PSORIATIC ARTHRITIS (2009)
Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis: a systematic review and economic evaluation
BackgroundPsoriatic arthritis is an inflammatory disease resulting in abnormality of joints. It is closely associated with psoriasis, which is a noncontagious inflammatory skin disease characterised by recurring reddish patches covered with silvery scales. Psoriatic arthritis is diagnosed when a patient has both psoriasis and typical inflammatory arthritis of the spine and/or other joints. It has been estimated that psoriatic arthritis occurs in 5-7% of those with psoriasis. The treatment for psoriatic arthritis is to improve arthritis, psoriasis or both. Managing severe active psoriatic arthritis is often difficult. The purpose of this project is to assess the benefits, adverse effects and cost-effectiveness of etanercept, infliximab and adalimumab for active and progressive psoriatic arthritis in patients who have an inadequate response to standard treatment. A further objective of this project is to evaluate whether these TNF-? inhibitor agents are cost-effective in these patients.
The data indicated that etanercept, infliximab and adalimumab were efficacious in the treatment of PsA compared with placebo, with beneficial effects on joint symptoms, functional status and skin. Short-term data suggested that these biologic agents can delay joint disease progression and evidence to support their use in the treatment of PsA is convincing. Future research would benefit from long-term observational studies with large sample sizes of patients with PsA to demonstrate that beneficial effects are maintained, along with further monitoring of the safety profiles of the biologic agents.Conducted by: CRD, the Centre for Health Economics, University of York and the University of Leicester