title: Emerging drugs for psoriatic arthritis.
abstract: BACKGROUND
  The majority of Psoriatic Arthritis patients experience a good clinical response to anti-Tumor Necrosis Factor (TNF)-α therapies. However, treatment failure with anti-TNF-α can represent a relevant clinical problem.
  
  
  METHODS
  We review the efficacy and safety profile of biological therapies that have been reported from randomized, controlled trials in phase II and phase III available in Pubmed Database for agents targeting IL-12/23p40 antibody (ustekinumab) and IL-17 (secukinumab), inhibitor of phosphodiesterase 4, (apremilast), and of JAK/STAT pathways (tofacitinib) and CTLA4 co-stimulation (abatacept) in Psoriatic Arthritis.
  
  
  CONCLUSIONS
  In Psoriatic Arthritis, main emerging drugs are represented by the fully human monoclonal IL-12/23p40 antibody, ustekinumab, the agent targeting IL-17, secukinumab, and the inhibitor of phosphodiesterase 4, apremilast. Results on T cell co-stimulation inhibition by abatacept are insufficient both in psoriasis and in PsA. In vitro investigations on JAK/STAT pathways in PsA suggest that tofacitinib could represent a further valuable therapeutic option. Emerging biological treatments other than anti-TNF agents, ustekinumab, secukinumab and apremilast appear promising for Psoriatic Arthritis and recent studies have showed a good efficacy and an acceptable safety profile; however, further and long-term studies are advocated.
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.|b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Peluso
authors.affiliation: c Geriatric Unit, Faculty of Medicine and Psychology , "Sapienza" University of Rome, S. Andrea Hospital , Rome , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Caso
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Girolimetto
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.affiliation: a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.|b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
mesh_terms: D000818:Animals; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000503:physiopathology; D001691:Biological Therapy / Q000379:methods; D015195:Drug Design; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha
keywords: Abatacept; apremilast; ixekizumab; psoriatic arthritis; secukinumab; therapy; tofacitinib; ustekinumab