title: Ustekinumab : targeting the IL-17 pathway to improve outcomes in psoriatic arthritis.
abstract: BACKGROUND
  Psoriatic arthritis (PsA) is a clinically diverse inflammatory arthritis that can affect peripheral joints and the axial skeleton. About 25% of psoriasis patients develop PsA and many suffer from reduced function and quality of life. Anti-TNF agents have emerged as a pivotal treatment for many patients but the lack of alternative biologics for those who become unresponsive and or tolerate these medications remain a major unmet need. Recently, ustekinumab (UST) an agent that targets the 12 - 23/Th17 pathway was approved by the FDA for the treatment of active PsA.
  
  
  METHODS
  Herein, we provide a comprehensive overview of the pharmacology and clinical efficacy and safety of UST in the treatment of PsA. In addition, the position of UST in the treatment of PsA is discussed.
  
  
  CONCLUSIONS
  The lack of alternative therapies for patients who cannot tolerate or fail anti-TNF agents remains a major challenge for clinicians who treat PsA. UST, an agent that has proven efficacy in psoriasis, has recently been shown to also be effective for a number of the manifestations associated with PsA, including peripheral arthritis, dactylitis and enthesitis. This agent also inhibits radiographic progression. FDA approval of UST provides a much needed addition to the treatment options for the heterogeneous clinical features of PsA.
authors.affiliation: University of Rochester Medical Center, Division of Allergy/Immunology & Rheumatology , 601 Elmwood Ave, Box 695, Rochester, NY 14623 , USA joshua_weitz@urmc.rochester.edu.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Weitz
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Ritchlin
mesh_terms: D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D017277:Drug Approval; D006801:Humans; D020381:Interleukin-17 / Q000502:physiology*; D008727:Methotrexate / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy; D015398:Signal Transduction / Q000187:drug effects*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D000069549:Ustekinumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D020381:Interleukin-17; D014409:Tumor Necrosis Factor-alpha; D000069549:Ustekinumab; D008727:Methotrexate