title: Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics.
abstract: Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this second of 5 sections of the guidelines of care for psoriasis, we give an overview of psoriatic arthritis including its cardinal clinical features, pathogenesis, prognosis, classification, assessment tools used to evaluate psoriatic arthritis, and the approach to treatment. Although patients with mild to moderate psoriatic arthritis may be treated with nonsteroidal anti-inflammatory drugs and/or intra-articular steroid injections, the use of disease-modifying antirheumatic drugs, particularly methotrexate, along with the biologic agents, are considered the standard of care in patients with more significant psoriatic arthritis. We will discuss the use of disease-modifying antirheumatic drugs and the biologic therapies in the treatment of patients with moderate to severe psoriatic arthritis.
authors.affiliation: Department of Dermatology, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Gottlieb
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Korman
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Gordon
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Mark
authors.initials: M
authors.lastname: Lebwohl
authors.forename: John Y M
authors.initials: JY
authors.lastname: Koo
authors.forename: Abby S
authors.initials: AS
authors.lastname: Van Voorhees
authors.forename: Craig A
authors.initials: CA
authors.lastname: Elmets
authors.forename: Craig L
authors.initials: CL
authors.lastname: Leonardi
authors.forename: Karl R
authors.initials: KR
authors.lastname: Beutner
authors.forename: Reva
authors.initials: R
authors.lastname: Bhushan
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D000068879:Adalimumab; D000077944:Alefacept; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D001688:Biological Products / Q000627:therapeutic use*; D000068800:Etanercept; D019317:Evidence-Based Medicine; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D001688:Biological Products; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D014409:Tumor Necrosis Factor-alpha; D000077944:Alefacept; D000068879:Adalimumab; D000068800:Etanercept; D008727:Methotrexate