Psoriatic Arthritis: Pearls from Arthur Kavanaugh, MD

There is increasing evidence that early diagnosis and treatment of PsA results in improved outcomes
There exists a large gap and unmet need in PsA, with many patients not being evaluated by doctors or receiving appropriate therapy
Because skin manifestations usually precede joint involvement, often by years, Dermatologists play a key role in PsA diagnosis. However, this can present challenges.
New guidelines for PsA treatment are under development, and may provide some assistance to clinicians.
TNF inhibitors have allowed improved outcomes in PsA, and there continues to be great interest in optimizing therapy with these agents.
There is great interest in new targets and agents for the treatment of PsA. Recently revealed data with IL-17 inhibition show promise for treatment of all the various domains of PsA, including peripheral arthritis, skin and nail disease, enthesitis and dactylitis, and axial/spinal arthritis.
The IL-12/23 inhibitor ustekinumab was approved last year in PsA and has been shown to be effective across domains of disease.
The PDE4 inhibitor apremilast received FDA approval for PsA 3/21/14 and for psoriasis 9/23/14. Its use is increasing in the clinic, for diverse PsA patients. Safety is a particularly attractive feature of this drug.
Additional agents are in development for PsA.
Optimal management of PsA depends on the levels of activity and severity across the various domains of disease.