Efficacy of Biological or Targeted Synthetic Disease‐Modifying Anti‐Rheumatic Drugs in Active Psoriatic Arthritis: A Network Meta‐Analysis of Randomized Controlled Trials

Objective: Many biological or targeted synthetic disease‐modifying anti‐rheumatic drugs (b/ts DMARDs) are used in the treatment of psoriatic arthritis (PsA) during recent years, but there are few head‐to‐head studies that directly compare these drugs to evaluate and compare the relative efficacy of these treatments at week 24. The aim of this study is to conduct a comprehensive comparison of all clinically used bDMARDs or tsDMARDs for PSA using a network meta‐analysis to evaluate relative efficacy of these drugs, which is evaluated by ACR20, ACR50, ACR70, PASI75, and PASI90. Methods: All randomized controlled trials of these treatments are searched in PubMed, Web of Science, and Embase, and data are extracted from the included articles, and network meta‐analysis is performed using the Stata 13 software. Results: secukinumab 300 mg is the top‐ranked treatment for ACR20 and PASI90, infliximab 5 mg/kg is the top‐ranked treatment for ACR50, and adalimumab 40 mg is the top‐ranked treatment for ACR70 and PASI75. Conclusions: Tumor necrosis factor‐α inhibitors and interleukin 17A inhibitors are the top‐ranked treatments for arthritis and skin responses of active PsA.