title: Comprehensive treatment of dactylitis in psoriatic arthritis.
abstract: Dactylitis, a hallmark clinical feature of psoriatic arthritis (PsA) and other spondyloarthropathies, may also be a severity marker for PsA and psoriasis. Traditionally, clinicians have used nonsteroidal antiinflammatory drugs and local corticosteroid injections to treat dactylitis, although conventional disease-modifying antirheumatic drugs are also used. We performed a systematic literature review to determine the most efficacious current treatment options for dactylitis in PsA. Effect sizes were greatest for the biologic agents ustekinumab, certolizumab, and infliximab, suggesting that therapy with one of these agents should be initiated in patients with dactylitis. However, the limited data highlight the need for randomized, placebo-controlled trials, with dactylitis as a primary outcome, to determine a valid, reliable, and responsive clinical outcome measure for PsA patients with dactylitis.
authors.affiliation: From the US National Institutes of Health, Bethesda, Maryland, USA; Rheumatology, Ministry of Health, San Fernando del Valle de Catamarca, Argentina; Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG, Bogotá, Colombia; University of Leeds, Leeds; and Bradford Hospitals NHS Foundation Trust, Bradford, UK.S. Rose, MD, PhD, Metzger Clinical Scholar, National Institutes of Health; S. Toloza, MD, Rheumatology, Ministry of Health; W. Bautista-Molano, MD, PhD(c), Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG; P.S. Helliwell, DM, PhD, FRCP, Senior Lecturer in Rheumatology, University of Leeds and Bradford Hospitals NHS Foundation Trust. Drs. Rose and Toloza contributed equally to this report.
authors.forename: Shawn
authors.initials: S
authors.lastname: Rose
authors.affiliation: From the US National Institutes of Health, Bethesda, Maryland, USA; Rheumatology, Ministry of Health, San Fernando del Valle de Catamarca, Argentina; Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG, Bogotá, Colombia; University of Leeds, Leeds; and Bradford Hospitals NHS Foundation Trust, Bradford, UK.S. Rose, MD, PhD, Metzger Clinical Scholar, National Institutes of Health; S. Toloza, MD, Rheumatology, Ministry of Health; W. Bautista-Molano, MD, PhD(c), Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG; P.S. Helliwell, DM, PhD, FRCP, Senior Lecturer in Rheumatology, University of Leeds and Bradford Hospitals NHS Foundation Trust. Drs. Rose and Toloza contributed equally to this report.
authors.forename: Sergio
authors.initials: S
authors.lastname: Toloza
authors.affiliation: From the US National Institutes of Health, Bethesda, Maryland, USA; Rheumatology, Ministry of Health, San Fernando del Valle de Catamarca, Argentina; Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG, Bogotá, Colombia; University of Leeds, Leeds; and Bradford Hospitals NHS Foundation Trust, Bradford, UK.S. Rose, MD, PhD, Metzger Clinical Scholar, National Institutes of Health; S. Toloza, MD, Rheumatology, Ministry of Health; W. Bautista-Molano, MD, PhD(c), Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG; P.S. Helliwell, DM, PhD, FRCP, Senior Lecturer in Rheumatology, University of Leeds and Bradford Hospitals NHS Foundation Trust. Drs. Rose and Toloza contributed equally to this report.
authors.forename: Wilson
authors.initials: W
authors.lastname: Bautista-Molano
authors.affiliation: From the US National Institutes of Health, Bethesda, Maryland, USA; Rheumatology, Ministry of Health, San Fernando del Valle de Catamarca, Argentina; Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG, Bogotá, Colombia; University of Leeds, Leeds; and Bradford Hospitals NHS Foundation Trust, Bradford, UK.S. Rose, MD, PhD, Metzger Clinical Scholar, National Institutes of Health; S. Toloza, MD, Rheumatology, Ministry of Health; W. Bautista-Molano, MD, PhD(c), Department of Rheumatology, Hospital Militar Central, Faculty of Medicine UMNG; P.S. Helliwell, DM, PhD, FRCP, Senior Lecturer in Rheumatology, University of Leeds and Bradford Hospitals NHS Foundation Trust. Drs. Rose and Toloza contributed equally to this report. p.helliwell@leeds.ac.uk.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D001685:Biological Factors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D005384:Finger Joint / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D001685:Biological Factors
keywords: DACTYLITIS; PSORIATIC ARTHRITIS; SYSTEMATIC REVIEW; TREATMENT