Safety of anti-tumor necrosis factor agents in psoriatic arthritis - an update

Expert Opin Drug Saf. 2014 Feb;13(2):191-6. doi: 10.1517/14740338.2014.857655. Epub 2013 Nov 13.


Introduction: Tumor necrosis factor (TNF) blockers have represented a real revolution in the treatment of rheumatoid arthritis and spondyloarthritides (SpAs). In the case of psoriatic arthritis (PsA), anti-TNF agents are much more effective than conventional disease modifying antirheumatic drugs on all manifestations of the disease, that is, axial involvement, peripheral arthritis, peripheral enthesitis, dactylitis and skin lesions. A complete understanding of their safety is fundamental in clinical practice.

Areas covered: This article addresses the safety of anti-TNF therapy in PsA. A systematic literature review was performed using the largest electronic databases (MEDLINE, EMBASE and COCHRANE). The reported data were derived from randomized controlled trials, open-observational studies and meta-analyses. Useful information derived from the experiences in rheumatoid arthritis has also been reported.

Expert opinion: Anti-TNF therapies are as safe as conventional disease-modifying antirheumatic drugs in the management of psoriatic arthritis when the candidate patients are accurately selected. An adverse event could still occur when the patient is managed according to current national and/or international recommendations; therefore, tight controls aimed to detect adverse events early is mandatory.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Psoriatic / drug therapy*
  • Arthritis, Rheumatoid / drug therapy
  • Drug-Related Side Effects and Adverse Reactions
  • Humans
  • Randomized Controlled Trials as Topic
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Antirheumatic Agents
  • Tumor Necrosis Factor-alpha