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Review
. 2021 Jun 28:12:689984.
doi: 10.3389/fgene.2021.689984. eCollection 2021.

Targeted Therapies in Axial Psoriatic Arthritis

Alberto Floris  1 , Mattia Congia  1 , Elisabetta Chessa  1 , Maria Maddalena Angioni  1 , Matteo Piga  1 , Alberto Cauli  1
Affiliations
Review

Targeted Therapies in Axial Psoriatic Arthritis

Alberto Floris et al. Front Genet. .

Abstract

Specific and high-quality evidence on the efficacy of the current targeted therapies for axial disease in psoriatic arthritis (axPsA) is still scarce. Indeed, almost all the cohorts investigated in clinical trials on PsA consisted of patients with peripheral arthritis, where a small number of them also had axial involvement. Only one randomized controlled trial was so far specifically designed to assess the efficacy of a biological disease-modifying antirheumatic drug (DMARD) in axPsA. For other biological and synthetic targeted DMARDs, the most specific evidence for treatment in axPsA is extrapolated from post-hoc analyses based on PsA patients with concomitant peripheral and axial manifestations. Furthermore, the current trials and post-hoc analysis on axPsA are affected by major limitations, including the lack of a widely accepted definition of axPsA and the lack of specific and validated outcome measures. Finally, poor data are available on the genetics of axPsA, although alleles differentially expressed in different patterns of axPsA might offer advantages in the prospective of personalized medicine in axPsA patients. Overall, this review suggests that there is an urgent need for more reliable evidence derived from studies specifically designed for axPsA and based on a validated definition of axPsA and on specific outcome measures.

Keywords: axial psoriatic arthritis; psoriatic arthritis; spondylarthritis; targeted therapy; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor declared a past co-authorship with the authors MP and AC.

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