Efficacy and Safety of tsDMARDs vs. bDMARDs in Psoriatic Arthritis: A Systematic Review and Meta-Analysis

Author(s): Md Anas Bin Naime, Sayeed Ahmed, Mohammad Amimul Ihsan

Psoriatic arthritis (PsA) is a chronic inflammatory condition of the joints, accompanying or associated with psoriasis, involving joint pain and stiffness, with the possibility of progressive joint damage. Proper management of PsA should be executed in order to prevent disability and improve quality of life. Treatment in PsA has been focused on the use of Disease Modifying Antirheumatic Drugs which include the traditional synthetic DMARDs (tsDMARDs) and biologic DMARDs. This study systematically reviewed and compared the efficacy, safety, and impacts on quality of life between the management of PsA with tsDMARDs and bDMARDs. According to the meta-analysis, the superiority of bDMARDs in the tsDMARD group in attaining clinical remission was consistently more common. Additionally, bDMARDs were related to lower incidences of adverse effects than tsDMARDs, as presented here. Moreover, bDMARD-treated patients showed an improvement in quality of life, with decreased pain and better physical function. Combined, this information suggests that bDMARDs may be considered for early use in PsA—namely, in moderate-to-severe disease or when patients do not respond to tsDMARDs. More research is necessary in order to make treatment decisions specific for the patient's long-term outcomes and safety related to these therapeutic strategies.