Frontiers in Medicine (Nov 2023)

Management of psoriatic arthritis: a consensus opinion by expert rheumatologists

  • Salvatore D’Angelo,
  • Fabiola Atzeni,
  • Maurizio Benucci,
  • Gerolamo Bianchi,
  • Fabrizio Cantini,
  • Roberto Felice Caporali,
  • Roberto Felice Caporali,
  • Giorgio Carlino,
  • Francesco Caso,
  • Alberto Cauli,
  • Francesco Ciccia,
  • Maria Antonietta D’Agostino,
  • Lorenzo Dagna,
  • Lorenzo Dagna,
  • Christian Dejaco,
  • Christian Dejaco,
  • Oscar Massimiliano Epis,
  • Maria Grazia Ferrucci,
  • Franco Franceschini,
  • Franco Franceschini,
  • Enrico Fusaro,
  • Marco Gabini,
  • Roberto Gerli,
  • Roberto Giacomelli,
  • Roberto Giacomelli,
  • Marcello Govoni,
  • Elisa Gremese,
  • Giuliana Guggino,
  • Annamaria Iagnocco,
  • Florenzo Iannone,
  • Bruno Laganà,
  • Ennio Lubrano,
  • Carlomaurizio Montecucco,
  • Rosario Peluso,
  • Roberta Ramonda,
  • Maurizio Rossini,
  • Carlo Salvarani,
  • Gian Domenico Sebastiani,
  • Marco Sebastiani,
  • Carlo Selmi,
  • Carlo Selmi,
  • Enrico Tirri,
  • Antonio Marchesoni,
  • Antonio Marchesoni

DOI
https://doi.org/10.3389/fmed.2023.1327931
Journal volume & issue
Vol. 10

Abstract

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BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease involving several articular and extra-articular structures. Despite the important progresses recently made in all of the aspects of this disease, its management is still burdened by unresolved issues. The aim of this exercise was to provide a set of statements that may be helpful for the management of PsA.MethodsA group of 38 Italian rheumatologists with recognized expertise in PsA selected and addressed the following four topics: “early PsA,” “axial-PsA,” “extra-articular manifestations and comorbidities,” “therapeutic goals.” Relevant articles from the literature (2016–2022) were selected by the experts based on a PubMed search. A number of statements for each topic were elaborated.ResultsNinety-four articles were selected and evaluated, 68 out of the 1,114 yielded by the literature search and 26 added by the Authors. Each of the four topic was subdivided in themes as follows: transition from psoriasis to PsA, imaging vs. CASPAR criteria in early diagnosis, early treatment for “early PsA”; axial-PsA vs. axialspondyloarthritis, diagnosis, clinical evaluation, treatment, standard radiography vs. magnetic resonance imaging for “axial PsA”; influence of inflammatory bowel disease on the therapeutic choice, cardiovascular comorbidity, bone damage, risk of infection for “comorbidities and extra-articular manifestations”; target and tools, treat-to-target strategy, role of imaging for “therapeutic goals.” The final document consisted of 49 statements.DiscussionThe final product of this exercise is a set of statements concerning the main issues of PsA management offering an expert opinion for some unmet needs of this complex disease.

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