Managing psoriatic arthritis in different clinical scenarios.

Autor:	Queiro R; Rheumatology & ISPA Translational Immunology Division, Central University Hospital of Asturias, Oviedo, Spain.; Department of Medicine, Oviedo University School of Medicine, Oviedo, Spain., Loredo M; Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain., Braña I; Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain., Pardo E; Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain., Alonso S; Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain., Alperi M; Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain.
Jazyk:	angličtina
Zdroj:	Expert review of clinical immunology [Expert Rev Clin Immunol] 2023 Jul-Dec; Vol. 19 (12), pp. 1469-1484. Date of Electronic Publication: 2023 Aug 21.
DOI:	10.1080/1744666X.2023.2249235
Abstrakt:	Introduction: Psoriatic arthritis (PsA) is a chronic, immune-mediated disease characterized by synovio-entheseal inflammation. It is estimated to affect around 30% of patients with psoriasis and significantly reduces patients' physical function and quality of life. There is a growing number of treatment options for PsA, but due to the heterogeneous clinical features of the disease and prevalence of comorbidities, managing PsA can be challenging. Areas Covered: In this article, we review current understanding of the disease and available pharmacological options. Based on published treatment guidelines, emerging evidence and clinical experience, we provide our expert opinion on treatment strategies, taking into consideration the predominant disease domain and the presence of comorbidities, which can impact treatment decisions and clinical outcomes. Expert Opinion: Biological and targeted synthetic disease-modifying agents are dramatically improving the lives of patients with PsA. Biosimilar TNF inhibitors offer a particularly versatile and cost-effective option, whilst newer biologics and targeted synthetic molecules that can be used to treat most domains of psoriatic disease are an attractive alternative to TNF inhibitors. Despite a lack of consensus on treatment sequencing and tapering, it is important that PsA patients, especially those with comorbidities, are looked after by a multidisciplinary team to optimize their care.
Databáze:	MEDLINE
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