Mease PJ, Ory P, Sharp JT et al. Ann Rheum Dis 2009;68:702–9.
Psoriatic arthritis (PsA) occurs in up to one-third of patients who have psoriasis; this can result in increased healthcare costs and a decreased health-related quality of life for patients. Treatment of PsA traditionally involves disease-modifying antirheumatic drugs such as methotrexate and azothioprine. In the current article, the authors investigated the long-term effectiveness and tolerability of adalimumab treatment in patients with PsA and found that the short-term benefits of adalimumab were sustained during long-term therapy. In addition, no change to the safety profile that is observed during short-term treatment was found with long-term treatment.
Adalimumab is widely used in dermatology and rheumatology for the treatment of psoriasis and psoriatic arthritis (PsA). Its short-term (<6 months of treatment) efficacy and safety is well established; approximately two-thirds of adalimumab-treated patients with psoriasis will achieve the satisfactory cutaneous response (defined as a ≥75% improvement in the Psoriasis Area and Severity Index score [PASI-75]) and half of patients with PsA will achieve a ≥20% improvement in American College of Rheumatology criteria (ACR-20), which is considered to be a cut-off value for efficacy in treating arthritis [1,2]. Moreover, adalimumab, similar to other approved tumor necrosis factor-α (TNF-α) blockers, stops the radiological progression of PsA (measured by the Sharp score). Because most TNF-α blockers are used continuously, it is important to document the long-term efficacy and safety of these agents.