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Current and Emerging Treatments for Psoriatic Arthritis

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Biologic and Systemic Agents in Dermatology

Abstract

Psoriatic arthritis (PsA) is an immunologically mediated inflammatory disease characterized by arthritis, enthesitis, dactylitis, spondylitis, and psoriasis. Prior to the introduction of targeted biologic and synthetic medications, such as TNF inhibitors, the ability to pharmacologically control disease activity was limited, with only modest effects noted with Conventional oral (rather than traditional) oral medications such as methotrexate and sulfasalazine. The introduction of TNF inhibitors and subsequently other immunologically targeted therapies has substantially changed our ability to achieve significant response in all relevant clinical domains including the ability to inhibit progressive structural damage of joints. As understanding of the pathophysiology of psoriasis and PsA has deepened, so has our understanding of potential cellular signaling pathway inhibition which can downregulate pro-inflammatory cell and cytokine function. Since it is possible that different disease mechanisms play different roles in various tissue domains that are anatomically distinct, such as the joint, enthesia, spine, bone, and skin, it is important to be able to assess these domains separately using not only physical examination, but also advanced imaging and, at least in select studies, tissue immunohistology in order to document impact on these different domains. This chapter reviews the evidence for current and emerging therapies in all clinical domains of PsA.

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Acknowledgments

Catherine Loeffler, manuscript preparation assistance.

Disclosures

Research grant, consultant, and/or speaker: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Crescendo, Corrona, Demira, Genentech, Janssen, Lilly, Merck, Novartis, Pfizer, Sun, UCB, and Zynerba.

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  1. Swedish Medical Center, Seattle, WA, 98122, USA

    Philip J. Mease M.D.

  2. University of Washington School of Medicine, Seattle, WA, 98122, USA

    Philip J. Mease M.D.

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Correspondence to Philip J. Mease M.D. .

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  1. Division of Dermatology, David Geffen School of Medicine a UCLA, Los Angeles, California, USA

    Paul S. Yamauchi

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Mease, P.J. (2018). Current and Emerging Treatments for Psoriatic Arthritis. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_18

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