Use of disease-modifying antirheumatic drugs in patients with psoriatic arthritis.
Few prospective placebo-controlled studies have evaluated disease-modifying antirheumatic drugs (DMARDs) in the treatment of peripheral psoriatic arthritis.


OBJECTIVE
To evaluate second-line treatments used in clinical practice in patients with psoriatic arthritis.


METHODS
We studied a cross-section of 100 consecutive patients seen by hospital-based or office-based rheumatologists for psoriatic arthritis.


METHODS
The 55 men and 45 women had a mean age of 48 years (range, 17-79 years) and a mean disease duration of 7 years (range, 1-24 years).


RESULTS
The most commonly used DMARDs were sulfasalazine, gold, methotrexate, and hydroxychloroquine (64, 43, 41 et 17 patients, respectively). These drugs had been stopped because of inefficacy in 31%, 31%, 12%, and 53% of patients, respectively, and because of adverse events in 23%, 44%, 22%, and 41% of patients, respectively. At the time of the study, mean treatment durations were 15, 21, 34, and 12 months, respectively, and the drugs were still being used in 45%, 21%, 66%, and 6% of patients.


CONCLUSIONS
Our data confirm the value of methotrexate and salazopyrine. Methotrexate had the best risk/benefit ratio. Gold was often responsible for side effects. Hydroxychloroquine was inadequately effective and poorly tolerated.
Marguerie
Laurent
L
Service de Rhumatologie, Institut Calot, Berck sur mer, France.
Flipo
René-Marc
RM
Grardel
Bruno
B
Beaurain
Didier
D
Duquesnoy
Bernard
B
Delcambre
Bernard
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D004338:Drug Combinations; D005260:Female; D005944:Glucosamine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D050607:Organogold Compounds; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D004338:Drug Combinations; D050607:Organogold Compounds; C028423:Salazopyrine; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D005944:Glucosamine; D008727:Methotrexate