title: Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review.
abstract: In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations.
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Acosta Felquer
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Laura C
authors.initials: LC
authors.lastname: Coates
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Soriano
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Roberto
authors.initials: R
authors.lastname: Ranza
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Luis R
authors.initials: LR
authors.lastname: Espinoza
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Oliver
authors.initials: O
authors.lastname: FitzGerald
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Neil
authors.initials: N
authors.lastname: McHugh
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Euthalia
authors.initials: E
authors.lastname: Roussou
authors.affiliation: From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D001688:Biological Products / Q000627:therapeutic use; D015897:Comorbidity; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D001688:Biological Products
keywords: BIOLOGICS; DISEASE MODIFYING ANTIRHEUMATIC DRUGS; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; THERAPEUTIC STRATEGIES; TUMOR NECROSIS FACTOR INHIBITORS