RESEARCH - Treatment of psoriatic arthritis and RA with DMARDs - comparison of drugs and adverse reactions

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J Rheumatol. 2008 Jan 15 [Epub ahead of print]

Treatment of Psoriatic Arthritis and Rheumatoid Arthritis with Disease

Modifying Drugs -- Comparison of Drugs and Adverse Reactions.

Helliwell PS, WJ.

From the Academic Unit of Musculoskeletal and Rehabilitation Medicine,

University of Leeds, Leeds, UK; and the Rehabilitation Teaching and

Research Unit, Department of Medicine, Wellington School of Medicine

and Health Sciences, University of Otago, Wellington, New Zealand.

OBJECTIVE: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are

chronic inflammatory diseases of the musculoskeletal system. Although

it seems likely that these conditions have a different pathogenesis,

the drugs used to treat them are the same. Our study used a

cross-sectional clinical database to compare drug use and side-effect

profile in these 2 diseases. METHODS: The CASPAR study collected data

on 588 patients with PsA and 536 controls, 70% of whom had RA. Data on

disease modifying drug treatments used over the whole illness were

recorded, together with their outcomes, including adverse events, for

RA and PsA. RESULTS: For both diseases methotrexate (MTX) was the most

frequently used disease modifying drug (39% of patients with PsA, 30%

with RA), with over 70% of patients in both diseases still taking the

drug. Other drugs were used with the following frequencies in PsA and

RA, respectively: sulfasalazine 22%/13%, gold salts 7%/11%,

antimalarial drugs 5%/14%, corticosteroids 10%/17%, and anti-tumor

necrosis factor (TNF) drugs 6%/5%. Compared to RA, cyclosporine and

anti-TNF agents were less likely to be ineffective in PsA. Compared to

RA, subjects with PsA were less likely to be taking MTX and more

likely to be taking anti-TNF agents. Hepatotoxicity with MTX was more

common in PsA and pulmonary toxicity with MTX was found more often in

RA. CONCLUSION: These data provide insight into prescribing patterns

of disease modifying drugs in RA and PsA in a large international

cohort, together with the differential adverse events of these drugs

between these diseases.

PMID: 18203324

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve & db=PubMed & list_uids=182033\

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