Authors' objectives:

The aim of this review is to provide guidance on the use of etanercept and infliximab for the treatment of adults with psoriatic arthritis.

Authors' recommendations: 1 Guidance 1.1 Etanercept, within its licensed indications, is recommended for the treatment of adults with severe active psoriatic arthritis only when the following criteria are met. - The person has peripheral arthritis with three or more tender joints and three or more swollen joints. - The psoriatic arthritis has not responded to adequate trials of at least two standard disease-modifying anti-rheumatic drugs (DMARDs), administered either individually or in combination. 1.2 Etanercept treatment should be discontinued in patients whose psoriatic arthritis has not shown an adequate response when assessed using the Psoriatic Arthritis Response Criteria (PsARC) at 12 weeks. An adequate response is defined as: - an improvement in at least two of the four PsARC criteria, one of which has to be joint tenderness or swelling score, with no worsening in any of the four criteria. 1.3 Infliximab, within its licensed indications, is recommended for the treatment of adults with severe active psoriatic arthritis if, under the circumstances outlined in section 1.1, treatment with an anti-TNF (tumour necrosis factor) agent is considered appropriate and the person has been shown to be intolerant of, or have contraindications to, treatment with etanercept or has major difficulties with self administered injections. 1.4 Infliximab treatment should be discontinued in patients whose psoriatic arthritis has not responded adequately at 12 weeks. An adequate response is defined in section 1.2. 1.5 It is recommended that the use of etanercept or infliximab for psoriatic arthritis should be initiated and supervised by specialist physicians experienced in the diagnosis and treatment of psoriatic arthritis. If a person has both psoriatic arthritis and psoriasis their treatment should be managed by collaboration between a rheumatologist and a dermatologist.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=TA104

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: National Institute for Health and Care Excellence

Contact Address: Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BT

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Health and Clinical Excellence (NICE)