Targeted therapies: what they teach us about the pathogenesis of psoriasis and psoriatic arthritis.
Biologic therapy has revolutionized treatment pathways in psoriatic joint and skin disease. It has also provided a useful tool with which pathological pathways of this condition may be explored. Areas covered: This review presents data on the clinical and biological effects of targeted therapy in psoriatic arthritis and psoriasis. Therapeutic agents covered include inhibitors of TNFα, inhibitors of the IL-23/IL-17 axis and inhibitors of intracellular small molecules involved in the transduction of the inflammatory signal. Trial data on clinical and imaging efficacy is reviewed in parallel with studies on biological effects at tissue level. Pathological insights gained from the use of these treatments are explored. Expert commentary: A close relationship exists between specific pathological types and clinical manifestations of psoriatic disease, including responses to treatment. Studying these relationships is likely to improve understanding of disease and enable rational selection of specific treatments for patients with specific pathotypes.
a Centre for Experimental Medicine and Rheumatology, John Vane Science Centre , William Harvey Research Institute, St. Bartholomew's and Royal London School of Medicine , London , United Kingdom.
Wang Sin Gina
WS
Tan
a Centre for Experimental Medicine and Rheumatology, John Vane Science Centre , William Harvey Research Institute, St. Bartholomew's and Royal London School of Medicine , London , United Kingdom.
Stephen
S
Kelly
a Centre for Experimental Medicine and Rheumatology, John Vane Science Centre , William Harvey Research Institute, St. Bartholomew's and Royal London School of Medicine , London , United Kingdom.
Costantino
C
Pitzalis
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D020381:Interleukin-17 / Q000037:antagonists & inhibitors*; D053759:Interleukin-23 / Q000037:antagonists & inhibitors*; D058990:Molecular Targeted Therapy; D011565:Psoriasis / Q000188:drug therapy*; D015398:Signal Transduction / Q000187:drug effects; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D000911:Antibodies, Monoclonal; D020381:Interleukin-17; D053759:Interleukin-23; D014409:Tumor Necrosis Factor-alpha
Pathogenesis; biologic therapy; interleukin-17; psoriasis; psoriatic arthritis; tumor necrosis factor-alpha