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Etanercept for psoriatic arthritis

BMJ 2010; 340 doi: (Published 03 February 2010) Cite this as: BMJ 2010;340:c229
  1. Dafna D Gladman, professor of medicine
  1. 1Toronto Western Hospital, 399 Bathurst Street, 1E-410B, Toronto, ON, Canada M5T 2S8
  1. dafna.gladman{at}

    Patients who do not respond to standard doses are unlikely to benefit from a higher one

    In the linked randomised controlled trial (doi:10.1136/bmj.c147) Sterry and colleagues compared the effectiveness of two different etanercept regimens (50 mg once a week or twice a week) in treating the skin manifestations of psoriasis in people who also had psoriatic arthritis over 12 weeks.1

    Psoriatic arthritis is an inflammatory arthritis that affects about 30% of patients with psoriasis. Over the past few decades it has become clear that the disease is more common and more severe than previously thought. Studies in the 1940s indicated that the frequency of psoriatic arthritis in patients with psoriasis was 7%, but more recent studies suggest a frequency of 30%.2 Psoriatic arthritis may cause joint destruction, disability, and reduced quality of life. Patients with the disease have more disability and a worse quality of life than those with psoriasis alone.3 Although disease modifying antirheumatic drugs have been used to treat psoriatic arthritis, they have not altered the disease course or prevented the progression of joint damage.4

    Since the advent …

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