| Evidence |
This question has been partially addressed in the evidence base from the following systematic reviews and guidelines:
**Coates, 2012. Key recommendations from the guidelines with reference to the management algorithm for considering using anti-TNF drugs in patients with PsA for both peripheral and axial disease https://pubmed.ncbi.nlm.nih.gov/23887065/
Venegas-Iribarren, 2018. Ustekinumab leads to clinical improvement in psoriatic arthritis, and probably is not associated to severe adverse effects https://pubmed.ncbi.nlm.nih.gov/29522505/
Vaengeberg, 2020. Data on cancer in patients with psoriatic arthritis remain scarce, and further research is warranted in this area. https://pubmed.ncbi.nlm.nih.gov/32074260/
Torres, 2021. Evidence for psoriatic disease (including psoriasis and peripheral arthritis. Secukinumab and ixekizumab were the treatments with the highest probability of reaching both PASI100 and ACR70 outcomes. Due to the lack of a standard evaluation of outcomes of the other psoriatic disease domains, a network meta-analysis for all the domains was not possible to perform https://pubmed.ncbi.nlm.nih.gov/33521024/
Ruyssen-Witrand, 2020. Network meta-analysis confirms the efficacy and acceptable safety profile of bDMARDs in patients with active PsA. There were generally few statistically significant differences between most treatments https://pubmed.ncbi.nlm.nih.gov/32094304/
Reygaerts, 2018. Biological disease modifying antirheumatic drugs and apremilast had a small effect on fatigue at 24 weeks in psoriatic arthritis randomized controlled trials and a higher effect on pain. These results are important to take into account in shared decision-making https://pubmed.ncbi.nlm.nih.gov/29452303/
Qui, 2020. Direct and indirect comparisons and integrated results suggested that the 3 anti- tumor necrosis factor -α biologics (GOL, ETN, and IFX) can be considered the best treatments for PsA after comprehensive consideration of efficacy and safety https://pubmed.ncbi.nlm.nih.gov/32756163/
Holroyd, 2019. DMARD safety guidelines in inflammatory arthritis. Biologics covered by this guideline are as follows: anti-TNF inhibitors: infliximab (IFX); etanercept (ETN); adalimumab (ADA); certolizumab pegol; golimumab; anti-CD20: rituximab (RTX); CTLA4-Ig: abatacept (ABA); anti-IL-6 receptor: tocilizumab (TCZ); and anti-IL-12/IL-23: ustekinumab. Recommendation: The decision to initiate a biologic should be made in conjunction with the patient/carer and initiated by an expert in the management of rheumatic disease. Patients should be assessed for co-morbidities as these may influence biologic choice, including evaluation for respiratory disease and screening for infection https://pubmed.ncbi.nlm.nih.gov/30137623/
Iragorri, 2018. Treatment with infliximab, golimumab, certolizumab pegol, ustekinumab, and apremilast resulted in improvements in self-reported work productivity. A pooled analysis was not possible because of the clinical heterogeneity of the trials and variability in outcome reporting https://pubmed.ncbi.nlm.nih.gov/29717037/
Huang, 2019. Both dosages of tofacitinib (5mg and 10mg) were safe to use. Even if similar adverse drug events were observed with 5 mg versus 10 mg tofacitinib twice daily for the treatment of autoimmune disorders, anemia was more prominent with 10 mg tofacitinib at a 3 month follow-up. Further research needed https://pubmed.ncbi.nlm.nih.gov/30242639/
Bilal, 2018. Our meta-analysis shows that the inhibitors of IL-6 (clazakizumab), IL-12/23 (ustekinumab), and IL-17A (secukinumab, brodalumab, ixekizumab) are efficacious and generally well tolerated when used to treat patients with PsA https://pubmed.ncbi.nlm.nih.gov/28926467/
Finelli, 2021. Systematic review of studies reporting semen analysis, evaluation of seminal oxidative stress, and/or sperm DNA fragmentation in patients affected by psoriasis and psoriatic arthritis, celiac disease, inflammatory bowel diseases, systemic lupus erythematosus, ankylosing spondylitis, hidradenitis suppurativa, uveitis, dermatomyositis, and rheumatoid arthritis. Evidence suggested that various autoimmune diseases or relevant medications can adversely affect male fertility parameters and that patients may benefit of counseling and sperm cryopreservation. Clinical trials further investigating any adverse effect of autoimmunity and related thereby on male infertility are warranted, to develop appropriate guidelines for males diagnosed and treated for autoimmune disorders https://pubmed.ncbi.nlm.nih.gov/33420722/
Dai, 2019. Leflunomide is an effective and well-tolerated treatment for PsA, and would be a safe and convenient option https://pubmed.ncbi.nlm.nih.gov/31134727/
|