Management of Psoriatic Arthritis

General measures

• joint protection
• exercise
• weight loss
• reduction of stress
• physical therapy, occupational therapy. Note: there is no randomized control trial (RCT) which assesses the benefit of physical therapy in patients

Classical Medication

• NSAIDS: Non Steroidal Anti Inflammatory Drugs
• Leflunomide
• Sulfasalazine
• Corticosteroids (intraarticular injections)
• Methotrexate (MTX): improves symptoms but does not delay radiographic progression of the disease
• Ciclosporine

“Biologics”

• Adalimumab (Humira)
• Etanercept (Enbrel)
• Infliximab (Remicade)
• Golimumab
• Overall efficacy of ACR  20 is reached in 50% of cases (ACR=American College of Rheumatology scoring system)

Comments

• Apremilast (Otezla), although no mentioned also shows interesting results
• Il -7 inhibitors such as ustekinumab and brodalumab (withdrawn at time of publication) respond more in a delayed way on the arthritis, although they work effectively on the skin

Psoriatic arthritis for the dermatologist. Alan Menter (United States). SY31 – Clinical Aspects of Psoriasis, Including Co-Morbidities. World Congress of Dermatology 2015 –  Vancouver, Canada