Novel Therapeutic Strategies in Inflammatory Joint Diseases

After efficacy and safety were demonstrated in several phase III trials, the first 2 JAK inhibitors (baricitinib and tofacitinib) have recently been approved for the treatment of moderate to severe active rheumatoid arthritis in Germany. Apremilast, a selective phosphodiesterase-4 (PDE4) inhibitor, has been used as an oral treatment for psoriasis and psoriatic arthritis since the beginning of 2015. In psoriatic arthritis, apremilast leads to a reduction in pain and an improvement in tender and swollen joints, dactylitis and enthesitis. Secukinumab is a recombinant, fully human, monoclonal antibody neutralising interleukin (IL)-17 A. It was used initially for the treatment of adult patients with moderate to severe plaque psoriasis. In November 2015, the EMA expanded the approval of Secukinumab to active psoriatic arthritis and ankylosing spondylitis. Ustekinumab is a human monoclonal antibody against the p40 subunit of IL-12/23 and has been used for the treatment of plaque psoriasis since 2009. In September 2013, Ustekinumab was also approved by the EMA for the treatment of psoriatic arthritis.