Understanding Psoriatic Arthritis
(Part IV)
There are some updated recommendations that form the basis of the management algorithm for Psoriatic Arthritis (PsA) by experts.
The recommendations list the possible treatments as well as contraindications and risks that are needed to be taken into account, and thus the balance between efficacy and safety.
The efficacy and safety of treatments for PsA are always dependent on the characteristics of the patient.
The experts have synthesis in the recommendations to help in the proper treatment for PsA.
Treatment should be aimed at achieving the goal of remission or, alternatively, low disease activity, by regular disease activity assessment and appropriate adjustment of treatment.
This recommendation emphasizes the importance of a treat-to-target (T2T) approach. The T2T approach includes the definition of a distinct target as well as adherence to rules for monitoring and therapies, are well validated in PsA.
The T2T recommendations for PsA have been updated and now state clearly that remission or low disease activity should be the goal.
The remission in PsA is difficult to define. Remission should be seen as removal of inflammation.
The use of Non-steroidal anti-inflammatory drugs (NSAID) may be used to relieve some symptoms.
NSAIDs are being used for the relief of symptoms at the same time look at the benefit to risk ratio and consider these things especially with those co-morbidities
However the use of NSAIDs alone may not be enough to control symptoms.
NSAIDs should be combined rapidly with other treatments.
NSAIDs have not shown any efficacy in skin psoriasis.
NSAID therapy should not be prolonged up to 12 weeks, provided they have already induced relief by 4 weeks. If the treatment target is not achieved, other therapies should be prescribed.
Next week we will continue with other recommendations for the treatment for PsA.