Journal
JOURNAL OF RHEUMATOLOGY
Volume 41, Issue 11, Pages 2295-2300Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.140879
Keywords
PSORIATIC ARTHRITIS; DACTYLITIS; TREATMENT; SYSTEMATIC REVIEW
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Dactylitis, a hallmark clinical feature of psoriatic arthritis (PsA) and other spondyloarthropathies, may also be a severity marker for PsA and psoriasis. Traditionally, clinicians have used nonsteroidal antiinflammatory drugs and local corticosteroid injections to treat dactylitis, although conventional disease-modifying antirheumatic drugs are also used. We performed a systematic literature review to determine the most efficacious current treatment options for dactylitis in PsA. Effect sizes were greatest for the biologic agents ustekinumab, certolizumab, and infliximab, suggesting that therapy with one of these agents should be initiated in patients with dactylitis. However, the limited data highlight the need for randomized, placebo-controlled trials, with dactylitis as a primary outcome, to determine a valid, reliable, and responsive clinical outcome measure for PsA patients with dactylitis.
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