A biológiai terápia szerepe az arthritis psoriatica gyógykezelésében (irodalmi áttekintés)

Translated title of the contribution: The role of biological agents in the treatment of psoriatic arthritis, literature review

Éva Koó, Valentin Brodszky, Márta Péntek, I. Újfalussy, Marianna Bettina Nagy, L. Gulácsi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: The recognition of the key pathogenetic role of TNF-α in psoriatic arthritis has made it possible to introduce new drugs in the treatment. TNF-alpha inhibitors available in Hungary (infliximab, etanercept, adalimumab) are potential therapies for patients who have not adequately responded to traditional disease-modifying antirheumatic drugs. Objective: The aim of the study was to present the epidemiology and progression of psoriatic arthritis in Hungary based on national and international data, to assess the target population for biological therapy and to analyze their effectiveness, reviewing the available literature of randomized controlled trials. Methods: The prevalence of psoriatic arthritis in Hungary was estimated using international data. Characteristics of psoriatic arthritis population were studied using the database of a rheumatology ward. A systematic literature search was performed to identify each relevant trial. A synthesis and comparison of the results from the 5 identified trials was performed and the average effect of biological agents was calculated. Both the fixed and the random effect model were used for the data synthesis; the results were probed with Mantel-Haenzel test. Results: The prevalence of psoriatic arthritis is about 10.000-20.000 in Hungary. Average disease-d u ration was 10 years in the sample (n = 189), the most frequent was polyarticular form (51%). Regarding functional status the mean HAQ score was 1.46, with an average progression of 0.05 points/year. The trial data confirmed that biological agents are superior to placebo in improving symptoms (achieving ACR20); risk difference between biological treatments and placebo is 47% (RD = 0.47, 95% Cl: 0.42-0.53). The biological treatment of 2 patients improves the status of 1 patient (NNT = 2.1 95% Cl 1.9-2.4). There is no significant difference in efficacy between the three biological agents. Conclusions: TNF-α inhibitors are effective treatments of psoriatic arthritis and are safe under strict medical control. The principles of indications, contra i nd ications, administration and control have been worked out by the Rheumatology and Physical Medicine Board.

Original languageHungarian
Pages (from-to)1963-1970
Number of pages8
JournalOrvosi Hetilap
Volume147
Issue number41
Publication statusPublished - Oct 15 2006

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Psoriatic Arthritis
Biological Factors
Hungary
Rheumatology
ametantrone
Therapeutics
Placebos
Physical and Rehabilitation Medicine
Biological Therapy
Antirheumatic Agents
Health Services Needs and Demand
Epidemiology
Randomized Controlled Trials
Tumor Necrosis Factor-alpha
Databases
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A biológiai terápia szerepe az arthritis psoriatica gyógykezelésében (irodalmi áttekintés). / Koó, Éva; Brodszky, Valentin; Péntek, Márta; Újfalussy, I.; Nagy, Marianna Bettina; Gulácsi, L.

In: Orvosi Hetilap, Vol. 147, No. 41, 15.10.2006, p. 1963-1970.

Research output: Contribution to journalArticle

Koó, Éva ; Brodszky, Valentin ; Péntek, Márta ; Újfalussy, I. ; Nagy, Marianna Bettina ; Gulácsi, L. / A biológiai terápia szerepe az arthritis psoriatica gyógykezelésében (irodalmi áttekintés). In: Orvosi Hetilap. 2006 ; Vol. 147, No. 41. pp. 1963-1970.
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abstract = "Introduction: The recognition of the key pathogenetic role of TNF-α in psoriatic arthritis has made it possible to introduce new drugs in the treatment. TNF-alpha inhibitors available in Hungary (infliximab, etanercept, adalimumab) are potential therapies for patients who have not adequately responded to traditional disease-modifying antirheumatic drugs. Objective: The aim of the study was to present the epidemiology and progression of psoriatic arthritis in Hungary based on national and international data, to assess the target population for biological therapy and to analyze their effectiveness, reviewing the available literature of randomized controlled trials. Methods: The prevalence of psoriatic arthritis in Hungary was estimated using international data. Characteristics of psoriatic arthritis population were studied using the database of a rheumatology ward. A systematic literature search was performed to identify each relevant trial. A synthesis and comparison of the results from the 5 identified trials was performed and the average effect of biological agents was calculated. Both the fixed and the random effect model were used for the data synthesis; the results were probed with Mantel-Haenzel test. Results: The prevalence of psoriatic arthritis is about 10.000-20.000 in Hungary. Average disease-d u ration was 10 years in the sample (n = 189), the most frequent was polyarticular form (51{\%}). Regarding functional status the mean HAQ score was 1.46, with an average progression of 0.05 points/year. The trial data confirmed that biological agents are superior to placebo in improving symptoms (achieving ACR20); risk difference between biological treatments and placebo is 47{\%} (RD = 0.47, 95{\%} Cl: 0.42-0.53). The biological treatment of 2 patients improves the status of 1 patient (NNT = 2.1 95{\%} Cl 1.9-2.4). There is no significant difference in efficacy between the three biological agents. Conclusions: TNF-α inhibitors are effective treatments of psoriatic arthritis and are safe under strict medical control. The principles of indications, contra i nd ications, administration and control have been worked out by the Rheumatology and Physical Medicine Board.",
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AU - Péntek, Márta

AU - Újfalussy, I.

AU - Nagy, Marianna Bettina

AU - Gulácsi, L.

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N2 - Introduction: The recognition of the key pathogenetic role of TNF-α in psoriatic arthritis has made it possible to introduce new drugs in the treatment. TNF-alpha inhibitors available in Hungary (infliximab, etanercept, adalimumab) are potential therapies for patients who have not adequately responded to traditional disease-modifying antirheumatic drugs. Objective: The aim of the study was to present the epidemiology and progression of psoriatic arthritis in Hungary based on national and international data, to assess the target population for biological therapy and to analyze their effectiveness, reviewing the available literature of randomized controlled trials. Methods: The prevalence of psoriatic arthritis in Hungary was estimated using international data. Characteristics of psoriatic arthritis population were studied using the database of a rheumatology ward. A systematic literature search was performed to identify each relevant trial. A synthesis and comparison of the results from the 5 identified trials was performed and the average effect of biological agents was calculated. Both the fixed and the random effect model were used for the data synthesis; the results were probed with Mantel-Haenzel test. Results: The prevalence of psoriatic arthritis is about 10.000-20.000 in Hungary. Average disease-d u ration was 10 years in the sample (n = 189), the most frequent was polyarticular form (51%). Regarding functional status the mean HAQ score was 1.46, with an average progression of 0.05 points/year. The trial data confirmed that biological agents are superior to placebo in improving symptoms (achieving ACR20); risk difference between biological treatments and placebo is 47% (RD = 0.47, 95% Cl: 0.42-0.53). The biological treatment of 2 patients improves the status of 1 patient (NNT = 2.1 95% Cl 1.9-2.4). There is no significant difference in efficacy between the three biological agents. Conclusions: TNF-α inhibitors are effective treatments of psoriatic arthritis and are safe under strict medical control. The principles of indications, contra i nd ications, administration and control have been worked out by the Rheumatology and Physical Medicine Board.

AB - Introduction: The recognition of the key pathogenetic role of TNF-α in psoriatic arthritis has made it possible to introduce new drugs in the treatment. TNF-alpha inhibitors available in Hungary (infliximab, etanercept, adalimumab) are potential therapies for patients who have not adequately responded to traditional disease-modifying antirheumatic drugs. Objective: The aim of the study was to present the epidemiology and progression of psoriatic arthritis in Hungary based on national and international data, to assess the target population for biological therapy and to analyze their effectiveness, reviewing the available literature of randomized controlled trials. Methods: The prevalence of psoriatic arthritis in Hungary was estimated using international data. Characteristics of psoriatic arthritis population were studied using the database of a rheumatology ward. A systematic literature search was performed to identify each relevant trial. A synthesis and comparison of the results from the 5 identified trials was performed and the average effect of biological agents was calculated. Both the fixed and the random effect model were used for the data synthesis; the results were probed with Mantel-Haenzel test. Results: The prevalence of psoriatic arthritis is about 10.000-20.000 in Hungary. Average disease-d u ration was 10 years in the sample (n = 189), the most frequent was polyarticular form (51%). Regarding functional status the mean HAQ score was 1.46, with an average progression of 0.05 points/year. The trial data confirmed that biological agents are superior to placebo in improving symptoms (achieving ACR20); risk difference between biological treatments and placebo is 47% (RD = 0.47, 95% Cl: 0.42-0.53). The biological treatment of 2 patients improves the status of 1 patient (NNT = 2.1 95% Cl 1.9-2.4). There is no significant difference in efficacy between the three biological agents. Conclusions: TNF-α inhibitors are effective treatments of psoriatic arthritis and are safe under strict medical control. The principles of indications, contra i nd ications, administration and control have been worked out by the Rheumatology and Physical Medicine Board.

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