Spondyloarthritis & psoriatic arthritis
EULAR points to consider and consensus definitions for difficult-to-manage and treatment-refractory psoriatic arthritis
Methodological detailsEULAR standardised operating procedures, systematic literature review, consensus process, multidisciplinary international task force
- EULAR standardised operating procedures
- Systematic literature review
- Consensus process
- Multidisciplinary international task force
Recommendations
As issued by the authors
4 overarching principles: a proportion of patients with psoriatic arthritis (PsA) have an unsatisfactory treatment response despite the best standard of care; causes likely multifactorial
6 points to consider (PtC): failure to achieve or maintain response to ≥2 b/tsDMARDs with ≥2 different mechanisms of action; management of signs and symptoms perceived as problematic by the rheumatologist and/or the patient; evidence of persistent disease activity with extramusculoskeletal manifestations and/or comorbidities and/or objective evidence of inflammatory activity
Definition 1: D2M PsA, an umbrella term including drivers such as inflammation, comorbidities, psychosocial or other factors
Definition 2: Treatment-refractory (TR) PsA (within D2M PsA), defined by persistent disease activity and objective evidence of active inflammation
Original publication
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