학술논문
Evaluation of the Synovial Effects of Biological and Targeted Synthetic DMARDs in Patients with Psoriatic Arthritis: A Systematic Literature Review and Meta-Analysis.
Document Type
Article
Author
Ciliento, Maria Sofia; Venturelli, Veronica; Schettini, Natale; Bertola, Riccardo; Garaffoni, Carlo; Lanza, Giovanni; Gafà, Roberta; Borghi, Alessandro; Corazza, Monica; Zabotti, Alen; Missiroli, Sonia; Boncompagni, Caterina; Patergnani, Simone; Perrone, Mariasole; Giorgi, Carlotta; Pinton, Paolo; Govoni, Marcello; Scirè, Carlo Alberto; Bortoluzzi, Alessandra; Silvagni, Ettore
Source
Subject
*PSORIATIC arthritis
*ANTIRHEUMATIC agents
*SYNOVIAL membranes
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Language
ISSN
1661-6596
Abstract
The aims of this systematic literature review (SLR) were to identify the effects of approved biological and targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) on synovial membrane of psoriatic arthritis (PsA) patients, and to determine the existence of histological/molecular biomarkers of response to therapy. A search was conducted on MEDLINE, Embase, Scopus, and Cochrane Library (PROSPERO:CRD42022304986) to retrieve data on longitudinal change of biomarkers in paired synovial biopsies and in vitro studies. A meta-analysis was conducted by adopting the standardized mean difference (SMD) as a measure of the effect. Twenty-two studies were included (19 longitudinal, 3 in vitro). In longitudinal studies, TNF inhibitors were the most used drugs, while, for in vitro studies, JAK inhibitors or adalimumab/secukinumab were assessed. The main technique used was immunohistochemistry (longitudinal studies). The meta-analysis showed a significant reduction in both CD3+ lymphocytes (SMD −0.85 [95% CI −1.23; −0.47]) and CD68+ macrophages (sublining, sl) (SMD −0.74 [−1.16; −0.32]) in synovial biopsies from patients treated for 4–12 weeks with bDMARDs. Reduction in CD3+ mostly correlated with clinical response. Despite heterogeneity among the biomarkers evaluated, the reduction in CD3+/CD68+sl cells during the first 3 months of treatment with TNF inhibitors represents the most consistent variation reported in the literature. [ABSTRACT FROM AUTHOR]