Eficacia del tratamiento de artritis psoriásica con anticuerpos monoclonales. Revisión Sistemática

Abstract

Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy that affects 20-30% of people with psoriasis and is characterized by a heterogeneous clinical presentation. Objective: To evaluate the efficacy of monoclonal antibody treatment for psoriatic arthritis. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines. Randomized clinical trials published between 2019 and 2023 were included and extracted from Scopus and Web of Science databases. PICO strategies were applied for screening. Results: Seventeen randomized clinical trials were collected, evaluating the efficacy and safety of monoclonal antibodies in the treatment of psoriatic arthritis. Discussion: Therapies targeting IL-17 and IL-23 have demonstrated efficacy in controlling the heterogeneous manifestations of PsA, with ixekizumab and guselkumab standing out. However, TNF inhibitors, such as adalimumab, remain the first-line treatment. IL-17 inhibitors have shown superior remission rates, particularly in axial manifestations. Conclusions: The monoclonal antibodies ixekizumab and brepocitinib have shown greater efficacy in the management of PsA. However, in terms of safety, guselkumab and tildrakizumab stand out, with the most common adverse events involving respiratory tract infections and mild infections. Keywords: psoriatic arthritis, efficacy, monoclonal antibodies, randomized clinical trial