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Difficult-to-treat psoriatic arthritis: moving out of the rheumatoid arthritis shadow

Nature Reviews Rheumatology volume 20, pages 135–136 (2024)Cite this article

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As in rheumatoid arthritis, achieving low disease activity or remission in psoriatic arthritis (PsA) remains a challenge and unmet need for many individuals. However, the complex pathogenesis, heterogeneity and varied tissue involvement in PsA mean that dedicated definitions and novel solutions are required for difficult-to-treat disease.

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References

  1. Nagy, G. et al. EULAR definition of difficult-to-treat rheumatoid arthritis. Ann. Rheum. Dis. 80, 31–35 (2021).

    Article  PubMed  Google Scholar 

  2. Nagy, G. et al. EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis. Ann. Rheum. Dis. 81, 20–33 (2022).

    Article  CAS  PubMed  Google Scholar 

  3. Perrotta, F. M., Scriffignano, S., Ciccia, F. & Lubrano, E. Clinical characteristics of potential “difficult-to-treat” patients with psoriatic arthritis: a retrospective analysis of a longitudinal cohort. Rheumatol. Ther. 9, 1193–1201 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Coates, L. C. et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis. Nat. Rev. Rheumatol. 18, 465–479 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gossec, L. et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann. Rheum. Dis. 79, 700–712 (2020).

    Article  PubMed  Google Scholar 

  6. Gossec, L. et al. Minimal disease activity as a treatment target in psoriatic arthritis: a review of the literature. J. Rheumatol. 45, 6–13 (2018).

    Article  CAS  PubMed  Google Scholar 

  7. Glintborg, B. et al. Clinical response, drug survival, and predictors thereof among 548 patients with psoriatic arthritis who switched tumor necrosis factor α inhibitor therapy: results from the Danish Nationwide DANBIO Registry. Arthritis. Rheumatol. 65, 1213–1223 (2013).

    Article  CAS  Google Scholar 

  8. Najm, A., Goodyear, C. S., McInnes, I. B. & Siebert, S. Phenotypic heterogeneity in psoriatic arthritis: towards tissue pathology-based therapy. Nat. Rev. Rheumatol. 19, 153–165 (2023).

    Article  PubMed  Google Scholar 

  9. Marzo-Ortega, H. et al. Time to address the challenge of difficult to treat psoriatic arthritis: results from an international survey. Ann. Rheum. Dis. https://doi.org/10.1136/ard-2023-225087 (2023).

    Article  PubMed  Google Scholar 

  10. Roodenrijs, N. M. T. et al. Difficult-to-treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology 2, 3778–3788 (2021).

    Article  Google Scholar 

Download references

Acknowledgements

H.M.-O.’s work is supported by the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (LBRC). The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health. S.S. and H.M.-O. are co-leads for the planned EULAR task force to develop Points to Consider for the Definition of Difficult-to-treat PsA.

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Authors and Affiliations

  1. School of Infection and Immunity, University of Glasgow, Glasgow, UK

    Stefan Siebert

  2. NIHR Leeds BRC, Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK

    Helena Marzo-Ortega

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  1. Stefan Siebert
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  2. Helena Marzo-Ortega
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Correspondence to Stefan Siebert.

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Competing interests

S.S. declares that he has received institutional research support from Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, GSK, Janssen, Teijin Pharma and UCB and honoraria and/or speaker fees from AbbVie, Amgen, AstraZeneca, Eli Lilly, Janssen, Teijin Pharma and UCB. H.M.-O. declares that she has received research grants from Janssen, Novartis, Pfizer and UCB and honoraria and/or speaker fees from AbbVie, Amgen, Eli-Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB.

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Siebert, S., Marzo-Ortega, H. Difficult-to-treat psoriatic arthritis: moving out of the rheumatoid arthritis shadow. Nat Rev Rheumatol 20, 135–136 (2024). https://doi.org/10.1038/s41584-024-01083-y

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