title: [Therapy of psoriatic arthritis].
abstract: In psoriatic arthritis (PsA) the heterogeneous spectrum of the disease with arthritis/synovitis, axial manifestation, enthesitis, dactylitis, psoriatic skin disease and nail psoriasis has to be considered. Moreover, PsA activity and severity as well as comorbidities are of importance for making therapeutic decisions. Measurement instruments developed for therapeutic studies of rheumatoid arthritis or ankylosing spondylitis are often not appropriate for application in PsA investigations. In this paper established therapies with nonsteroidal antirheumatic drugs, disease modifying antirheumatic drugs (DMARDs) and TNF-alpha inhibitors and the current EULAR guidelines from 2012 are reviewed. However, there is a need for new therapeutic agents for those patients who do not respond to or do not tolerate the current therapies. Other biologic agents have also been tested for PsA with moderate effects only. New therapeutic options could result from the anti-IL12 and anti-IL23 receptor monoclonal antibody ustekinumab and from small molecules such as the oral PDE-4 inhibitor apremilast.
authors.affiliation: Klinik Innere Medizin IV (Rheumatologie, klinische Immunologie, Nephrologie), HSK Dr. Horst Schmidt Kliniken GmbH, Ludwig Erhard Str. 100, 65199, Wiesbaden, Deutschland, Elisabeth.Maerker-Hermann@HSK-Wiesbaden.de.
authors.forename: E
authors.initials: E
authors.lastname: Märker-Hermann
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000628:therapy*; D001688:Biological Products / Q000008:administration & dosage*; D006801:Humans; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha
references.citation: Z Rheumatol. 2009 Feb;68(1):16-22
references.pmid: 19148655
references.citation: Rheumatology (Oxford). 2012 Jul;51(7):1261-8
references.pmid: 22378715
references.citation: Clin Rheumatol. 2010 Oct;29(10):1169-73
references.pmid: 20532937
references.citation: Lancet. 2013 Aug 31;382(9894):780-9
references.pmid: 23769296
references.citation: Arthritis Rheum. 2004 Jun;50(6):1939-50
references.pmid: 15188371
references.citation: Lancet. 2008 May 17;371(9625):1675-84
references.pmid: 18486740
references.citation: Arthritis Rheum. 2011 Feb;63(2):382-90
references.pmid: 21279995
references.citation: Dermatology. 2012;225(1):14-7
references.pmid: 22890275
references.citation: Arthritis Rheum. 1996 Dec;39(12):2013-20
references.pmid: 8961906
references.citation: Arthritis Care Res (Hoboken). 2013 Mar;65(3):464-70
references.pmid: 23042698
references.citation: Ann Rheum Dis. 2006 Mar;65(3):405-7
references.pmid: 16150791
references.citation: Ann Rheum Dis. 2010 Apr;69(4):671-6
references.pmid: 19740904
references.citation: Lancet. 2009 Feb 21;373(9664):633-40
references.pmid: 19217154
references.citation: J Rheumatol. 2012 Dec;39(12):2327-31
references.pmid: 22896028
references.citation: Arthritis Rheum. 2013 May;65(5):1213-23
references.pmid: 23460467
references.citation: Ann Rheum Dis. 2011 Feb;70(2):272-7
references.pmid: 21115550
references.citation: Ann Rheum Dis. 2010 Feb;69(2):394-9
references.pmid: 19815494
references.citation: Arthritis Rheum. 2011 Apr;63(4):939-48
references.pmid: 21128258
references.citation: Ann Rheum Dis. 2012 Jan;71(1):4-12
references.pmid: 21953336
references.citation: Ann Rheum Dis. 2014 Feb;73(2):349-56
references.pmid: 23361084
references.citation: Ann Rheum Dis. 2012 Nov;71(11):1868-71
references.pmid: 22833373
references.citation: Biologics. 2012;6:417-27
references.pmid: 23271892
references.citation: J Rheumatol. 2012 Mar;39(3):568-73
references.pmid: 22247361
references.citation: Rheumatology (Oxford). 2012 Aug;51(8):1368-77
references.pmid: 22344575
references.citation: Arthritis Rheum. 2012 Oct;64(10):3156-67
references.pmid: 22806399