Updated Evidence Reinforces Efficacy and Safety of Pharmacologic Therapies in Psoriatic Arthritis

A new systematic literature review (SLR), published in Annals of the Rheumatic Diseases, provides an updated overview of the efficacy and safety of pharmacologic treatments for psoriatic arthritis (PsA), reinforcing the utility of conventional synthetic (cs), biological (b), and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) in clinical practice.

The review analyzed 38 articles, including 30 clinical trials published between 2019 and December 2022, and assessed 24 safety studies. Agents evaluated included csDMARDs, such as methotrexate and leflunomide; bDMARDs targeting interleukins IL-17, IL-23, IL-12/23; tumor necrosis factor inhibitors (TNFi); and Janus kinase inhibitors (JAKi).

“The compounds investigated were efficacious in improving signs and symptoms of PsA, improving physical functioning and quality of life,” the authors reported. This comprehensive analysis highlights the broad range of therapeutic options now available, supporting individualized treatment approaches based on disease phenotype and patient needs.

Safety outcomes were derived from both observational studies and long-term trial follow-ups. The SLR examined adverse events of special interest, including serious infections (herpes zoster, influenza, tuberculosis), malignancies, major adverse cardiovascular events, venous thromboembolism, liver toxicity, laboratory abnormalities, and psychiatric effects.

“Safety indicators were generally coherent with the previous SLR in 2019,” the study noted, suggesting no new major safety concerns have emerged since the last update. Agents such as TNFi, IL-17i, JAKi, IL-12/23i, and PDE4i (apremilast) maintained acceptable safety profiles in both controlled and real-world settings.

The findings directly informed the 2023 update of the European Alliance of Associations for Rheumatology recommendations for PsA management, ensuring that clinicians have access to the most current evidence base.

For dermatologists managing patients with PsA, this SLR supports continued confidence in the efficacy of available agents and reinforces the importance of monitoring safety parameters in routine care. The inclusion of emerging therapies, such as bimekizumab, risankizumab, and deucravacitinib, provides further insight into the expanding treatment landscape.

These results equip dermatologists with an updated evidence base to guide therapeutic decisions and align with evolving treatment recommendations.

Reference
Kerschbaumer A, Smolen JS, Ferreira RJO, et al. Efficacy and safety of pharmacological treatment of psoriatic arthritis: a systematic literature research informing the 2023 update of the EULAR recommendations for the management of psoriatic arthritis. Ann Rheum Dis. 2024;83(6):760-774. doi:10.1136/ard-2024-225534