Download PDF
Arthritis und Rheuma 2017; 37(02): 112-119
DOI: 10.1055/s-0037-1618412
Neues zur rheumatologischen Pharmakotherapie – biologische DMARDs
Schattauer GmbH

Psoriasis-Arthritis

Aktuelle Therapieoptionen mit biologischen DMARDsPsoriatic arthritisUp-to-date status in focus on treatment with biologic DMARDs
M. Köhm
1   Abteilung Rheumatologie, Universitätsklinikum Frankfurt, Frankfurt
2   Projektgruppe Translationale Medizin und Pharmakologie Fraunhofer IME, Universitätsklinikum Frankfurt, Frankfurt
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2017 (online)

  PDF Download  Permissions and Reprints

Zusammenfassung

Die Psoriasis-Arthritis ist eine heterogene Erkrankung, die neben der Haut und den Gelenken auch eine Beteiligung der Enthesen und extraartikulärer Strukturen aufweisen kann. Die Auswahl der geeigneten therapeutischen Strategie richtet sich nach der dominanten Manifestationsform und ist interindividuell zu entscheiden. Biologika-Therapeutika, sogenannte bDMARDs, richten sich gezielt gegen Zytokine, die im Aktivitätsstadium der Psoriasis-Arthritis überexprimiert werden. Verschiedene bDMARDs liegen zur Therapie der Psoriasis-Arthritis vor. Vor allem TNF-α-Inhibitoren, aber auch IL-17- oder IL-12/23-blockierende Substanzen werden zur Therapie der Psoriasis-Arthritis eingesetzt und zeigen eine gute Effektivität in der Reduktion der Krankheitssymptome, ver -glichen zu den Standard-Basistherapeutika. Der Einsatz der bDMARDs ist in den Therapieempfehlungen der GRAPPA-Gruppe und der EULAR für den Kliniker festgelegt. Neue Substanzen, die vor allem in die IL-17/23-Achse der Entzündung der Psoriasis-Arthritis eingreifen, sind aktuell noch im Entwicklungs-stadium und werden voraussichtlich in den nächsten Jahren auf dem Markt zur Behand-lung der Psoriasis und der Psoriasis-Arthritis verfügbar sein.

Summary

Psoriatic arthritis is a heterogeneous immune-mediated disease, that usually involves skin and joints within the disease course but can also affect entheses and extra articular structures. The choice of therapy must be directed by diagnosis of dominant manifestation of the disease and should be performed on inter individual base. Biologic therapeutics (bDMARDs) are substances that targeted inhibit cytokines that are over expressed in the active disease stadium. Different bDMARDs are licensed for the treatment of psoriatic arthritis. Especially TNFα inhibitors, but also inhibitors for IL17 or IL12/23 are often used in the therapy of psoriatic arthritis and show significant efficacy in the reduction of signs and symptoms of the disease compared to standard DMARDs. Recommendations for use of bDMARDs are available from the GRAPPA group as well as from EULAR. New substances that influence especially IL17/IL23 axis in the active disease stadium are actual in development and will be available for treatment of psoriatic arthritis within the next years.

Schlüsselwörter

Psoriasis-Arthritis - TNF-α - IL-17/23-Achse - GRAPPA-Therapieleitlinie

Keywords

Psoriatic arthritis - TNFα - IL17/IL23 axis - GRAPPA recommendations
 

  • Literatur

  • 1 Gladman DD. Recent advances in understanding and managing psoriatic arthritis. F1000Research 2016; 5: 2670
    CrossrefPubMedGoogle Scholar
  • 2 Mease PJ. Biologic Therapy for Psoriatic Arthritis. Rheumatic diseases clinics of North America 2015; 41 (04) 723-738.
    CrossrefPubMedGoogle Scholar
  • 3 Bradley JR. TNF-mediated inflammatory disease. The Journal of pathology 2008; 214 (02) 149-160.
    CrossrefPubMedGoogle Scholar
  • 4 Perez C, Albert I, DeFay K. et al. A nonsecretable cell surface mutant of tumor necrosis factor (TNF) kills by cell-to-cell contact. Cell 1990; 63 (02) 251-258.
    CrossrefPubMedGoogle Scholar
  • 5 Partsch G, Steiner G, Leeb BF. et al. Highly increased levels of tumor necrosis factor-alpha and other proinflammatory cytokines in psoriatic arthritis synovial fluid. J Rheumatol 1997; 24 (03) 518-523.
    Google Scholar
  • 6 Husby G, Williams Jr RC. Synovial localization of tumor necrosis factor in patients with rheumatoid arthritis. Journal of autoimmunity 1988; 1 (04) 363-371.
    CrossrefPubMedGoogle Scholar
  • 7 Mease PJ, Gladman DD, Ritchlin CT. et al. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis and rheumatism 2005; 52 (10) 3279-3289.
    CrossrefPubMedGoogle Scholar
  • 8 Yoo DH, Hrycaj P, Miranda P. et al. A randomised, double-blind, parallel-group study to demonstrate equivalence in efficacy and safety of CT-P13 compared with innovator infliximab when coadministered with methotrexate in patients with active rheumatoid arthritis: the PLANETRA study. Annals of the rheumatic diseases 2013; 72 (10) 1613-1620.
    CrossrefPubMedGoogle Scholar
  • 9 Behrens F, Canete JD, Olivieri I. et al. Tumour necrosis factor inhibitor monotherapy vs combination with MTX in the treatment of PsA: a systematic review of the literature. Rheumatology (Oxford, England) 2015; 54 (05) 915-926.
    CrossrefPubMedGoogle Scholar
  • 10 Antoni C, Krueger GG, de Vlam K. et al. Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial. Annals of the rheumatic diseases 2005; 64 (08) 1150-1157.
    CrossrefPubMedGoogle Scholar
  • 11 Sterry W, Ortonne JP, Kirkham B. et al. Comparison of two etanercept regimens for treatment of psoriasis and psoriatic arthritis: PRESTA randomised double blind multicentre trial. BMJ (Clinical research ed) 2010; 340: c147
    CrossrefPubMedGoogle Scholar
  • 12 Kavanaugh A, McInnes I, Mease P. et al. Golimumab, a new human tumor necrosis factor alpha antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: Twenty-four-week efficacy and safety results of a randomized, placebo-controlled study. Arthritis and rheumatism 2009; 60 (04) 976-986.
    CrossrefPubMedGoogle Scholar
  • 13 Mease PJ, Fleischmann R, Deodhar AA. et al. Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a Phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Annals of the rheumatic diseases 2014; 73 (01) 48-55.
    CrossrefPubMedGoogle Scholar
  • 14 Thorlund K, Druyts E, Avina-Zubieta JA, Mills EJ. Anti-tumor necrosis factor (TNF) drugs for the treatment of psoriatic arthritis: an indirect comparison meta-analysis. Biologics - targets & therapy 2012; 6: 417-427.
    Google Scholar
  • 15 Coates LC, Kavanaugh A, Ritchlin CT, Committee GTG. Systematic review of treatments for psoriatic arthritis: 2014 update for the GRAPPA. J Rheumatol 2014; 41 (11) 2273-2276.
    CrossrefPubMedGoogle Scholar
  • 16 Kay J, Fleischmann R, Keystone E. et al. Golimumab 3-year safety update: an analysis of pooled data from the long-term extensions of randomised, double-blind, placebo-controlled trials conducted in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis. Annals of the rheumatic diseases 2015; 74 (03) 538-546.
    CrossrefPubMedGoogle Scholar
  • 17 Suzuki E, Mellins ED, Gershwin ME. et al. The IL-23/IL-17 axis in psoriatic arthritis. Autoimmunity reviews 2014; (13-4) 5: 496-502.
    Google Scholar
  • 18 Leonardi CL, Kimball AB, Papp KA. et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet (London, England) 2008; 371 9625 1665-1674.
    CrossrefPubMedGoogle Scholar
  • 19 Papp KA, Langley RG, Lebwohl M. et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet (London, England) 2008; 371 9625 1675-1684.
    CrossrefPubMedGoogle Scholar
  • 20 McInnes IB, Kavanaugh A, Gottlieb AB. et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double-blind, placebo-controlled PSUMMIT 1 trial. Lancet (London, England) 2013; 382 9894 780-789.
    CrossrefPubMedGoogle Scholar
  • 21 Ritchlin C, Rahman P, Kavanaugh A. et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial. Annals of the rheumatic diseases 2014; 73 (06) 990-999.
    CrossrefPubMedGoogle Scholar
  • 22 Hueber W, Patel DD, Dryja T. et al. Effects of AIN457, a fully human antibody to interleukin-17A, on psoriasis, rheumatoid arthritis, and uveitis. Sci Transl Med 2010; 2 (52) 52ra72
    PubMedGoogle Scholar
  • 23 Langley RG, Elewski BE, Lebwohl M. et al. Secukinumab in plaque psoriasis - results of two phase 3 trials. The New England journal of medicine 2014; 371 (04) 326-338.
    CrossrefPubMedGoogle Scholar
  • 24 Mease PJ, McInnes IB, Kirkham B. et al. Secukinumab Inhibition of Interleukin-17A in Patients with Psoriatic Arthritis. The New England journal of medicine 2015; 373 (14) 1329-1339.
    CrossrefPubMedGoogle Scholar
  • 25 van der Heijde D, Landewe RB, Mease PJ. et al. Brief Report: Secukinumab Provides Significant and Sustained Inhibition of Joint Structural Damage in a Phase III Study of Active Psoriatic Arthritis. Arthritis & rheumatology (Hoboken, NJ) 2016; 68 (08) 1914-1921.
    CrossrefPubMedGoogle Scholar
  • 26 McInnes IB, Mease PJ, Kirkham B. et al. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet (London, England) 2015; 386 9999 1137-1146.
    CrossrefPubMedGoogle Scholar
  • 27 Krueger JG, Fretzin S, Suarez-Farinas M. et al. IL-17A is essential for cell activation and inflammatory gene circuits in subjects with psoriasis. The Journal of allergy and clinical immunology 2012; 130 (01) 145-154e9.
    CrossrefPubMedGoogle Scholar
  • 28 Griffiths CE, Reich K, Lebwohl M. et al. Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet (London, England) 2015; 386 9993 541-551.
    CrossrefPubMedGoogle Scholar
  • 29 Mease PJ. Inhibition of interleukin-17, interleukin-23 and the TH17 cell pathway in the treatment of psoriatic arthritis and psoriasis. Curr Opin Rheumatol 2015; 27 (02) 127-133.
    CrossrefPubMedGoogle Scholar
  • 30 Martin DA, Churchill M, Flores-Suarez L. et al. A phase Ib multiple ascending dose study evaluating safety, pharmacokinetics, and early clinical response of brodalumab, a human anti-IL-17R antibody, in methotrexate-resistant rheumatoid arthritis. Arthritis Res Ther 2013; 15 (05) R164
    CrossrefPubMedGoogle Scholar
  • 31 Mease PJ, Genovese MC, Greenwald MW. et al. Brodalumab, an anti-IL17RA monoclonal antibody, in psoriatic arthritis. The New England journal of medicine 2014; 370 (24) 2295-2306.
    CrossrefPubMedGoogle Scholar
  • 32 Papp K, Leonardi C, Menter A. et al. Safety and efficacy of brodalumab for psoriasis after 120 weeks of treatment. Journal of the American Academy of Dermatology 2014; 71 (06) 1183-1190e3.
    CrossrefPubMedGoogle Scholar
  • 33 Papp K, Menter A, Strober B. et al. Efficacy and safety of brodalumab in subpopulations of patients with difficult-to-treat moderate-to-severe plaque psoriasis. Journal of the American Academy of Dermatology 2015; 72 (03) 436-439e1.
    CrossrefPubMedGoogle Scholar
  • 34 Mumtaz A, FitzGerald O. Application of the GRAPPA psoriatic arthritis treatment recommendations in clinical practice. Curr Rheumatol Rep 2010; 12 (04) 264-271.
    CrossrefPubMedGoogle Scholar
  • 35 Coates LC, Murphy R, Helliwell PS. New GRAPPA recommendations for the management of psoriasis and psoriatic arthritis: process, challenges and implementation. Br J Dermatol 2016; 174 (06) 1174-1178.
    CrossrefPubMedGoogle Scholar
  • 36 Gossec L, Smolen JS, Ramiro S. et al. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Annals of the rheumatic diseases 2016; 75 (03) 499-510.
    CrossrefPubMedGoogle Scholar
  • 37 Kohm M, Burkhardt H, Behrens F. Anti-TNFalpha-therapy as an evidence-based treatment option for different clinical manifestations of psoriatic arthritis. Clin Exp Rheumatol 2015; 33 (5 Suppl 93) S109-S114.
    PubMedGoogle Scholar