Management of psoriatic arthritis from the view of the dermatologist

Abstract

Psoriatic arthritis (PsA) is an inflammatory seronegative spondyloarthropathy associated with psoriasis. Although the main assessment measures for PsA are borrowed from the standard criteria used to assess rheumatoid arthritis, a number of new criteria such as the PsAJAI and CPDAI are being developed specifically for PsA. Long-term consequences of untreated PsA include persistent inflammation, progressive joint damage and, in many cases, substantial functional limitations, pain and disability. Moreover, patients with PsA have an increased mortality risk and an increased risk of developing cardiovascular disease and metabolic syndrome. Both GRAPPA and the AAD have developed treatment guidelines, which are discussed here. Psoriasis commonly precedes arthritic symptoms; thus, dermatologists are ideally placed to make the initial diagnosis of PsA and treat it appropriately, affording the opportunity to slow disease progression, improve physical function and enhance quality of life. This Review explores the management of patients with PsA, with a particular emphasis on assessment tools, long-term consequences and treatment issues from the viewpoint of the dermatologist.

Certolizumab pegol and secukinumab for treating active psoriatic arthritis following inadequate response to disease-modifying antirheumatic drugs: a systematic review and economic evaluation

“…l PsARC identifies only relative changes from baseline and overestimates the number of responders. 27 In general, PsARC placebo response rates are higher than other composite measures. 28 …”

“…The Cochrane highly sensitive search strategy for identifying randomised trials in Ovid MEDLINE: sensitivity maximising version was used to limit retrieval to clinical trials (lines [25][26][27][28][29][30][31][32][33][34][35]. 148 The search was updated on 28 April 2016 and retrieved 749 records.…”

Clinical and epidemiological characterization of psoriasis and psoriatic arthritis in a multidisciplinary assessment model

“…Between both groups it was possible to observe differences in the ESR values, in the group of presented nail psoriasis. The median PASI score was 5.4 (1.5, 16.4); 61.3% of the participants had a mild disease, 6.5% [2] had moderate disease and 32.3% [8] had severe disease. The median of the NAPSI score was 45.…”

“…The disorder affects approximately 1-3% of the world population [2]. Psoriatic arthritis (PsA) is a spondyloarthritic condition, which is present in up to 42% of individuals with psoriasis and up to 15% of patients with psoriasis may have undiagnosed PsA [3].…”

A Needs-Based Rheumatologist Education Program on Treating to Target in Psoriatic Arthritis and Spondyloarthropathy: Insights and Challenges

“…Topics on PsA included the classification of peripheral and axial PsA [5] [6], data on sacroilitis and skin involvement [7], characteristics of the typical PsA patient in Canadian practices [8], EULAR treatment recommendations [9] as com-pared to GRAPPA recommendations [10], and data from the TICOPA trial [1]. Data for early identification of PsA and SpA were discussed [11], as was predictors of poor outcomes [12] [13], consequences of diagnostic delay [14], the relationship between skin involvement and PsA risk [15] [16], and available and emerging agents within pathways such as PDE4, IL-12, IL-23, and IL-17.…”