Hormonal therapy and biologic therapy for psoriatic arthritis (PSA)

Hormonal therapy and biologic therapy for psoriatic arthritis PsA:

1. Glucocorticoid treatment: used when the condition is severe and general drug treatment cannot control it. Because of the large adverse reactions, sudden discontinuation can induce severe psoriasis, and it is easy to relapse after discontinuation, so it is generally not used or used for a long time. However, some scholars believe that small doses of glucocorticoids can relieve patients' symptoms and play a "bridge" role before DMARD takes effect.

2. Biological agents: In recent years, there have been a lot of reports on the use of biological agents to treat PsA, and they have also achieved good results. They can also be used in combination with methotrexate. Etanercept, a recombinant human type II tumor necrosis factor receptor-antibody fusion protein for injection, is used for patients with moderate to severe PsA who are not well treated with other drugs. Each 25 mg subcutaneous injection is given twice a week. Another type is the monoclonal antibody of tumor necrosis factor-αTNF-α, including infliximab for injection. After the first intravenous infusion of 3-5 mg/Kg, the same dose is given once in the second and sixth weeks and every 8 weeks thereafter. In recent years, IL-17A monoclonal antibodies have been used to treat PsA, and good results have been achieved, especially for the rapid improvement of PsA finger/toe inflammation and enthesitis. Recently, it has been reported that oral small molecule targeted drugs JAK inhibitors, such as tofacitinib, are also safe and effective in the treatment of PsA. Before using the above drugs, blood routine, urine routine, liver function, kidney function, and examinations related to diseases such as hepatitis and tuberculosis should be checked; regular inspections should also be carried out during the application process. Common adverse reactions include injection site reactions, such as erythema, itching, pain and swelling, which usually last for 3 to 5 days, and others include headache, dizziness, rash, cough, abdominal pain, blood system damage, infection, allergic reaction, etc. It is contraindicated for patients with active infection, active tuberculosis, tumor, congestive heart failure and allergic to the ingredients of this product.