Recent Developments in Management of Psoriatic Arthritis

Until recently, little attention has been paid to psoriatic arthritis, perhaps because the disease was thought to be mild and infrequent. However, it has become clear that the disease may be severe in a significant proportion of the patients and may be more prevalent than initially considered. Recent studies supported the increasing clinical evidence that disruption of specific immune interactions can improve psoriasis and its musculoskeletal manifestations. Agents being evaluated for the treatment of psoriasis and psoriatic arthritis include, TNF-α antagonists: infliximab and etanercept, an anti-CD11a monoclonal antibody, efalizumab, and a soluble LFA-3-IgG fusion protein, alefacept. However, in concordance with the advent of new and emerging therapies, similar development in the measures of the disease activity and severity is highly required. This article gives an overview of the new developments in clinical assessment and management of psoriasis and its associated musculoskeletal manifestation. With the understanding of the disease immunopathogenesis, this review will outline a new suggested algorithm for management of psoriasis in its different clinical forms incorporating the new biologic agents with the conventional modalities.