Advances in the treatment of psoriatic arthritis

The etiology of psoriatic arthritis (PsA) involves a combination of genetic factors and abnormal immune response with associated inflammation, possibly precipitated by infection or injury but most likely occurring without a specific antecedent event. PsA follows a progressive course. Advanced cases are comparable in severity and disability to rheumatoid arthritis. Treatment of PsA could involve separate interventions for the skin and the joints. Systemic therapies for PsA have been traditionally reserved for patients with refractory or severe symptoms. The marginal efficacy of these interventions must be balanced against tolerability and safety concerns. Newer treatment strategies target both the skin and joint symptoms that characterize PsA. Etanercept is the only new therapy that has been systematically studied in large-scale trials and approved by the FDA for the treatment of PsA. Promising outcomes have also been reported with infliximab. Continued development of these and similar interventions may lead to well-tolerated and effective therapeutic options that manage both the skin and joint symptoms of PsA.