The Resource Drug therapy for psoriatic arthritis in adults : update of a 2007 report, investigators, Katrina E Donahue ... [et al.], (electronic resource)

Drug therapy for psoriatic arthritis in adults : update of a 2007 report, investigators, Katrina E Donahue ... [et al.], (electronic resource)

Label
Drug therapy for psoriatic arthritis in adults : update of a 2007 report
Title
Drug therapy for psoriatic arthritis in adults
Title remainder
update of a 2007 report
Statement of responsibility
investigators, Katrina E Donahue ... [et al.]
Contributor
Subject
Genre
Language
  • eng
  • eng
Summary
OBJECTIVES: To compare the benefits and harms of corticosteroids and oral and biologic disease-modifying antirheumatic drugs (DMARDs) for adults with psoriatic arthritis (PsA). DATA SOURCES: English language articles from 1980 to February 2011 identified through PubMed, Embase, Cochrane Library and International Pharmaceutical Abstracts; unpublished literature including dossiers from pharmaceutical companies. METHODS: Two people independently selected relevant head-to-head trials of any sample size, observational studies with at least 100 participants, and relevant good- or fair-quality meta-analyses that compared benefits or harms of 14 drug therapies. Observational studies were included only for harms. For biologic DMARDs, placebo-controlled, double-blind randomized controlled trials (RCTs) also were included. We required trials and observational studies to be at least 12 weeks in duration. Literature was synthesized qualitatively within and between the two main drug classes (oral and biologic DMARDs). RESULTS: No head-to-head controlled trials meeting inclusion criteria existed for any drugs in this review for treating patients with PsA. The available evidence was limited to two head-to-head cohort studies and placebo-controlled trials. For oral DMARDs, including sulfasalazine and methotrexate, the sparse data available involved placebo comparisons. For biologic DMARDs, evidence supported the efficacy of adalimumab, etanercept, golimumab, and infliximab for the treatment of PsA when compared with placebo. Qualitatively, these biologic DMARDs appeared to achieve similar improvements in disease activity, functional capacity, and health-related quality of life (American College of Rheumatology 20 percent improvement from baseline to endpoint, Health Assessment Questionnaire, and Short Form 36 Physical Component scores) in these trials. No difference in treatment response was found between the combination of an anti-tumor necrosis factor (TNF) (adalimumab, etanercept, or infliximab) with methotrexate compared with anti-TNF only. Evidence was insufficient to draw conclusions about the comparative harms for oral DMARDs. Among biologics, low evidence indicated that etanercept had a lower rate of withdrawals due to adverse events compared with infliximab. Compared with placebo, adalimumab and etanercept had more injection site reactions and adalimumab had few events of aggravated psoriasis. No comparative evidence was identified for subgroups. CONCLUSIONS: Overall, the data are quite limited and the evidence is insufficient to draw firm conclusions on comparative efficacy, effectiveness, and harms of either oral or biologic DMARDs for PsA. This report's findings did not reveal any differences with current standard of care. Head-to-head (RCTs) are needed to establish the comparative efficacy and safety of different treatments with and without corticosteroids, oral DMARDs, and biologic DMARDs, to determine the best therapy to prevent or minimize debilitating joint damage and optimize quality of life for people with PsA
Member of
Cataloging source
DNLM
Funding information
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850; www.ahrq.gov Contract No. HHSA-290-2007-10056-I, Prepared by: RTI International-University of North Carolina Evidence-based Practice Center, Research Triangle Park, NC
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • reviews
NLM call number
WE 344
http://library.link/vocab/relatedWorkOrContributorName
  • Donahue, Katrina E
  • United States
  • RTI International-University of North Carolina Evidence-based Practice Center
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • no. 54
  • no. 12-EHC024-EF
http://library.link/vocab/subjectName
  • Arthritis, Rheumatoid
  • Arthritis, Psoriatic
  • Antirheumatic Agents
  • Comparative Effectiveness Research
Label
Drug therapy for psoriatic arthritis in adults : update of a 2007 report, investigators, Katrina E Donahue ... [et al.], (electronic resource)
Instantiates
Publication
Note
  • "Contract No. HHSA-290-2007-10056-I."
  • "Updated June 2012."
Color
multicolored
Dimensions
unknown
Extent
1 online resource (PDF file (various pagings))
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • 1585930
  • (DNLM)BKSHLF:NBK95257
Label
Drug therapy for psoriatic arthritis in adults : update of a 2007 report, investigators, Katrina E Donahue ... [et al.], (electronic resource)
Publication
Note
  • "Contract No. HHSA-290-2007-10056-I."
  • "Updated June 2012."
Color
multicolored
Dimensions
unknown
Extent
1 online resource (PDF file (various pagings))
Form of item
online
Other physical details
ill.
Specific material designation
remote
System control number
  • 1585930
  • (DNLM)BKSHLF:NBK95257

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