Spondyloarthritis & psoriatic arthritis
EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update
Methodological detailssystematic literature review, consensus meeting of 36 international experts
- Systematic literature review
- Consensus meeting of 36 international experts
Recommendations
As issued by the authors
NSAIDs in monotherapy only for mild psoriatic arthritis (PsA) and in the short term; oral GCs not recommended.
Peripheral arthritis: rapid initiation of csDMARDs, MTX preferred.
If treatment target not achieved, initiate a biological disease-modifying antirheumatic drug (bDMARD), without preference among modes of action.
Relevant skin psoriasis should orient towards bDMARDs targeting IL-23p40, IL-23p19, IL-17A and IL-17A/F inhibitors.
Predominant axial or entheseal disease: an algorithm is proposed.
JAKi proposed primarily after bDMARD failure, taking relevant risk factors into account, or where bDMARDs are not an appropriate choice.
IBD and uveitis, if present, should influence drug choices, with monoclonal TNFi proposed.
Drug switches and tapering in sustained remission are also addressed.
Original publication
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