Psoriatic arthritis

Short-term management of acute ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, psoriatic arthritis, rheumatoid arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, epicondylitis... 

Konig A, Krenn V, Toksoy A, Gerhard N, Gillitzer R. Mig, GRO alpha and RANTES messenger RNA expression in lining layer, infiltrates and different leucocyte populations of synovial tissue from patients with rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Virchows Arch 2000 436(5) 449 458. 

Culy CR, Keating GM. Etanercept. An updated review of its use in rheumatoid arthritis, psoriatic arthritis and juvenile rheumatoid arthritis. Drugs 2002 62 2493-537. 

Etanercept is a recombinant human soluble tumor necrosis factor-alpha (TNFo ) receptor fusion protein that binds to TNFo and decreases its role in disorders involving excess inflammation. It is approved for subcutaneous use in the treatment of patients with moderate to severe active rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing arthritis and plaque psoriasis. To the adverse reactions mentioned for infliximab, rare reports of congestive heart failure should be added. 

Rheumatoid arthritis, psoriatic arthritis Subcutaneous 40 mg every other week. Dose maybe increased to 40 mg/wk in those not taking methotrexate. 

Uniabeied Uses Treatment of acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis, vascular headache... 

Etanercept Enbrel Rheumatoid arthritis psoriatic arthritis 1998... 

Rheumatoid arthritis Psoriatic arthritis Ankylosing spondylitis Psoriasis... 

Rheumatoid arthritis psoriatic arthritis ankylosing spondylitis... 

Psoriasis generally appears at the joints, limbs and scalp but may appear anywhere on the body. At least 10% those with psoriasis develop psoriatic arthritis, a degenerative disease of the joints and connective tissue. Approximately 1 million people in the U.S. have psoriatic arthritis. Psoriatic arthritis usually develops between the ages of 30 and 50 but can develop without the lesions characteristic of psoriasis (Natl Psoriasis Foundation, 2005, Specific forms of psoriasis, psoriasis.org). Of those with psoriatic arthritis, about 20% will develop spinal involvement. The inflammation associated with spinal involvement can lead to vertebral fusion as in alkylosing spondylitis. 

Methotrexate is used widely as a DMARD for rheumatoid arthritis, psoriatic arthritis, and for its steroid-sparing effects in many other conditions, especially if azathioprine is not tolerated. In high dose, with folinic acid rescue, methotrexate is used to treat solid and haematological malignancies (see p. 612). Low dose methotrexate slows the progression of rheumatoid arthritis. The evidence for a true disease-modifying effect on psoriatic arthritis is less definite, but methotrexate is often preferred to other DMARDs for its beneficial effect on the skin lesions. 

Adalimumab Humira (Abbott) Rheumatoid arthritis psoriatic arthritis... 

Systemic levels of 8-iso-PGp2 are higher in patients with rheumatoid arthritis, psoriatic arthritis, reactive arthritis and osteoarthritis than in healthy controls (Basu et al, 2001b). High levels of 8-iso-PGp2 in the synovial fluid have also been found in these patients. Systemic sclerosis and other chronic inflammatory diseases have been shown to increase the levels of urinary F -isoprostanes or their metabolites (Cracowski et al, 2001a,b Stein et al, 1996). This proves that isoprostanes are involved in chronic inflammation, both locally and systemically. 

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