title: Treatment strategies for early psoriatic arthritis.
abstract: BACKGROUND
  Until a few years ago, the early diagnosis of psoriatic arthritis (PsA) did not receive much attention, especially in view of the lack of drugs capable of altering the disease course. This changed with the introduction of the TNF-alpha-blocking agents, as a result of which the early diagnosis of PsA is now a topic of great interest.
  
  
  OBJECTIVE
  The aim of the study was to review the treatment for PsA in order to determine the optimal approach to managing early disease.
  
  
  METHODS
  The systematic review performed by members of GRAPPA (Group of Research and Assessment of Psoriasis and Psoriatic Arthritis) was integrated with data from more recent studies.
  
  
  CONCLUSIONS
  After making the diagnosis of PsA, the next step is to stage of the disease with the aim of establishing the prevalent manifestation (peripheral arthritis, peripheral enthesitis, axial involvement and dactylitis) and degree of severity (mild, moderate or severe) of the disease. Each patient should be treated according to the defined disease status following the suggested treatment algorithms.
authors.affiliation: San Carlo Hospital of Potenza, Rheumatology Department Contrada Macchia Romana, 85100, Potenza, Italy. i.olivieri@ospedalesancarlo.it
authors.forename: Ignazio
authors.initials: I
authors.lastname: Olivieri
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Angelo
authors.forename: Carlo
authors.initials: C
authors.lastname: Palazzi
authors.forename: Angela
authors.initials: A
authors.lastname: Padula
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D006801:Humans; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D052246:Cyclooxygenase 2 Inhibitors; D014409:Tumor Necrosis Factor-alpha