Abstract
Psoriatic arthritis (PsA) is a chronic, multi-domain immune–mediated inflammatory arthritis with a high disease burden. PsA patients have significant co-morbidities like obesity, depression, fibromyalgia which can impact disease activity assessment. The management of PsA has undergone a paradigm shift over the last decade due to the availability of multiple biologic and targeted synthetic disease modifying anti-rheumatic drugs. Despite the availability of multiple therapeutic agents, it is not uncommon to find patients not responding adequately and continuing to have active disease and/or high disease burden. In our review, we propose what is “difficult to treat PsA”, discuss differential diagnosis, commonly overlooked factors, co-morbidities that affect treatment responses, and suggest a stepwise algorithm to manage these patients.
Original language | English (US) |
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Pages (from-to) | 2251-2265 |
Number of pages | 15 |
Journal | Clinical Rheumatology |
Volume | 42 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2023 |
Keywords
- Biologic therapy
- Comorbidities
- Difficult-to-treat
- Disease activity
- Psoriatic arthritis (PsA)
ASJC Scopus subject areas
- Rheumatology