Permanent joint damage in psoriatic arthritis

Permanent joint damage in psoriatic arthritis


Psoriatic arthritis remains a dilemma for
both dermatologists and rheumatologists alike. We have to understand whether patients are
going on to permanent joint damage, or are we simply treating signs and symptoms, many
of which are extraarticular, which is distinct from other forms of inflammatory arthritis? New data is suggesting that we can control
the extraarticular manifestations, but the challenge of understanding the importance
of X-ray changes and permanent joint damage still remains to be seen. Do our newer medications that go beyond the
anti-TNF realm help us to understand what we’re doing to affect permanent joint damage,
what patients are going on to permanent joint damage, and what we can do to help these patients
reach complete function? So over time, with psoriatic arthritis, we’re
going to be challenged to understand both our older agents and their impact on both
joint damage and signs and symptoms, and our newer medications. Anti-TNF therapy has remained the treatment
of choice for psoriatic arthritis; but will that be eventually overthrown by medications
like interleukin-17 inhibitors, which might have similar psoriatic arthritis data, but
might actually improve on the data in the skin of psoriasis? So for many years, we’re going to have to
be understanding—exactly how should we go about treating psoriatic arthritis, how aggressive
should we be early, and what agents can we use that could best treat these patients with
both skin and joint disease?

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