yıl: 2017Cilt: 4Sayı: 1ISSN: 2147-9720 / 2148-4279Sayfa Aralığı: 1 - 10İngilizce

78 2
Real-life experience of using conventional diseasemodifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA
Objective: With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs).Material and Methods: A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment. The indices used were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), wellbeing (WB), and treatment effect (TxE). The indices measured at baseline were compared with those measured on one occasion in a FU visit at least 1 year later.Results: A total of 73 patients, 51 with PsA (mean age 49.8±12.8 years; male-to-female ratio [M:F]=18:33) and 22 with other SpAs (mean age 50.6±16 years; M:F=2:20), were studied. BASDAI, BASFI, and WB displayed consistent improvements during FU assessments in both PsA patients and controls in comparison to baseline values. SSZ exhibited better efficacy as confirmed by TxE in both PsA patients and controls. ESR and CRP displayed no differences in either the PsA or the SpA group between the cases before and after treatment.Conclusion: Real-life retrospective analysis of three DMARDs used in PsA (and SpAs other than PsA) demonstrated that all three DMARDs that were used brought about improvements in BASDAI, BASFI, TxE, and WB. However, the greatest improvements at FU were seen with SSZ use in both PsA and control cohorts
Fen > Tıp > Romatoloji
DergiAraştırma MakalesiErişime Açık
  • 1. Gossec L, Ramiro S, Cutolo M, Dougados M, De Wit M, Emery P, et al. SP0035 Eular recommendation update on the management of psoriatic arthritis. Ann Rheum Dis 2015; 74:9 [CrossRef]
  • 2. Ash Z, Gaujoux-Viala C, Gossec L, Hensor E.M, FitzGerald O, Winthrop K, et al. A systematic literature review of drug therapies for the treatment of psoriatic arthritis: current evidence and meta-analysis informing the EULAR recommendations for the management of psoriatic arthritis. Ann Rheum Dis 2012; 71: 319-26. [CrossRef]
  • 3. Kaltwasser JP, Nash P, Gladman D, Rosen CF, Behrens F, Jones P, et al. Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: a multinational, double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum 2004; 50: 1939-50. [CrossRef]
  • 4. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packam JC, McHugh NJ, et al. A randomized placebo controlled trial of methotrexate in psoriatic arthritis. Rheumatology 2012; 51: 1368-77. [CrossRef]
  • 5. Farr M, Kitas G, Waterhouse L., Jubb R, Felix-Davies D, Bacon PA. Sulphasalazine in PsA: A double blind placebo-controlled study. Br J Rheumatol 1990; 29: 46-9. [CrossRef]
  • 6. Fraser SM, Hopkins R, Hunter JA, Neumann V, Capell HA, Bird HA. Sulphasalazine in the management of psoriatic arthritis. Br J Rheumatol 1993; 32: 923-5. [CrossRef]
  • 7. Gupta AK, Grober JS, Hamilton TA, Ellis CN, Siegel MT, Voorhees JJ et Al. Sulphasalazine therapy for psoriatic arthritis: a double blind placebo-controlled trial. J Rheumatol 1995; 22: 894-8.
  • 8. Clegg DO, Reda DJ, Mejias E, Cannon GW, Welsman MH, Taylor T, et al. Comparison of sulphasalazine and placebo in the treatment of psoriatic arthritis. A Department of Veterans Affairs Cooperative Studt. Arthritis Rheum 1996; 39: 2013-20. [CrossRef]
  • 9. Combe B, Goupille P, Kuntz JL, Tebib J, Liote F, Bregeon C. Sulphasalazine in psoriatic arthritis: a randomized multicentre, placebo controlled study. Br J Rheumatol 1996; 35: 664-8. [CrossRef]
  • 10. Dougados M, van der Linden S, Leirisalo-Repo M, Huitfeldt B, Juhlin R, Zeidler H, et al. Sulphasalazine in the treatment of spondyloarthropathy. A randomized multicentre, double blind placebo-controlled study. Arthritis Rheum 1995; 38: 618-27. [CrossRef]
  • 11. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-73. [CrossRef]
  • 12. Rudvaleit M., van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of assessment of spondyloarthritis international society (ASAS) classification criteria for Axial Spondylo-arthritis (part II): validation and final selection. Ann Rheum Dis 2009; 68: 777-83. [CrossRef]
  • 13. Rudvaleit M, van der Heijde, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society (ASAS) classification criteria for peripheral spodyloarthritis and spondyloarthritis in general. Ann Rheum Dis 2011; 70: 25-31. [CrossRef]
  • 14. Calin A, Porta J, Fries JF, Schurman DJ. Clinical history as a screening test for ankylosing spondylitis. JAMA 1977; 237: 2613-4. [CrossRef]
  • 15. Rudwaleit, M, Metter A, Listing J, Sieper J, Braun J. Inflammatory back pain in ankylosing spondylitis: A reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 2006; 54: 569-78. [CrossRef]
  • 16. Sieper J, Van der Heijde D, Landewe R, Brandt J, Burgos-Vegas R, Collantes-Estevez E, et al. New criteria for inflammatory back pain in patients with chronic back pain: A real patient exercise by experts from the Assessment of Spondyloarthritis International Society. Ann Rheum Dis 2009; 68: 784-8. [CrossRef]
  • 17. Roussou E, Jurik AG. Difficulties for the detection of positive signs of sacroiliitis in spondyloarthritides by magnetic resonance imaging (MRI) in everyday clinical practice Clin Exp Rheumatol 2011; 29: 594-5.
  • 18. Roussou E, Chopra S, Ngandu DL. Phenotypic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis living in North East London. Clin Rheumatol 2013; 32: 591-9. [CrossRef]
  • 19. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994; 21: 2286-91.
  • 20. McKenna S, Doward L, Whalley D, Tennant A, Emery P, Veale D. Development of the psoriatic Arthritis quality of life: a quality of life instrument specific to psoriatic arthritis. Ann Rheum Dis 2004; 63: 162-9. [CrossRef]
  • 21. Doward L, Sporenberg A, Cook S, Whalley D, Helliwell P, Kay L, et al. Development of the ASQoL: a quality of life instrument specific for ankylosing spondylitis. Ann Rheum Dis 2003; 62: 20-6. [CrossRef]
  • 22. Blackmore M, Gladman DD, Husted J, Long J, Farewell VT. Measuring health status in psoriatic arthiritis: the HAQ and its modification. J Rheumatol 1995; 22: 886-93.
  • 23. Husted JA, Brian T, Farewell VT, Schentag CT, Gladman DD. Description and prediction of physical functional disability in psoriatic arthritis (PsA): a longitudinal analysis using a Markov model approach. Arthritis Rheum 2005; 53: 404-9. [CrossRef]
  • 24. Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: The development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994; 21: 2281-5.
  • 25. Coates LC, Moverley AR, McParland L, Brown S, Navarro-Coy N, O'Dwyer JL, et al. Effect of tight control of inflammation of early psoriatic arthritis (TICOPA): a UK multicentre open label randomised controlled trial. Lancet 2015; 386: 2489-98. [CrossRef]
  • 26. Visser K, van der Heijde D. Optimal dosage and route of administration of MTX in RA: a systematic review of the literature. Ann Rheum Dis 2009; 68: 1094-9. [CrossRef]
  • 27. Black RL, O'Brien WM, Vanscott EJ, Auerbach R, EisenAZ, Bunim JJ. Methotrexate therapy in psoriatic arthritis; double blind study on 21 patients. JAMA 1964; 189: 743-7. [CrossRef]
  • 28. Pipitone N, Kingsley GH, Manzo A, Scott DL, Pitzalls C. Current concepts and new developments in the treatment of psoriatic arthritis. Rheumatology (Oxford) 2003; 42: 1138-48. [CrossRef]
  • 29. Wilkens RF, Williams HJ, Ward JR, Egger MJ, Reading JC, Clements PJ, et al. Randomized double blind placebo controlled trial of low dose pulse methotrexate in psoriatic arthritis. Arthritis Rheum 1984; 27: 376-81. [CrossRef]
  • 30. Scarpa R, Peluso R, Atteno M, Manguso F, Spano A, Iervolino S, et al. The effectiveness of a traditional therapeutic approach in early psoriatic arhritis: results of a pilot randomised 6 month trial with methotrexate. Clin Rheumatol 2008; 27: 823-6. [CrossRef]
  • 31. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Long term methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. J Rheumatol 1995; 22: 241-5.
  • 32. Espinosa LR, Zakraoui L, Espinosa CG, Gutierrez F, Jara L.J, Silveira LH, et al. Psoriatic arthritis: Clinical response and side effects to methotrexate therapy. J Rheumatol 1992; 19; 872-7.
  • 33. Zachariae H, Zachariae E. Methotrexate in psoriatic arthritis. Acta Derm Venereol 1987; 67: 270-3.
  • 34. Kane D, Gogarty M, O'Leary J, Silva I, Bermingham N, Bresnihan B, et al. Reduction of synovial sublining layer inflammation and proinflammatory cytokine expression in psoriatic arthritis treated with methotrexate. Arthritis Rheum 2004; 50: 3286-95. [CrossRef]
  • 35. Kragballe K, Zachariae E, Zachariae H. Methotrexate in psoriatic arthritis: a retrospective study. Acta Derm Venereol 1983; 63: 165-7.
  • 36. Ranza R, Marchesoni A, Rosseti A, Tosi S, Gibelli E. Methotrexate in psoriatic polyarhtritis J Rheumatol 1993; 20: 1804-5.
  • 37. Ricci M, De Marco G, Desiati F, Mazzocchi L, Rotunno L, Battafarano N, et al. Long term survival of methotrexate in psoriatic arhritis. Reumatismo 2009; 61: 125-31.
  • 38. Chadran V, Schentag CT, Gladman DD. Reappraisal of the effectiveness of MTX in psoriatic arhtritis: results from a longitudinal observational cohort. J Rheumatol 2008; 35: 469-71.
  • 39. Whiting -O'Keefe QE, Fye KH, Sack KD. Methotrexate and histologic hepatic abnormalities: a meta analysis. Am J Med 1991; 90: 711-16. [CrossRef]
  • 40. Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, et al. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/ or leflunomide. Ann Rheum Dis 2010; 69: 43-7. [CrossRef]
  • 41. Rosenberg P, Urwitz H, Johannesson A, Ros AM, Lindholm J, Kinnman N, et al. Psoriasis patients with diabetes type 2 are at high risk of developing liver fibrosis during MTX treatment. J Hepatol 2007; 46: 1111-18. [CrossRef]
  • 42. Heydendael VMR, Spuls PI, Bossuyt PM et al. Analysis of risk factors in psoriatic patients with mtx induced increases in transaminase levels. Acta Dermatol. 2004; 140:1289-90.
  • 43. van Ede AE, Laan RFJM, Rood MJ, Huizinga T.W.J, Van De Laar M.A.F.J., Van Denderen CJ, et al. Effect of folic or folinic acid supplementation on the toxicity and efficacy if MTX in RA. Arthritis Rheum 2001; 44: 1515-24. [CrossRef]
  • 44. Soriano ER, NJ McHugh. Therapies for peripheral Joint disease in psoriatic arthritis. A systematic review. J Rheumatol 2006; 33: 1422-30.
  • 45. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of Cyclosprin A and MTX in the treatment of psoriatic arthritis: a one year prospective study. Clin Exp Rheumatol 1995; 13: 589-93.
  • 46. Liang GC, Barr WG. Open trial of leflunomide for refractory psoriasis and psoriatic arthritis. J Clin Rheumatol 2001; 7: 366-70. [CrossRef]
  • 47. Thami GP, Garg G. Leflunomide in psoriasis and psoriatic arthritis: a preliminary study. 2004; 140: 1288-9.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.