Diagnosing and Treating Psoriatic Arthritis: An Update
Diagnosing and Treating Psoriatic Arthritis: An Update
PsA is among the most significant comorbidities associated with psoriasis, resulting in pain and deformities that limit function and reduce QoL. Additionally, patients with PsA are at greater risk for developing metabolic syndrome and cardiovascular disease and should be routinely monitored for cardiovascular risk factors. PsA may lead to progressive joint deterioration, which treatment may slow or prevent. Because psoriasis often presents years before the onset of PsA, the dermatologist is uniquely positioned to recognize the early signs of PsA. In many cases, dermatologists may choose to work closely with rheumatologists to minimize symptoms, slow disease progression and maximize QoL. Many treatment options are currently approved for PsA, with biologic DMARDs producing significant improvements in disease activity and progression. Interestingly, anti-TNF therapy was recently shown to improve cardiovascular comorbidities associated with PsA, suggesting clinical benefit beyond treating joint symptoms and supporting a comprehensive approach to long-term care. Several additional biologics targeting inflammatory pathways are currently under investigation for the treatment of PsA.
Conclusions
PsA is among the most significant comorbidities associated with psoriasis, resulting in pain and deformities that limit function and reduce QoL. Additionally, patients with PsA are at greater risk for developing metabolic syndrome and cardiovascular disease and should be routinely monitored for cardiovascular risk factors. PsA may lead to progressive joint deterioration, which treatment may slow or prevent. Because psoriasis often presents years before the onset of PsA, the dermatologist is uniquely positioned to recognize the early signs of PsA. In many cases, dermatologists may choose to work closely with rheumatologists to minimize symptoms, slow disease progression and maximize QoL. Many treatment options are currently approved for PsA, with biologic DMARDs producing significant improvements in disease activity and progression. Interestingly, anti-TNF therapy was recently shown to improve cardiovascular comorbidities associated with PsA, suggesting clinical benefit beyond treating joint symptoms and supporting a comprehensive approach to long-term care. Several additional biologics targeting inflammatory pathways are currently under investigation for the treatment of PsA.
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