Pharmacotherapeutic management of psoriatic disease: addressing psoriatic arthritis and cutaneous manifestations.

Abstract

Introduction: Psoriasis and psoriatic arthritis (PsA) are interrelated autoimmune conditions sharing similar genetic and immunological pathways. PsA often develops within 10 years of psoriasis onset, though it may precede cutaneous symptoms in some patients. Effective management of these conditions requires a multidisciplinary approach to address skin, bone, joint, and vascular manifestations.

Areas covered: The review summarizes the current pharmacotherapies and to provide treatment guidelines for managing cutaneous psoriasis and PsA in psoriatic disease.

Expert opinion: The management for mild psoriasis and mild PsA flare-ups can be addressed with topical treatments and with NSAIDs or intra-articular glucocorticoid injections. For more persistent or severe cases, systemic treatments with oral small molecules (Methotrexate, Apremilast, Janus kinase inhibitors) or with biologics (TNF inhibitors, IL-17 inhibitors, IL-23 inhibitors, CTLA-4 Ig) are effective in managing both psoriasis and PsA. With many treatment options, providers can tailor management, which considers patient disease severity, preference, comorbidities, and other factors. Early detection and a multidisciplinary management strategy can optimize patient quality of life and improve health outcomes.