{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:34:06Z","timestamp":1780472046394,"version":"3.54.1"},"reference-count":33,"publisher":"The Journal of Rheumatology","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Biologic agents with different mechanisms of action [inhibitors of tumor necrosis factor-\u03b1 (TNF-\u03b1), interleukin (IL)-12\/23, and IL-17] showed efficacy in randomized controlled trials (RCT) in the treatment of psoriatic arthritis. We conducted a pooled metaanalysis of these agents for treatment of dactylitis and enthesitis and compared results with the American College of Rheumatology 20 (ACR20) response and Health Assessment Questionnaire\u2013Disability Index (HAQ-DI) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A systematic literature search was performed and a pooled metaanalysis of RCT with anti-TNF-\u03b1 (infliximab, golimumab, adalimumab), anti\u2013IL-12\/23 (ustekinumab), and anti\u2013IL-17 (secu kinumab, ixekizumab) was conducted using the random-effects model. Bias was assessed using the Cochrane risk-of-bias tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Eighteen RCT were included in the pooled analysis (n = 6981). Both TNF-\u03b1 inhibitors and novel biologics (ustekinumab, secukinumab, ixekizumab) demonstrated significant resolution of dactylitis at Week 24 with pooled risk ratios (RR) versus placebo of 2.57 (95% CI 1.36\u20134.84) and 1.88 (95% CI 1.33\u20132.65), respectively. For resolution of enthesitis at Week 24, RR for TNF-\u03b1 inhibitors was 1.93 (95% CI 1.33\u20132.79) versus 1.95 (95% CI 1.60\u20132.38) for novel biologics. Both biologic categories showed overlapping ranges of ACR20 responses (TNF-\u03b1 inhibitors: RR = 2.23, 95% CI 1.60\u20133.11; pooled IL-12\/23 and \u221217: RR = 2.30, 95% CI 1.94\u20132.72) and similar quality of life improvement scores with mean HAQ-DI score changes of \u22120.29 (95% CI \u22120.39 to \u22120.19) and \u22120.26 (95% CI \u22120.31 to \u22120.22), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>The pooled analysis demonstrated that anti\u2013TNF-\u03b1 agents have the same efficacy as novel agents (ustekinumab, secukinumab, and ixekizumab) in dactylitis and enthesitis.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.180797","type":"journal-article","created":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T17:25:29Z","timestamp":1551461129000},"page":"59-65","source":"Crossref","is-referenced-by-count":47,"title":["Treatment of Dactylitis and Enthesitis in Psoriatic Arthritis with Biologic Agents: A Systematic Review and 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