Effectiveness and safety of biological and target synthetic drugs treatment for psoriatic arthritis: a systematic review with network meta-analysis.

Psoriatic arthritis (PA) is a chronic inflammatory systemic arthritis that can result in loss of functional capacity and joint deformation. This systematic review assessed the effectiveness and safety of biological and target synthetic drugs for treating PA. We searched for randomized clinical trials (RCTs) that evaluated the use of Adalimumab, Etanercept, Infliximab, Golimumab, Secukinumab, Certolizumab Pegol and Tofacitinib in the main general databases and clinical trial registers databases. The primary outcomes were ACR 50, PsARC, and serious adverse events. Two independent reviewers performed study selection and data extraction. Network meta-analyses were conducted using a random effects model and frequentist approach. The CINeMA software was used to assess the certainty of evidence. We included 33 RCTs (n = 11,034). The results from the network meta-analysis for the ACR 50 at 6-months follow-up showed that all drugs were superior to placebo, with Secukinumab (high certainty of evidence), Infliximab (very low certainty of evidence) and Adalimumab (high certainty of evidence) ranking the highest. Regarding the PsARC (at 6-months follow-up), all drugs, except for Golimumab (very low certainty of evidence), were superior to placebo, with Etanercept (low certainty of evidence), Infliximab (low certainty of evidence) and Certolizumab Pegol (low certainty of evidence) being the most effective drugs. There were no significant differences in the risk of serious adverse events between the drugs and placebo. Golimumab (very low certainty of evidence), Secukinumab (low certainty of evidence), and Adalimumab (very low certainty of evidence) ranked the highest for safety. In conclusion, based on the balance between efficacy and safety, Secukinumab and Adalimumab may be the preferred options among the evaluated drugs for treating patients with PsA. However, caution is necessary when interpreting the safety findings, as they are supported by evidence of low to very low certainty. Consequently, the balance between benefits and potential risks may change as new safety evaluation studies become available. PROSPERO: CRD42022315577.

Montezuma T ，Probst LF ，Almeida MO 《Advances in Rheumatology》

Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.

Sbidian E ，Chaimani A ，Garcia-Doval I ，Do G ，Hua C ，Mazaud C ，Droitcourt C ，Hughes C ，Ingram JR ，Naldi L ，Chosidow O ，Le Cleach L ... -  《Cochrane Database of Systematic Reviews》

Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.

Singh JA ，Hossain A ，Mudano AS ，Tanjong Ghogomu E ，Suarez-Almazor ME ，Buchbinder R ，Maxwell LJ ，Tugwell P ，Wells GA ... -  《Cochrane Database of Systematic Reviews》

Biologics or tofacitinib for rheumatoid arthritis in incomplete responders to methotrexate or other traditional disease-modifying anti-rheumatic drugs: a systematic review and network meta-analysis.

Singh JA ，Hossain A ，Tanjong Ghogomu E ，Kotb A ，Christensen R ，Mudano AS ，Maxwell LJ ，Shah NP ，Tugwell P ，Wells GA ... -  《Cochrane Database of Systematic Reviews》

Biologic or tofacitinib monotherapy for rheumatoid arthritis in people with traditional disease-modifying anti-rheumatic drug (DMARD) failure: a Cochrane Systematic Review and network meta-analysis (NMA).

Singh JA ，Hossain A ，Tanjong Ghogomu E ，Mudano AS ，Tugwell P ，Wells GA ... -  《Cochrane Database of Systematic Reviews》