Real-Life Rheumatology: Clinical Pearls for Psoriatic Arthritis

Third, the significant heterogeneity among patients should compel physicians to treat each patient as a unique individual.

Fourth, many treatment options are currently available for PsA, and disease phenotype and trajectory of disease should be among the variables that influence which medications to use (for a list of these medications and considerations, see “Psoriatic Arthritis Treatment Update,” October 2021).

Finally, although up to about 60% of patients experience improvement while on treatment, only about 30% of patients will achieve remission.

Dr. Orbai’s session was a tour de force with regard to approaching PsA in an evidence-based and patient-centered manner.

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Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.

References

1. The Four Founding Physicians. Johns Hopkins Medicine.
2. Fry L, Baker BS. Triggering psoriasis: The role of infections and medications. Clin Dermatol. 2007 Nov-Dec;25(6):606–615.
3. Siegel SAR, Winthrop KL. In the real world: Infections associated with biologic and small molecule therapies in psoriatic arthritis and psoriasis. Curr Rheumatol Rep. 2019 Jun 6;21(7):36.
4. Tuttle KSL, Vargas SO, Callahan MJ, et al. Enthesitis as a component of dactylitis in psoriatic juvenile idiopathic arthritis: Histology of an established clinical entity. Pediatr Rheumatol Online J. 2015 Feb 28;13:7.
5. Vollmer O, Felten R, Mertz P, et al. Characterization of auto-immune hepatitis associated with the use of anti-TNFα agents: An analysis of 389 cases in VigiBase. Autoimmun Rev. 2020 Mar;19(3):102460.
6. Haberman RH, Castillo R, Scher JU. Induction of remission in biologic-naive, severe psoriasis and PsA with dual anti-cytokine combination. Rheumatology (Oxford). 2021 Jul 1;60(7):e225–e226.
7. Thibodeaux Q, Ly K, Reddy V, et al. Dual biologic therapy for recalcitrant psoriasis and psoriatic arthritis. JAAD Case Rep. 2019 Oct 10;5(10):928–930.