Biological treatment of psoriatic arthritis

Psoriatic arthritis (PsA) is a heterogeneous disease affecting, besides synovial joints, also the entheses, the soft tissues of the whole finger (dactylitis) and the axial skeleton. Currently the classification criteria CASPAR are used to diagnose PsA. In a large number of patients the disease leads to irreversible joint damage (X-ray, respectively clinical) which significantly reduces life quality and limits the patient in his/her everyday activities and also considerably limits their work capacity. There is evidence showing that early commencement of treatment and treat to target principle can significantly reduce this negative development. In recent time the knowledge of the disease pathogenesis has been extending and at the same time new drugs appear that act on the critical pathogenetic processes in a targeted way. These are biological drugs from the group of TNFα inhibitors and, most recently, also inhibitors of Th17 - IL17 pathway. Together with that is further specified the treatment strategy and the way of its monitoring. These new findings have led to the update of recommendations for the treatment and monitoring of psoriatic arthritis by the Czech Society for Rheumatology.

Keywords: biological drugs; conventional synthetic disease-modifying antirheumatic drugs; early treatment; psoriatic arthritis; targeted synthetic disease modifying drugs; treat to target