Targeted Therapy in Psoriatic Arthritis, Including Juvenile Psoriatic Arthritis: Efficacy and Safety of TNF-alpha, IL-17 and JAK Inhibitors - A Literature Review
DOI:
https://doi.org/10.12775/QS.2026.66.73985Keywords
psoriatic arthritis, juvenile psoriatic arthritis, targeted therapy, TNF-alpha inhibitors, Janus kinase inhibitors, IL-17 inhibitorsAbstract
Background: Psoriatic arthritis (PsA) and juvenile psoriatic arthritis (JPsA) are chronic inflammatory diseases with heterogeneous, multi-domain presentation; targeted therapies against TNF-alpha, IL-17 and the JAK-STAT pathway have expanded treatment options.
Aim: To evaluate efficacy and safety of three classes of targeted therapies in PsA and JPsA: TNF-alpha inhibitors (TNF-i), IL-17 inhibitors (IL-17-i) and Janus kinase inhibitors (JAK-i).
Material and methods: A narrative PubMed (MEDLINE) review of phase I-III randomized trials and open-label extensions, real-world studies, and selected reviews assessing efficacy and safety of TNF-i, IL-17-i and JAK-i in adults and children with PsA/JPsA.
Results: Anti-TNF therapies show high ACR response rates, favourable skin effects, and inhibition of radiographic progression, with acceptable long-term safety. IL-17-i provide sustained improvement across major PsA domains, particularly in TNF-i-naive patients, with a stable safety profile. JAK-i are effective after failure of conventional and biologic treatment, improving joint activity, function and quality of life, but carry a characteristic adverse-event profile requiring assessment. Real-world analyses in PsA and axial spondyloarthritis show no significantly increased cardiovascular or malignancy risk with JAK-i versus anti-TNF/anti-IL-17 therapies, though rheumatoid arthritis data warrant caution in high-risk patients. In JPsA, TNF-i remain the principal biologic class, while anti-IL-17 trials confirm efficacy and safety in children.
Conclusions: Targeted therapy of PsA and JPsA requires individualization based on phenotype, prior treatment, and cardiovascular, thromboembolic and oncologic risk. Further paediatric studies are needed to define each class's role in JPsA management.
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Copyright (c) 2026 Agnieszka Anna Gaczoł, Gabriela Piotrowska, Paulina Kopcińska, Magdalena Mortka, Hubert Bednarz, Michał Kawa, Kamil Idzik, Dominika Grzybowska, Aleksander Urbaś, Zuzanna Lechowska, Tomasz Kilian, Michał Kurnik, Weronika Grzyb-Kurnik
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