Targeted therapies for psoriatic arthritis: an update for the dermatologist

Semin Cutan Med Surg. 2018 Sep;37(3):173-181. doi: 10.12788/j.sder.2018.045.

Abstract

Dermatologists are on the front line to identify psoriatic arthritis (PsA) in their patients with psoriasis. PsA is a prevalent and underdiagnosed disease with potential long-term complications and sequelae for patients. Targeted biologics have transformed the landscape of psoriasis and PsA therapy. These medications variably treat clinical manifestations of psoriatic disease: skin psoriasis, peripheral and axial arthritis, enthesitis, and nail disease. With many new medications either on the market or currently being evaluated by the Food and Drug Administration, the purpose of this article is to review PsA for the dermatologist, to identify the current therapies that are available, and to help select which patients may benefit from these medications. Overall, it is important to decide therapy for patients based on the active domains of their disease, their comorbidities, and the safety profiles of these medications, as well as patient preference for route of administration, frequency, and tolerability.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Psoriatic / diagnosis
  • Arthritis, Psoriatic / drug therapy*
  • Dermatologic Agents / therapeutic use*
  • Dermatology
  • Humans
  • Interleukin-17 / antagonists & inhibitors
  • Interleukin-23 / antagonists & inhibitors
  • Janus Kinase Inhibitors / therapeutic use*
  • Molecular Targeted Therapy*
  • Phosphodiesterase 4 Inhibitors / therapeutic use*
  • Piperidines / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrroles / therapeutic use
  • Severity of Illness Index
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Dermatologic Agents
  • Interleukin-17
  • Interleukin-23
  • Janus Kinase Inhibitors
  • Phosphodiesterase 4 Inhibitors
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • Tumor Necrosis Factor-alpha
  • Thalidomide
  • tofacitinib
  • apremilast