Pharmakotherapie der Psoriasisarthritis : Behandlungsempfehlungen vor dem Hintergrund limitierter Evidenzen

International treatment recommendations for assisting the choice of pharmaceutical treatment of psoriatic arthritis are currently available in two different versions. While the group for research and assessment of psoriasis and psoriatic arthritis (GRAPPA) recommendations mainly focus on both the description of treatment options for the different phenotypes of psoriatic arthritis and the listing of evidence grades, the European League against Rheumatism (EULAR) recommendations try to implement the knowledge about drugs into an algorithm for the different treatment steps. However, the presentation of a treatment algorithm suggests comparable evidence levels for the individual treatment steps, which is at present not the case for psoriatic arthritis. This should be borne in mind for each individual treatment option and treatment step when using a predetermined therapy algorithm and in view of the heterogeneous study results (or no study results available). Both recommendations are currently being revised and will allow the latest evidence trends to be included in the updated version

Therapie der Psoriasisarthritis: Gibt es eine Differenzialindikation?

Psoriatic arthritis (PsA) is a very heterogeneous immune-mediated disease that usually involves skin and joints but can also affect entheses and extra-articular structures during the disease course. Furthermore, it can also be linked with other associated diseases. Therefore, the individualized selection of an effective and patient-oriented treatment must be carried out taking the extent of various manifestations of the PsA itself and also of other influencing factors into consideration. Various recommendations for selection and control of the suitable treatment of PsA are available for clinical use. The recommendations of the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) are the two recommendations that are frequently used and internationally acknowledged. Both recommendations were updated in 2016. Specific German treatment recommendations are currently missing. In analogy to the treat-to-target strategy for rheumatoid arthritis, at least minimal disease activity (MDA) should be achieved in PsA patients with the use of specific therapeutic interventions if remission as the maximum therapeutic goal cannot be reached. New treatment options, which target different specific molecules, offer possibilities for a more differentiated personalized medicinal treatment for improvement of the care of PsA patients. This particularly applies to a focus on personalized strategies for optimal treatment of various manifestation forms and patterns

Aktuelle Therapie der Psoriasisarthritis: Current treatment options for psoriatic arthritis

Psoriatic arthritis is a heterogeneous immune-mediated disease, which usually involves skin and joints, but can also affect entheses, the spine and extraarticular structures. An effective, patient-oriented therapy must be guided by the diagnosis of dominant manifestations of the disease and should be performed on an individual basis. Different recommendations for the treatment of psoriatic arthritis are available for clinical use. The recommendations from the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) are most frequently used and internationally acknowledged. Both recommendations are available as an update from 2016. German treatment recommendations are not available to date. New treatment options targeting different, specific molecules offer possibilities for a differentiated personalised therapy to improve patient care