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Psoriatic Arthritis: Clinical Review and Update

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Advances in Psoriasis

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Abstract

Psoriatic arthritis (PsA) a debilitating, seronegative spondyloarthropathy associated with psoriasis. The prevalence of PsA among psoriatic patients is estimated to be between 7 and 42 %. Skin lesions of psoriasis most often precede arthritic symptoms, however up to 20 % of patients with PsA manifest joint disease prior to skin involvement. Potential benefits of treatment include better quality of life and radiologic improvement of joint damage. Currently no universally accepted gold standard exists for diagnosing PsA, although the ClASsification criteria for Psoriatic Arthritis (CASPAR) criteria may gain widespread acceptance. While there is no universal agreement on the most accurate methods to evaluate PsA treatment, the Outcome Measures in Rheumatology (OMERACT) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommend using tools to assess of joint, skin, function, pain, patient’s global assessment and quality of life. Treatment guidelines vary between GRAPPA and AAD, but generally recommend that mild PsA should be managed with NSAIDs and intralesional corticosteroid injections, and moderate to severe PsA should be managed with methotrexate or biologics. Biologic therapies, including TNF-α inhibitors, are recommended in the treatment of moderate to severe PsA, especially those patients with poor prognostic factors. With the potential benefits of early treatment, dermatologists and rheumatologists are strongly encouraged to assess patients for the signs and symptoms of PsA at each visit.

Disclosure of Relevant Relationships with Industry

Current Consulting/Advisory Board Agreements:

Amgen Inc.; Astellas, Akros, Centocor (Janssen), Inc.; Celgene Corp., Bristol Myers Squibb Co., Beiersdorf, Inc., Abbott Labs. (Abbvie), TEVA, Actelion, UCB, Novo Nordisk, Novartis, Dermipsor Ltd., Incyte, Pfizer, Canfite, Lilly, Coronado, Vertex, Karyopharm, CSL Behring Biotherapies for Life, Glaxo Smith Kline, Xenoport

Research/Educational Grants (paid to Tufts Medical Center):

Centocor (Janssen), Amgen, Abbott (Abbvie), Novartis, Celgene, Pfizer, Lilly, Coronado, Levia

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Authors and Affiliations

  1. Department of Dermatology, Tufts Medical Center, 800 Washington St., 114, Boston, MA, 02111, USA

    Shiu-chung Au MD, Noori Kim MD, Ari M. Goldminz BA, Maha Abdulrahman Alkofide MD & Alice B. Gottlieb MD, PhD

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  1. Shiu-chung Au MD
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  2. Noori Kim MD
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  3. Ari M. Goldminz BA
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  4. Maha Abdulrahman Alkofide MD
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  5. Alice B. Gottlieb MD, PhD
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Correspondence to Shiu-chung Au MD .

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  1. St. Luke's -Roosevelt Hospital Center, New York, New York, USA

    Jeffrey M. Weinberg

  2. Department of Dermatology, Icahn School of Medicine, New York, New York, USA

    Mark Lebwohl

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Au, Sc., Kim, N., Goldminz, A.M., Alkofide, M.A., Gottlieb, A.B. (2014). Psoriatic Arthritis: Clinical Review and Update. In: Weinberg, J., Lebwohl, M. (eds) Advances in Psoriasis. Springer, London. https://doi.org/10.1007/978-1-4471-4432-8_5

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