OBJECTIVES: To evaluate the efficacy and safety of biological disease modifying antirheumatic drugs (DMARDs) adalimumab, etanercept, golimumab and infliximab in the treatment of psoriatic arthritis (PA) in adults. METHODS: We conducted a systematic review of controlled clinical trials to access the efficacy and safety of these agents in patients with active PsA which have or have not been treated with biological DMARDs before. The databases MEDLINE, EMBASE, LILACS and Central Cochrane where searched until February 2013 to identify articles that reported data on clinical improvement measurements and adverse events. Metanalysis were performed using Review Manager® 5.1 and the Random Effect Model. RESULTS: Seven RCTs comparing biological DMARDs with placebo where included; two comparing either adalimumabe, etanercept and infliximab to placebo, and one comparing golimumab to placebo. After 12 weeks of treatment, adalimumabe and etanercepte were more effective than placebo with respect to 20% improvement from baseline in the American College of Rheumatology response criteria (ACR 20); Risk Ratio 3.42 ([2.08, 5.63]; I² 38%) and 4.15 ([2.71, 6.36]; I² 0%), respectively. After 16 weeks, infliximab patients also achieved ACR20 in a greater rate than placebo; RR 5.71 ([3.53, 9.25]; I² 0%). However, results after 54 weeks of treatment showed no significant differences between infliximab and placebo; RR 0.98 ([0.82, 1.18]; I² 0%). Golimumab was more effective than placebo at 24 weeks; ACR20 RR 4.53 ([2.75, 7.48]). After 16 weeks infliximab shown a 50% reduction in the psoriasis area and severity index (PASI50) in a greater rate than placebo, RR 10.67 ([5.52, 20.64]; I² 1%), however, once again 54 weeks results have shown no significant differences between infliximab and placebo, RR 0.94 ([0.80, 1.12] I² 66%). Adverse events where similar between the biological and placebo groups, nevertheless the placebo group showed a slightly higher rate of adverse events than adalimumabe; RR 0.68 ([0.50, 0.92]; I² 0%). CONCLUSIONS: Results show clinical improvement with the use of biological DMARs in the treatment of PA. Still, there is a lack of evidence to support the spread the use of these medicines especially in synthetic DMARD naïve patients.