The introduction of highly effective therapies and clearly defined targets has altered the treatment paradigm in psoriatic arthritis (PsA). Validated classification criteria and outcome measures specific to PsA have helped standardize a therapeutic approach to this heterogeneous disease that affects multiple clinical domains. This article discusses the importance of early intervention using a treat-to-target strategy; emerging evidence for tight control based on minimal disease activity criteria; disease considerations specific to PsA (prognostic markers, biomarkers, subclinical disease, comorbidities); and new treatment strategies to deal with refractory disease (eg, tumor necrosis factor inhibitor switching and use of novel disease-modifying therapies) and controlled disease (eg, tapering or discontinuing biologic therapy).
Keywords: Anti-TNF drugs; Comorbidities; DMARDs (biologic); Dose reduction; Minimal disease activity criteria; Psoriatic arthritis; Tight control; Treat-to-target.
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