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EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update

2024Artigo científico Open access
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dc.contributor.authorGossec, Laure
dc.contributor.authorKerschbaumer, Andreas
dc.contributor.authorFerreira, Ricardo J.O.
dc.contributor.authorAletha, Daniel
dc.contributor.authorBaraliakos, Xenofon
dc.contributor.authorBertheussen, Heidi
dc.contributor.authorBoehncke, Wolf-Henning
dc.contributor.authorEsbensen, Bente Appel
dc.contributor.authorMcInnes, Iain B
dc.contributor.authorMcGonagle, Dennis
dc.contributor.authorWinthrop, Kevin L
dc.contributor.authorBalanescu, Andra
dc.contributor.authorBalint, Peter V
dc.contributor.authorBurmester, Gerd R
dc.contributor.authorCañete, Juan D
dc.contributor.authorClaudepierre, Pascal
dc.contributor.authorEder, Lihi
dc.contributor.authorHetland, Merete Lund
dc.contributor.authorLagnocco, Annamaria
dc.contributor.authorKristensen, Lars Erik
dc.contributor.authorLories, Rik
dc.contributor.authorQueiro, Rubén
dc.contributor.authorMauro, Daniele
dc.contributor.authorMarzo-Ortega, Helena
dc.contributor.authorMease, Philip J
dc.contributor.authorNash, Peter
dc.contributor.authorWagenaar, Wendy
dc.contributor.authorSavage, Laura
dc.contributor.authorSchett, Georg
dc.contributor.authorShoop-Worrall, Stephanie J W
dc.contributor.authorTanaka, Yoshiya
dc.contributor.authorVan den Bosch, Filip E
dc.contributor.authorvan der Helm-van Mil, Annette
dc.contributor.authorZabotti, Alen
dc.contributor.authorvan der Heijde, Désirée
dc.contributor.authorSmolen, Josef S
dc.date.accessioned2025-03-26T12:10:37Z
dc.date.available2025-03-26T12:10:37Z
dc.date.issued2024
dc.description.abstractObjective: New modes of action and more data on the efficacy and safety of existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 recommendations for the pharmacological treatment of PsA. Methods: Following EULAR standardised operating procedures, the process included a systematic literature review and a consensus meeting of 36 international experts in April 2023. Levels of evidence and grades of recommendations were determined. Results: The updated recommendations comprise 7 overarching principles and 11 recommendations, and provide a treatment strategy for pharmacological therapies. Non-steroidal anti-inflammatory drugs should be used in monotherapy only for mild PsA and in the short term; oral glucocorticoids are not recommended. In patients with peripheral arthritis, rapid initiation of conventional synthetic disease-modifying antirheumatic drugs is recommended and methotrexate preferred. If the treatment target is not achieved with this strategy, a biological disease-modifying antirheumatic drug (bDMARD) should be initiated, without preference among modes of action. Relevant skin psoriasis should orient towards bDMARDs targeting interleukin (IL)-23p40, IL-23p19, IL-17A and IL-17A/F inhibitors. In case of predominant axial or entheseal disease, an algorithm is also proposed. Use of Janus kinase inhibitors is proposed primarily after bDMARD failure, taking relevant risk factors into account, or in case bDMARDs are not an appropriate choice. Inflammatory bowel disease and uveitis, if present, should influence drug choices, with monoclonal tumour necrosis factor inhibitors proposed. Drug switches and tapering in sustained remission are also addressed. Conclusion: These updated recommendations integrate all currently available drugs in a practical and progressive approach, which will be helpful in the pharmacological management of PsA.eng
dc.identifier.citationGossec, L., Kerschbaumer, A., Ferreira, R. J. O., Aletaha, D., Baraliakos, X., Bertheussen, H., Boehncke, W. H., Esbensen, B. A., McInnes, I. B., McGonagle, D., Winthrop, K. L., Balanescu, A., Balint, P. V., Burmester, G. R., Cañete, J. D., Claudepierre, P., Eder, L., Hetland, M. L., Iagnocco, A., Kristensen, L. E., … Smolen, J. S. (2024). EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update. Annals of the rheumatic diseases, 83(6), 706–719. https://doi.org/10.1136/ard-2024-225531
dc.identifier.doi10.1136/ard-2024-225531
dc.identifier.issn1468-2060
dc.identifier.urihttp://hdl.handle.net/10400.26/57450
dc.language.isoeng
dc.peerreviewedyes
dc.publisherBMJ Publishing Group
dc.relation.hasversionhttps://ard.bmj.com/content/83/6/706
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectBiological therapy
dc.subjectBiosimilar pharmaceuticals
dc.subjectPsoriatic arthritis
dc.subjecttreatment
dc.titleEULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 updateeng
dc.typeArtigo científico
dspace.entity.typePublication
oaire.citation.endPage719
oaire.citation.issue6
oaire.citation.startPage706
oaire.citation.titleAnnals of the Rheumatic Diseases
oaire.citation.volume83
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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