Use of disease-modifying antirheumatic drugs in patients with psoriatic arthritis

• Published in: Joint, bone, spine : revue du rhumatisme Vol. 69; no. 3; pp. 275 - 281
• Main Authors: Marguerie, Laurent, Flipo, René-Marc, Grardel, Bruno, Beaurain, Didier, Duquesnoy, Bernard, Delcambre, Bernard
• Format: Journal Article
• Language: English
• Published: France Elsevier SAS 01.05.2002
• Subjects: Adolescent; Adult; Aged; Antirheumatic Agents - administration & dosage; Antirheumatic Agents - adverse effects; Arthritis, Psoriatic - drug therapy; disease-modifying antirheumatic drugs; Drug Combinations; Female; Glucosamine - administration & dosage; Glucosamine - adverse effects; Glucosamine - analogs & derivatives; Humans; Hydroxychloroquine - administration & dosage; Hydroxychloroquine - adverse effects; Male; Methotrexate - administration & dosage; Methotrexate - adverse effects; Middle Aged; Organogold Compounds; psoriatic arthritis; Retrospective Studies; second-line treatment; Sulfasalazine - administration & dosage; Sulfasalazine - adverse effects; treatment; Treatment Outcome; treatment; second-line treatment; psoriatic arthritis; disease-modifying antirheumatic drugs
• ISSN: 1297-319X
• DOI: 10.1016/S1297-319X(02)00396-2

Few prospective placebo-controlled studies have evaluated disease-modifying antirheumatic drugs (DMARDs) in the treatment of peripheral psoriatic arthritis. Objective. To evaluate second-line treatments used in clinical practice in patients with psoriatic arthritis. Method. We studied a cross-section of 100 consecutive patients seen by hospital-based or office-based rheumatologists for psoriatic arthritis. Patients. The 55 men and 45 women had a mean age of 48 years (range, 17–79 years) and a mean disease duration of 7 years (range, 1–24 years). Results. The most commonly used DMARDs were sulfasalazine, gold, methotrexate, and hydroxychloroquine (64, 43, 41 et 17 patients, respectively). These drugs had been stopped because of inefficacy in 31%, 31%, 12%, and 53% of patients, respectively, and because of adverse events in 23%, 44%, 22%, and 41% of patients, respectively. At the time of the study, mean treatment durations were 15, 21, 34, and 12 months, respectively, and the drugs were still being used in 45%, 21%, 66%, and 6 % of patients. Conclusion. Our data confirm the value of methotrexate and salazopyrine. Methotrexate had the best risk/benefit ratio. Gold was often responsible for side effects. Hydroxychloroquine was inadequately effective and poorly tolerated.