Global Guidelines for Psoriatic Arthritis Management: A Comparative Analysis.

Shikha Singla, Parjanya Bhatt, Enrique Roberto Soriano
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Abstract

Background: Psoriatic arthritis (PsA) is a complex immune-mediated heterogeneous inflammatory disease. Treatment decisions are challenging given the multisystem involvement. To further guide management strategies, we conducted a comparative analysis of the latest global guidelines highlighting the contrast in their approach to treat different PsA domains.

Methods: Major global guidelines for PsA management were reviewed, including American College of Rheumatology 2018 update, European Alliance of Associations for Rheumatology 2023 update, British Society of Rheumatology 2022, Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2021, and Pan American League of Associations for Rheumatology 2024.

Results: The guidelines unanimously recommend a treat-to-target strategy with a focus on active PsA. Divergence existed in treatment sequencing regarding the use of biologic and targeted disease-modifying antirheumatic drugs (DMARDs). Variations were also noted in the management of enthesitis and dactylitis. Addressing comorbidities and associated conditions is regarded to be a cornerstone for optimizing disease control and preventing flares.

Conclusion: This review highlights the different management strategies among the global guidelines. Furthermore, we pointed at promising new therapeutic targets that are likely to be incorporated into future recommendations.

银屑病关节炎管理全球指南:比较分析。
背景:银屑病关节炎(Psoriatic arthritis, PsA)是一种复杂的免疫介导异质性炎症性疾病。考虑到多系统的参与,治疗决策是具有挑战性的。为了进一步指导管理策略,我们对最新的全球指南进行了比较分析,强调了不同PsA域治疗方法的对比。方法:回顾全球主要的PsA管理指南,包括美国风湿病学会2018年更新、欧洲风湿病协会联盟2023年更新、英国风湿病学会2022年更新、银屑病和银屑病关节炎研究与评估小组2021年更新、泛美风湿病协会联盟2024年更新。结果:指南一致推荐针对活性PsA的靶向治疗策略。在使用生物和靶向疾病改善抗风湿药物(DMARDs)的治疗顺序上存在分歧。鼻炎和指炎的治疗也存在差异。解决合并症和相关条件被认为是优化疾病控制和预防耀斑的基石。结论:本综述强调了全球指南中不同的管理策略。此外,我们指出了有希望的新治疗靶点,这些靶点可能被纳入未来的推荐中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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