title: Current approach to the management of psoriatic arthritis according to a sample of Italian rheumatologists.
abstract: OBJECTIVE
  The purpose of this study was to have an overview of the current approach to psoriatic arthritis (PsA) by a group of Italian rheumatologists.
  
  
  METHODS
  Rheumatologists from all around Italy were asked to participate in a survey to give their opinion on a number of statements made by a panel of rheumatologists who are experts in PsA. The survey was conducted through two rounds using a Delphi-like method. The two rounds yielded a consensus on the management of PsA.
  
  
  RESULTS
  Fifty rheumatologist from 50 rheumatology centres participated in the survey. Of the 117 proposed statements, only 10 did not reach the 66% concordance threshold. The main results of the survey were that diagnosis of PsA should be made using both the CASPAR criteria and clinical judgment, that all of the features of the psoriatic disease are relevant in the assessment and therapy of PsA, that treatment recommendations are taken into account, that all of the available biological agents may be used in bio-naïve patients, that anti-drug antibody testing is still not used in daily practice, that both switching or swapping are useful options in the case of bio-failure because of lack or loss of efficacy, and that swapping is considered the best choice in the case of bio-failure due to adverse events.
  
  
  CONCLUSIONS
  The results of this survey showed that a comprehensive evaluation of the patient and a therapy choice based on both patient clinical features and evidence of drug efficacy and safety are considered the current best of care for PsA patients.
authors.affiliation: Day Hospital of Rheumatology, Gaetano Pini-CTO Orthopaedic Traumatologic Centre, Milan, Italy. marchesoni@gpini.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchesoni
authors.affiliation: Academic Rheumatology Unit, Dipartimento di Medicina e Scienze per la Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.affiliation: Day Hospital of Rheumatology, Gaetano Pini-CTO Orthopaedic Traumatologic Centre, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Manara
authors.affiliation: Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ramonda
authors.affiliation: Rheumatology Unit, Azienda Ospedaliera-IRCCS di Reggio Emilia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
authors.affiliation: Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Olivieri
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D000072140:Rheumatologists; D012219:Rheumatology; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products