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Publication Detail
Established and new biologic therapies for psoriatic arthritis and psoriasis
Psoriatic arthritis (PsA) is part of the group of seronegative spondyloarthropathies (SpA), sharing common clinical features such as sacroiliitis, spondylitis, enthesitis, psoriasis, uveitis, and similar wider genetic markers. The newly developed biologic treatments aim to target molecular and cellular abnormalities associated with autoimmunity in PsA and psoriasis. There are several biologic agents which are currently used, or are under investigation in both diseases, which creates an opportunity for rheumatologists and dermatologists to share their expertise for patients’ benefit. Apart from the large body of evidence for efficacy of the licensed biologic therapies in psoriasis and PsA, research efforts are currently put into discovering and testing new molecular targets with therapeutic potential. This chapter will review all the biologic agents ever tested in these two diseases, stratified based on the level of evidence regarding their efficacy. As PsA and psoriasis have a diverse clinical phenotype it is useful to identify which treatments are effective for a particular clinical manifestation, such as axial and peripheral arthritis, dactylitis, enthesitis, skin and nail disease. Another aspect of biologic treatment effectiveness which will be explored in this chapter is the impact of these agents on patients’ quality of life and functional ability. We propose that by analysing the patient’s individual disease phenotype, based on clinical assessments and biomarkers, there is huge to optimise the cost-effectiveness of biologic treatment by facilitating individually tailored treatment options for patients with PsA and psoriasis.
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