title: Anti-TNFα-therapy as an evidence-based treatment option for different clinical manifestations of psoriatic arthritis.
abstract: The development programmes of different TNF-blocking agents in psoriatic arthritis (PsA) not only provided substantial evidence for the therapeutic benefits of the specific treatment options, but also enabled new insights into the differential treatment effects on distinct disease manifestations. For the first time, specific robust evidence for distinctive effects on different manifestations of PsA, as a distinct entity separate from rheumatoid arthritis (RA), has been generated in a standardized way. The clearest evidence was shown for an effect on peripheral arthritis (polyarticular) with ACR20 response rates from 45 up to 58% (vs. 9-24% for placebo), and an inhibition of radiographic progression demonstrated for the first time for a treatment principle in PsA. However, as PsA does not remain confined to the peripheral joints, it was necessary to address diverse patterns of PsA-subtypes in the outcome measurements of the anti-TNF trials. Accordingly, the results of the clinical studies on anti-TNF treatment also have demonstrated efficacy on enthesitis, dactylitis and skin psoriasis, either in sub analysis of results from phase III RCTs, or in additional prospective studies.
authors.affiliation: Rheumatology Department, Goethe-University Frankfurt am Main; and Fraunhofer IME, Projectgroup Translational Medicine and Pharmacology TMP at Goethe-University Frankfurt am Main, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Köhm
authors.affiliation: Rheumatology Department, Goethe-University Frankfurt am Main; and Fraunhofer IME, Projectgroup Translational Medicine and Pharmacology TMP at Goethe-University Frankfurt am Main, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Burkhardt
authors.affiliation: Rheumatology Department, Goethe-University Frankfurt am Main; and Fraunhofer IME, Projectgroup Translational Medicine and Pharmacology TMP at Goethe-University Frankfurt am Main, Germany. frank.behrens@ime.fraunhofer.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Behrens
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D058990:Molecular Targeted Therapy; D012074:Remission Induction; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha