Current Treatment Options in Rheumatology

, Volume 4, Issue 2, pp 197–213 | Cite as

Disease Modification in Psoriatic Arthritis

  • Alicia LiebermanEmail author
  • Christopher Ritchlin
Seronegative Arthritis (N Haroon, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Seronegative Arthritis


Purpose of review

To provide clinicians evidence-based strategies to diagnose and treat psoriatic arthritis (PsA) patients based on involvement of the key domains peripheral arthritis, psoriasis and nails, axial involvement, dactylitis, and enthesitis, with the goal of improving outcomes for PsA patients by lessening joint pain and swelling and the degree of inflammation in the other key domains. It is also imperative to limit or eliminate progressive X-ray damage.

Recent findings

Evidence from phase III randomized trials demonstrate that agents that inhibit tumor necrosis factor (TNF), interleukin (IL)-17, and IL12/23 relieve joint inflammation and decrease or completely inhibit radiographic progression. Agents that block TNF and IL-17 are also effective for axial disease. Additional agents effective for psoriatic arthritis but without documentation of effect on progressive damage include apremilast, abatacept, and tofacitinib. Most agents have demonstrated efficacy for treatment of enthesitis and dactylitis.


A number of therapies that effectively treat the key domains of psoriatic arthritis are now available. Comprehensive assessment of patients to determine the extent and degree of domain involvement is essential to properly individualize treatment, improve outcomes, and limit progressive joint damage.


Psoriatic arthritis Domains Disease modification Biologic agents 


Compliance with ethical standards

Conflict of interest

Dr. Ritchlin reports grants and personal fees from Abbvie, grants and personal fees from Amgen, grants and personal fees from UCB, personal fees from Novartis, personal fees from Pfizer, personal fees from Lilly, and personal fees from Janssen, during the conduct of the study. Dr. Lieberman declares no conflict of interest.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Moll JM, Wright V. Psoriatic arthritis. Semin Arthritis Rheum. 1973;3(1):55–78.CrossRefPubMedGoogle Scholar
  2. 2.
    Coates LC, Helliwell PS. Psoriatic arthritis: state of the art review. Clin Med. 2017;17(1):65–70.CrossRefGoogle Scholar
  3. 3.
    Ogdie A, Schwartzman S, Husni ME. Recognizing and managing comorbidities in psoriatic arthritis. Curr Opin Rheumatol. 2015;27(2):118–26.CrossRefPubMedGoogle Scholar
  4. 4.
    Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin N Am. 2015;41(4):545–68.CrossRefGoogle Scholar
  5. 5.
    Haroon M, Gallagher P, FitzGerald O. Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2015;74(6):1045–50.CrossRefPubMedGoogle Scholar
  6. 6.
    • Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med. 2017;376(10):957–70. Recent comprehensive review of PsA.CrossRefPubMedGoogle Scholar
  7. 7.
    Coates LC, Kavanaugh A, Mease PJ, et al. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheum (Hoboken, NJ). 2016;68(5):1060–71. Scholar
  8. 8.
    Kavanaugh AF, Ritchlin CT, Committee GTG. Systematic review of treatments for psoriatic arthritis: an evidence based approach and basis for treatment guidelines. J Rheumatol. 2006;33(7):1417–21.PubMedGoogle Scholar
  9. 9.
    Armstrong AW, Koning JW, Rowse S, Tan H, Mamolo C, Kaur M. Under-treatment of patients with moderate to severe psoriasis in the United States: analysis of medication usage with health plan data. Dermatol Ther (Heidelb). 2017;7(1):97–109.CrossRefGoogle Scholar
  10. 10.
    Sbidian E, Chaimani A, Garcia-Doval I, Do G, Hua C, Mazaud C, et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev. 2017;12:CD011535. Scholar
  11. 11.
    Okhovat JP, Ogdie A, Reddy SM, Rosen CF, Scher JU, Merola JF. Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network Consortium (PPACMAN) Survey: benefits and challenges of combined rheumatology-dermatology clinics. J Rheumatol. 2017;44(5):693–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Helliwell P, Coates L, Chandran V, Gladman D, de Wit M, FitzGerald O, et al. Qualifying unmet needs and improving standards of care in psoriatic arthritis. Arthritis Care Res (Hoboken). 2014;66(12):1759–66.CrossRefGoogle Scholar
  13. 13.
    Ritchlin C. Spondyloarthritis: closing the gap in psoriatic arthritis. Nat Rev Rheumatol. 2014;10(12):704–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Tillett W, Charlton R, Nightingale A, Snowball J, Green A, Smith C, et al. Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. Rheumatology (Oxford). 2017;56(12):2109–13.CrossRefGoogle Scholar
  15. 15.
    Ritchlin C. Psoriatic disease—from skin to bone. Nat Clin Pract Rheumatol. 2007;3(12):698–706.CrossRefPubMedGoogle Scholar
  16. 16.
    Coates LC, Helliwell PS. Defining low disease activity states in psoriatic arthritis using novel composite disease instruments. J Rheumatol. 2016;43(2):371–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Cutolo M, Myerson GE, Fleischmann RM, Lioté F, Díaz-González F, Filip Van den B, et al. A phase III, randomized, controlled trial of apremilast in patients with psoriatic arthritis: Results of the palace 2 trial. J Rheumatol. 2016;43(9):1724–34.
  18. 18.
    Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, et al. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012;51(8):1368–77.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Clegg DO, Reda DJ, Mejias E, Cannon GW, Weisman MH, Taylor T, et al. Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis. A Department of Veterans Affairs Cooperative Study. Arthritis Rheum. 1996;39(12):2013–20.CrossRefPubMedGoogle Scholar
  20. 20.
    Kaltwasser JP, Nash P, Gladman D, Rosen CF, Behrens F, Jones P, et al. Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: a multinational, double-blind, randomized, placebo-controlled clinical trial. Arthritis Rheum. 2004;50:1939–50. Scholar
  21. 21.
    • Coates LC, Moverley AR, McParland L, Brown S, Navarro-Coy N, O’Dwyer JL, et al. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015;386(10012):2489–98. First study to examine tighy control versus usual care of patients with PsA.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Keating GM. Apremilast: a review in psoriasis and psoriatic arthritis. Drugs. 2017;77(4):459–72.CrossRefPubMedGoogle Scholar
  23. 23.
    Mease PJ, Kivitz AJ, Burch FX, Siegel EL, Cohen SB, Ory P, et al. Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum. 2004;50(7):2264–72.CrossRefPubMedGoogle Scholar
  24. 24.
    Antoni C, Krueger GG, de Vlam K, Birbara C, Beutler A, Guzzo C, et al. Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial. Ann Rheum Dis. 2005;64(8):1150–7.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Mease PJ, Gladman DD, Ritchlin CT, Ruderma EM, Steinfeld SD, Choy EHS, et al. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2005;52:3279–89. Scholar
  26. 26.
    Kavanaugh A, van der Heijde D, McInnes IB, Mease P, Krueger GG, Gladman DD, et al. Golimumab in psoriatic arthritis: One-year clinical efficacy, radiographic, and safety results from a phase III, randomized, placebo-controlled trial. Arthritis Rheum. 2012;64:2504–17. Scholar
  27. 27.
    Mease PJ, Fleischmann R, Deodhar AA, Wollenhaupt J, Khraishi M, Kielar D, et al. Effect of certolizumab pegol on signs and symptoms in patients with psoriatic arthritis: 24-week results of a phase 3 double-blind randomised placebo-controlled study (RAPID-PsA). Ann Rheum Dis. 2014;73(1):48–55.CrossRefPubMedGoogle Scholar
  28. 28.
    • Kavanaugh A, Husni ME, Harrison DD, Kim L, Lo KH, Leu JH, et al. Safety and efficacy of intravenous golimumab in patients with active psoriatic arthritis: results through week twenty-four of the GO-VIBRANT study. Arthritis Rheum. 2017;69(11):2151–61. This phase III trial demonstrated that IV golimumab is very effective for all the domains of PsA and it inhibited radiographic progression.CrossRefGoogle Scholar
  29. 29.
    Mease PJ. Biologic therapy for psoriatic arthritis. Rheum Dis Clin N Am. 2015;41(4):723–38.CrossRefGoogle Scholar
  30. 30.
    Kavanaugh A, Ritchlin C, Rahman P, Puig L, Gottlieb AB, Li S, et al. Ustekinumab, an anti-IL-12/23 p40 monoclonal antibody, inhibits radiographic progression in patients with active psoriatic arthritis: results of an integrated analysis of radiographic data from the phase 3, multicentre, randomised, double-blind, placebo-controlled PSUMMIT-1 and PSUMMIT-2 trials. Ann Rheum Dis. 2014;73(6):1000–6.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Ritchlin C, Rahman P, Kavanaugh A, McInnes IB, Puig L, Li S, et al. Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial. Ann Rheum Dis. 2014;73(6):990–9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    • Mease PJ, Gottlieb AB, van der Heijde D, FitzGerald O, Johnsen A, Nys M, et al. Efficacy and safety of abatacept, a T-cell modulator, in a randomised, double-blind, placebo-controlled, phase III study in psoriatic arthritis. Ann Rheum Dis. 2017;76(9): 1550–1558. T Abatacept was approved by the FDA for treatment of PsA based on the results from this phase III study. The trial showed modest results on joint inflammation and resolution of psoriatic plaques. No radiographic data was presented.Google Scholar
  33. 33.
    McInnes IB, Sieper J, Braun J, Emery P, van der Heijde D, Isaacs JD, et al. Efficacy and safety of secukinumab, a fully human anti-interleukin-17A monoclonal antibody, in patients with moderate-to-severe psoriatic arthritis: a 24-week, randomised, double-blind, placebo-controlled, phase II proof-of-concept trial. Ann Rheum Dis. 2014;73(2):349–56.CrossRefPubMedGoogle Scholar
  34. 34.
    •• Mease PJ, van der Heijde D, Ritchlin CT, Okada M, Cuchacovich RS, Shuler CL, et al. Ixekizumab, an interleukin-17A specific monoclonal antibody, for the treatment of biologic-naive patients with active psoriatic arthritis: results from the 24-week randomised, double-blind, placebo-controlled and active (adalimumab)-controlled period of the phase III trial SPIRIT-P1. Ann Rheum Dis. 2017;76(1):79–87. This study in DMARD refractory PsA patients demonstrated strong efficacy and safety although enthesitis responses were not impressive.CrossRefPubMedGoogle Scholar
  35. 35.
    •• Nash P, Kirkham B, Okada M, Rahman P, Combe B, Burmester GR, et al. Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors: results from the 24-week randomised, double-blind, placebo-controlled period of the SPIRIT-P2 phase 3 trial. Lancet. 2017;389(10086):2317–27. Ixekizumab was effective in PsA patients who were inadequate responders to TNFi agents.CrossRefPubMedGoogle Scholar
  36. 36.
    Deodhar AA, Gottlieb AB, Boehncke WH, Dong B, Wang Y, Barchuk W, et al. Efficacy and safety results of guselkumab, an anti-IL23 monoclonal antibody, in patients with active psoriatic arthritis over 24 weeks: a phase 2a, randomized, double-blind, placebo-controlled study. Arthritis Rheum. 2016;68(suppl 10)Google Scholar
  37. 37.
    Boehncke WH, Schon MP. Psoriasis. Lancet. 2015;386(9997):983–94.CrossRefPubMedGoogle Scholar
  38. 38.
    Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION). Br J Dermatol. 2008;158(3):558–66.CrossRefPubMedGoogle Scholar
  39. 39.
    Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1). J Am Acad Dermatol. 2015;73(1):37–49.CrossRefPubMedGoogle Scholar
  40. 40.
    Papp KA, Krueger HG, Feldman SR, Langley RG, Thaci D, Torii H, et al. Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: long-term efficacy and safety results from 2 randomized phase-III studies and 1 open-label long-term extension study. J Am Acad Dermatol. 2016;74(5):841–50.CrossRefPubMedGoogle Scholar
  41. 41.
    Tsai YC, Tsai TF. Anti-interleukin and interleukin therapies for psoriasis: current evidence and clinical usefulness. Ther Adv Musculoskelet Dis. 2017;9(11):277–94.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Blauvelt A, Papp KA, Griffiths CE, Randazzo B, Wasfi Y, Shen YL, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405–17.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Jabbar-Lopez ZK, Yiu ZZN, Ward V, Exton LS, Mohd Mustapa MF, Samarasekera E, et al. Re: Quantitative evaluation of biologic therapy options for psoriasis: a systematic review and network meta-analysis. J Invest Dermatol. 2017;137(12):2644–6.CrossRefPubMedGoogle Scholar
  44. 44.
    Gomez-Garcia F, Epstein D, Isla-Tejera B, Lorente A, Velez Garcia-Nieto A, Ruano J. Short-term efficacy and safety of new biological agents targeting the interleukin-23-T helper 17 pathway for moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis. Br J Dermatol. 2017;176(3):594–603.CrossRefPubMedGoogle Scholar
  45. 45.
    Nieradko-Iwanicka B. Nail psoriasis—what a rheumatologist should know about. Reumatologia. 2017;55(1):44–7.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Ventura A, Mazzeo M, Gaziano R, Galluzzo M, Bianchi L, Campione E. New insight into the pathogenesis of nail psoriasis and overview of treatment strategies. Drug Des Devel Ther. 2017;11:2527–35.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Jadon DR, Sengupta R, Nightingale A, Lindsay M, Korendowych E, Robinson G, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis. 2017;76(4):701–7.CrossRefPubMedGoogle Scholar
  48. 48.
    Ward MM, Deodhar A, Akl EA, Lui A, Ermann J, Gensler LS, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheum. 2016;68(2):282–98.CrossRefGoogle Scholar
  49. 49.
    Baeten D, Sieper J, Braun J, Baraliakos X, Dougados M, Emery P, et al. Secukinumab, an interleukin-17A Inhibitor, in ankylosing spondylitis. N Engl J Med. 2015;373(26):2534–48.CrossRefPubMedGoogle Scholar
  50. 50.
    van der Heijde D, Deodhar A, Wei JC, Drescher E, Fleishaker D, Hendrikx T, et al. Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study. Ann Rheum Dis. 2017;76(8):1340–7.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Haroon N, Inman RD, Learch TJ, Weisman MH, Lee M, Rahbar MH, et al. The impact of tumor necrosis factor alpha inhibitors on radiographic progression in ankylosing spondylitis. Arthritis Rheum. 2013;65(10):2645–54.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Molnar C, Scherer A, Baraliakos X, de Hooge M, Micheroli R, Exer P, et al. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort. Ann Rheum Dis. 2018;77(1):63–9.CrossRefPubMedGoogle Scholar
  53. 53.
    Braun J, Baraliakos X, Deodhar A, Baeten D, Sieper J, Emery P, et al. Effect of secukinumab on clinical and radiographic outcomes in ankylosing spondylitis: 2-year results from the randomised phase III MEASURE 1 study. Ann Rheum Dis. 2017;76(6):1070–7.CrossRefPubMedGoogle Scholar
  54. 54.
    Mease PJ. Measures of psoriatic arthritis: tender and swollen joint assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S64–85.CrossRefGoogle Scholar
  55. 55.
    Mease PJ, Karki C, Palmer JB, Etzel CJ, Kavanaugh A, Ritchlin CT, et al. Clinical characteristics, disease activity, and patient-reported outcomes in psoriatic arthritis patients with dactylitis or enthesitis: results from the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. Arthritis Care Res (Hoboken). 2017;69(11):1692–9.CrossRefGoogle Scholar
  56. 56.
    Polachek A, Li S, Chandran V, Gladman DD. Clinical enthesitis in a prospective longitudinal psoriatic arthritis cohort: incidence, prevalence, characteristics, and outcome. Arthritis Care Res (Hoboken). 2017;69(11):1685–91.CrossRefGoogle Scholar
  57. 57.
    Kehl AS, Corr M, Weisman MH. Review:, Enthesitis: new insights into pathogenesis, diagnostic modalities, and treatment. Arthritis Rheum. 2016;68(2):312–22.CrossRefGoogle Scholar
  58. 58.
    Schett G, Lories RJ, D’Agostino MA, Elewaut D, Kirkham B, Soriano ER, et al. Enthesitis: from pathophysiology to treatment. Nat Rev. Rheum. 2017;13(12):731–41.CrossRefGoogle Scholar
  59. 59.
    McGonagle D, Lories RJ, Tan AL, Benjamin M. The concept of a “synovio-entheseal complex” and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum. 2007;56(8):2482–91.CrossRefPubMedGoogle Scholar
  60. 60.
    Sherlock JP, Joyce-Shaikh B, Turner SP, et al. IL-23 induces spondyloarthropathy by acting on ROR-gammat+ CD3+CD4-CD8- entheseal resident T cells. Nat Med. 2012;18:1069–76.CrossRefPubMedGoogle Scholar
  61. 61.
    Ramiro S, Smolen JS, Landewé R, van der Heijde D, Gossec L. How are enthesitis, dactylitis and nail involvement measured and reported in recent clinical trials of psoriatic arthritis? A systematic literature review. Ann Rheum Dis. 2017;,447.
  62. 62.
    Kavanaugh A, McInnes I, Mease P, Krueger GG, Gladman D, Gomez-Reino J, et al. Golimumab, a new human tumor necrosis factor alpha antibody, administered every four weeks as a subcutaneous injection in psoriatic arthritis: twenty-four-week efficacy and safety results of a randomized, placebo-controlled study. Arthritis Rheum. 2009;60(4):976–86.CrossRefPubMedGoogle Scholar
  63. 63.
    •• Gladman D, Rigby W, Azevedo VF, Behrens F, Blanco R, Kaszuba A, et al. Tofacitinib for psoriatic arthritis in patients with an inadequate response to TNF Inhibitors. N Engl J Med. 2017;377(16):1525–36. Phase III trial demonstrating efficacy for tofacitinib in PsA patients who were inadequate responders to TNFi agents.CrossRefPubMedGoogle Scholar
  64. 64.
    Mease P, Hall S, FitzGerald O, van der Heijde D, Merola JF, Avila-Zapata F, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017;377(16):1537–50.CrossRefPubMedGoogle Scholar
  65. 65.
    Kavanaugh A, Mease PJ, Gomez-Reino JJ, Adebajo AO, Wollenhaupt J, Gladman DD, et al. Treatment of psoriatic arthritis in a phase 3 randomised, placebo-controlled trial with apremilast, an oral phosphodiesterase 4 inhibitor. Ann Rheum Dis. 2014;73(6):1020–6.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Nash P, Ohson K, Walsh J, Delev N, Nguyen D, Teng L, et al. Early and sustained efficacy with apremilast monotherapy in biological-naïve patients with psoriatic arthritis: a phase IIIB, randomised controlled trial (ACTIVE). Ann Rheum Dis. 2018;,568.
  67. 67.
    Araujo EG, Englbrech M, Hoepken S, Finzel S, Hueber AJ, Rech J, et al. Ustekinumab is superior to TNF inhibitor treatment in resolving enthesitis in psa patients with active enthesitis—results from the enthesial clearance in psoriatic arthritis study [abstract]. Arthritis Rheum. 2017;69(suppl 10)Google Scholar
  68. 68.
    Siegel EL, Orbai AM, Ritchlin CT. Targeting extra-articular manifestations in PsA: a closer look at enthesitis and dactylitis. Curr Opin Rheum. 2015;27(2):111–7.CrossRefGoogle Scholar
  69. 69.
    Brockbank JE, Stein M, Schentag CT, Gladman DD. Dactylitis in psoriatic arthritis: a marker for disease severity? Ann Rheum Dis. 2005;64(2):188–90.CrossRefPubMedGoogle Scholar
  70. 70.
    Mease PJ, Lesperance T, Liu M, Collier DH, Mason M, Deveikis S, et al. Changes in treatment patterns in patients with psoriatic arthritis initiating biologic and nonbiologic therapy in a clinical registry. J Rheum. 2017;44(2):184–92.CrossRefPubMedGoogle Scholar
  71. 71.
    Damjanov N, Karpati S, Kemeny L, Bakos N, Bobic B, Majdan M, et al. Efficacy and safety of etanercept in psoriasis and psoriatic arthritis in the PRESTA study: analysis in patients from Central and Eastern Europe. J Dermatolog Treat. 2018;29(1):8–12.CrossRefPubMedGoogle Scholar
  72. 72.
    • McInnes IB, Mease PJ, Kirkham B, Kavanaugh A, Ritchlin CT, Rahman P, et al. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;386(9999):1137–46. Pivotal phase III trial demonstrating efficacy across the domains for this agent in PsA with an excellent safety profile.CrossRefPubMedGoogle Scholar
  73. 73.
    Mease PJ, McInnes IB, Kirkham B, Kavanaugh A, Rahman P, van der Heijde D, et al. Secukinumab inhibition of interleukin-17A in patients with psoriatic arthritis. N Engl J Med. 2015;373(14):1329–39.CrossRefPubMedGoogle Scholar
  74. 74.
    Kavanaugh A, McInnes IB, Krueger GG, Gladman D, Beutler A, Gathany T, et al. Patient-reported outcomes and the association with clinical response in patients with active psoriatic arthritis treated with golimumab: findings through 2 years of a phase III, multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Care Res (Hoboken). 2013;65(10):1666–73.Google Scholar
  75. 75.
    Tillett W, Shaddick G, Jobling A, Askari A, Cooper A, Creamer P, et al. Effect of anti-TNF and conventional synthetic disease-modifying anti-rheumatic drug treatment on work disability and clinical outcome in a multicentre observational cohort study of psoriatic arthritis. Rheumatology 2017;56(4):603–12.
  76. 76.
    Strand V, Mease P, Gossec L, Elkayam O, van den Bosch F, Zuazo J, et al. Secukinumab improves patient-reported outcomes in subjects with active psoriatic arthritis: results from a randomised phase III trial (FUTURE 1). Ann Rheum Dis. 2017;76(1):203–7.CrossRefPubMedGoogle Scholar
  77. 77.
    McInnes IB, Kavanaugh A, Gottlieb AB, Puig L, Rahman P, Ritchlin C, et al. Efficacy and safety of ustekinumab in patients with active psoriatic arthritis: 1 year results of the phase 3, multicentre, double-blind, placebo-controlled PSUMMIT 1 trial. Lancet 2013;382(9894):780-9.Google Scholar
  78. 78.
    • Smolen JS. Schols M, Braun J, Dougados M, FitzGerald O, Gladman DD, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis.2017. Recommendations of an international task force regarding treat to target strategies in spondyloarthritis.Google Scholar
  79. 79.
    Reddy SM, Anandarajah AP, Fisher MC, Mease PJ, Greenberg JD, Kremer JM, et al. Comparative analysis of disease activity measures, use of biologic agents, body mass index, radiographic features, and bone density in psoriatic arthritis and rheumatoid arthritis patients followed in a large U.S. disease registry. J Rheum. 2010;37(12):2566–72.CrossRefPubMedGoogle Scholar
  80. 80.
    Kathuria P, Gordon KB, Silverberg JI. Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures. J Am Acad Dermatol. 2017;76(6):1045–53. e1043Google Scholar
  81. 81.
    Haroon M, FitzGerald O. Psoriatic arthritis: complexities, comorbidities and implications for the clinic. Expert Rev. Clin Immunol. 2016;12(4):405–16.Google Scholar
  82. 82.
    Dubreuil M, Rho YH, Man A, Zhu Y, Zhang Y, Love TJ, et al. Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study. Rheumatology (Oxford). 2014;53(2):346–52.CrossRefGoogle Scholar
  83. 83.
    Ogdie A, Yu Y, Haynes K, Love TJ, Maliha S, Jiang Y, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2014.Google Scholar
  84. 84.
    Jafri K, Bartels CM, Shin D, Gelfand JM, Ogdie A. Incidence and management of cardiovascular risk factors in psoriatic arthritis and rheumatoid arthritis: a population-based study. Arthritis Care Res (Hoboken). 2017;69(1):51–7.CrossRefGoogle Scholar
  85. 85.
    • Ogdie A, Grewal SK, Noe MH, Shin D, Takeshita J, Chiesa Fuxench ZC, et al. Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study. J Invest Dermatol. 2017; Important contribution that outlines the risk of liver disease in these patient populations.Google Scholar
  86. 86.
    Eder L, Thavaneswaran A, Chandran V, Cook RJ, Gladman DD. Obesity is associated with a lower probability of achieving sustained minimal disease activity state among patients with psoriatic arthritis. Ann Rheum Dis. 2015;74(5):813–7.CrossRefPubMedGoogle Scholar
  87. 87.
    Galindez E, Carmona L. Is obesity in psoriatic arthritis associated with a poorer therapeutic response and more adverse effects of treatment with an anchor drug? Reumatol Clin. 2016;12(6):307–12.CrossRefPubMedGoogle Scholar
  88. 88.
    Hojgaard P, Glintborg B, Kristensen LE, Gudbjornsson B, Love TJ, Dreyer L. The influence of obesity on response to tumour necrosis factor-alpha inhibitors in psoriatic arthritis: results from the DANBIO and ICEBIO registries. Rheumatology (Oxford). 2016;55(12):2191–9.CrossRefGoogle Scholar
  89. 89.
    Eder L, Abji F, Rosen CF, Chandran V, Gladman DD. The association between obesity and clinical features of psoriatic arthritis: a case-control study. J Rheumatol. 2017;44(4):437–43.CrossRefPubMedGoogle Scholar
  90. 90.
    Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, et al. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis. 2010;69(1):43–7.CrossRefPubMedPubMedCentralGoogle Scholar
  91. 91.
    Rosenberg P, Urwitz H, Johannesson A, Ros AM, Lindholm J, Kinnman N, et al. Psoriasis patients with diabetes type 2 are at high risk of developing liver fibrosis during methotrexate treatment. J Hepatol. 2007;46(6):1111–8.CrossRefPubMedGoogle Scholar
  92. 92.
    Michelsen B, Kristianslund EK, Sexton J, Hammer HB, Fagerli KM, Lie E, et al. Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study. Ann Rheum Dis. 2017;76(11):1906–10.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Allergy, Immunology & RheumatologyUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Department of PediatricsUniversity of Rochester Medical CenterRochesterUSA

Personalised recommendations