Open AccessA Systematic Review Characterizing Psoriatic Arthritis Onset and Exacerbation in Patients Receiving Biologic Therapy
Author(s) -
Muskaan Sachdeva,
Abrahim Abduelmula,
Asfandyar Mufti,
Jorge R. Georgakopoulos,
Yuliya Lytvyn,
Jensen Yeung
Publication year - 2022
Publication title -
journal of cutaneous medicine and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.593
H-Index - 47
eISSN - 1615-7109
pISSN - 1203-4754
DOI - 10.1177/12034754221088556
Subject(s) - medicine , exacerbation , discontinuation , psoriatic arthritis , adverse effect , biologic agents , tnf inhibitor , etanercept , arthritis , tumor necrosis factor alpha , rheumatoid arthritis
Background While biologic therapies revolutionized treatment of immune-mediated inflammatory diseases (IMIDs), some adverse effects have been noted. This includes the development and exacerbation of PsA in patients on biologic agents, however the outcomes were not extensively explored.Objective To perform a systematic review to characterize the outcomes of PsA onset or exacerbation secondary to biologic use.Methods MEDLINE and EMBASE search conducted on March 23, 2021 resulted in 18 studies comprised of 64 patients.Results Of the 64 patients, 57 (89.1%) experienced new-onset PsA and 7 (10.9%) experienced exacerbation of preexisting PsA following exposure to a biologic; most commonly a TNF-α inhibitor (42.2%, n = 27/64) and IL-12/23 inhibitors (39.1%, n = 25/64). The mean durations of biologic use before PsA onset and exacerbation were 14.8 months and 5.2 months, respectively. Twenty-four patients (44.4%) subsequently switched to an alternate biologic without further reports of PsA-related adverse events. All 64 patients reported a specific treatment for PsA; most commonly discontinuation of the associated biologic agent (32.8%, n = 21/64). Complete resolution of PsA was reported in 35.9% ( n = 23/64) of cases, of which 91.3% ( n = 21/23) resulted after discontinuation of biologic.Conclusion Although we characterized outcomes of PsA induction and exacerbation secondary to biologic use, large-scale studies are required.