Objective. Enthesitis is a key pathological and clinical feature of psoriatic arthritis (PsA) in children and adults. Enthesitis is typically assessed clinically using several validated enthesitis scoring systems that have been used in clinical trials. Enthesitis treatment response has been reported as change in the total enthesitis score or the proportion of patients who achieved complete resolution. The majority of trials in PsA did not require patients to have enthesitis at study entry since enthesitis was evaluated only as a secondary outcome. Despite the inherent limitations of the clinical assessment of enthesitis, imaging of the entheses using ultrasound or magnetic resonance imaging has rarely been used in clinical trials to assess response to treatment of enthesitis. This systematic review summarizes existing evidence regarding pharmaceutical and nonpharmaceutical interventions for enthesitis in patients with PsA to facilitate an evidence-based update of the Group for Research and Assessment in Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for PsA. Methods. We performed a systematic literature review to identify 41 randomized clinical trials that reported enthesitis treatment response in patients with PsA. For each intervention, the response effect size was summarized and the quality of evidence was graded. Recommendations were then formulated for the various pharmacological and nonpharmacological therapies. Results. We included 41 randomized clinical trials in our review and graded each intervention. Conclusion. Several classes of systemic conventional and advanced therapies and local measures were recommended for active enthesitis in patients with PsA.
Management of Enthesitis in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations / Eder, L.; Mathew, A. J.; Carron, P.; Bertheussen, H.; Canete, J. D.; Azem, M.; Sedie, A. D.; Salvarani, C.; Ranza, R.; Elliott, A.; Turkiewicz, A.; de Toledo, R. A.; Bukulmez, H.; Stoenoiu, M. S.; Mandelin, A. M.; Koehm, M.; Lindsay, C. A.; Siegel, E.; Mease, P. J.. - In: THE JOURNAL OF RHEUMATOLOGY. - ISSN 0315-162X. - 50:2(2023), pp. 258-264. [10.3899/jrheum.220312]
Management of Enthesitis in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
Salvarani C.;
2023
Abstract
Objective. Enthesitis is a key pathological and clinical feature of psoriatic arthritis (PsA) in children and adults. Enthesitis is typically assessed clinically using several validated enthesitis scoring systems that have been used in clinical trials. Enthesitis treatment response has been reported as change in the total enthesitis score or the proportion of patients who achieved complete resolution. The majority of trials in PsA did not require patients to have enthesitis at study entry since enthesitis was evaluated only as a secondary outcome. Despite the inherent limitations of the clinical assessment of enthesitis, imaging of the entheses using ultrasound or magnetic resonance imaging has rarely been used in clinical trials to assess response to treatment of enthesitis. This systematic review summarizes existing evidence regarding pharmaceutical and nonpharmaceutical interventions for enthesitis in patients with PsA to facilitate an evidence-based update of the Group for Research and Assessment in Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for PsA. Methods. We performed a systematic literature review to identify 41 randomized clinical trials that reported enthesitis treatment response in patients with PsA. For each intervention, the response effect size was summarized and the quality of evidence was graded. Recommendations were then formulated for the various pharmacological and nonpharmacological therapies. Results. We included 41 randomized clinical trials in our review and graded each intervention. Conclusion. Several classes of systemic conventional and advanced therapies and local measures were recommended for active enthesitis in patients with PsA.File | Dimensione | Formato | |
---|---|---|---|
258.full.pdf
Open access
Tipologia:
VOR - Versione pubblicata dall'editore
Dimensione
303 kB
Formato
Adobe PDF
|
303 kB | Adobe PDF | Visualizza/Apri |
Pubblicazioni consigliate
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris