Treating psoriatic arthritis how effective are TNF antagonists 英文参考文献.docVIP

Available online /content/6/S2/S31 Review Treating psoriatic arthritis: how effective are TNF antagonists? Alice B Gottlieb1 and Christian E Antoni2 1Clinical Research Center UMDNJ-RWJ Medical School, New Brunswick, NJ, USA 2Department of Medicine, University of Erlangen-Nurnberg, Germany Corresponding author: Alice B Gottlieb (e-mail: alice.gottlieb@) Received: 30 Sep 2003 Accepted: 22 Oct 2003 Published: 21 Jun 2004 Arthritis Res Ther 2004, 6(Suppl 2):S31-S35 (DOI 10.1186/ar1016) ? 2004 BioMed Central Ltd (Print ISSN 1478-6354; Online ISSN 1478-6362) Abstract Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy that commonly appears after the onset of the characteristic cutaneous lesions. This complication affects about 40% of patients with moderate to severe cutaneous disease. Analysis of synovial fluid and tissue in patients with PsA demonstrates a profile of high levels of tumor necrosis factor (TNF) plus other cytokines similar to those seen in patients with rheumatoid arthritis (RA). In the past, medical management of patients with this disease consisted of treatment with nonsteroidal anti-inflammatory agents. Patients with more severe disease have tried a number of different disease-modifying drugs including methotrexate, azathioprine, and gold salts. However, there is no evidence that these agents can arrest the progress of structural joint damage. Infliximab and etanercept are TNF antagonists that have demonstrated significant efficacy and safety in patients with RA. Clinical trials with these two agents in patients with PsA have shown significant improvement in the rheumatologic and cutaneous manifestations of the disease. Keywords: arthritis, etanercept, infliximab, psoriasis, spondyloarthropathies, tumor necrosis factor Introduction gist also had PsA [4]. Gladman and colleagues investi- gated the presence of spinal involvement based on clinical and radiologic evidence in patients