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Management of Concomitant Inflammatory Bowel Disease or Uveitis in Patients With Psoriatic Arthritis: An Updated Review Informing the 2021 GRAPPA Treatment Recommendations

R. Jadon, Deepak; Corp, Nadia; Van Der Windt, Danielle; C. Coates, Laura; R. Soriano, Enrique; Kavanaugh, Arthur; Raine, Tim; Rieder, Florian; Siebert, Stefan; Zummer, Michel; Schwartzman, Sergio; T. Rosenbaum, James; Michelsen, Brigitte; Laxminarayan, Ramasharan; Wu, Dongze; Gupta, Latika; Ng, Beverly; Jethwa, Hannah; De Windt, Nick; Gudu, Tania; Hutton, Joseph; O'Sullivan, Denis; M. Luchetti, Michele; Stoll, Matthew; A. Singh, Jasvinder; Peluso, Rosario; Rademacher, Judith; Elaine Husni, M.

Management of Concomitant Inflammatory Bowel Disease or Uveitis in Patients With Psoriatic Arthritis: An Updated Review Informing the 2021 GRAPPA Treatment Recommendations Thumbnail


Authors

Deepak R. Jadon

Laura C. Coates

Enrique R. Soriano

Arthur Kavanaugh

Tim Raine

Florian Rieder

Stefan Siebert

Michel Zummer

Sergio Schwartzman

James T. Rosenbaum

Brigitte Michelsen

Ramasharan Laxminarayan

Dongze Wu

Latika Gupta

Beverly Ng

Hannah Jethwa

Nick De Windt

Tania Gudu

Joseph Hutton

Denis O'Sullivan

Michele M. Luchetti

Matthew Stoll

Jasvinder A. Singh

Rosario Peluso

Judith Rademacher

M. Elaine Husni



Abstract

Objective: Several advanced therapies have been licensed across the related conditions of psoriatic arthritis (PsA), Crohn disease (CD), ulcerative colitis (UC), and noninfectious uveitis. We sought to summarize results from randomized controlled trials (RCTs) investigating the efficacy and safety of advanced therapies for these related conditions in patients with PsA.

Methods: We updated the previous systematic search conducted in 2013 with literature reviews of MEDLINE, Embase, and the Cochrane Library (from February 2013 to August 2020) on this subject; only those new studies are presented here. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

Results: The number of RCTs meeting eligibility criteria were 12 for CD, 15 for UC, and 5 for uveitis. The tumor necrosis factor inhibitor (TNFi) class appears to be efficacious and safe across CD, UC, and uveitis, with the exception of etanercept. Interleukin 12/23 inhibitors (IL-12/23i) are efficacious for CD and UC. Phase II and III RCTs of Janus kinase inhibitors (JAKi) and IL-23i in CD and UC are promising in terms of efficacy and safety. IL-17i must be used with great caution in patients with PsA at high risk of inflammatory bowel disease (IBD). RCTs in uveitis have mainly studied adalimumab.

Conclusion: We have identified 32 recent RCTs in IBD and uveitis and updated recommendations for managing patients with PsA and these related conditions. A multispecialty approach is essential to effectively, safely, and holistically manage such patients. Advanced therapies are not equally efficacious across these related conditions, with dosing regimens and safety varying.

Journal Article Type Article
Acceptance Date Jun 28, 2022
Online Publication Date Dec 1, 2022
Publication Date Mar 1, 2023
Publicly Available Date Mar 28, 2024
Journal The Journal of Rheumatology
Print ISSN 0315-162X
Electronic ISSN 1499-2752
Publisher Journal of Rheumatology
Peer Reviewed Peer Reviewed
Volume 50
Issue 3
Pages 438-450
DOI https://doi.org/10.3899/jrheum.220317
Keywords GRAPPA; psoriasis; psoriatic arthritis
Publisher URL https://www.jrheum.org/content/early/2022/11/25/jrheum.220317

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