RT Journal Article
SR Electronic
T1 European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 499
OP 510
DO 10.1136/annrheumdis-2015-208337
VO 75
IS 3
A1 L Gossec
A1 J S Smolen
A1 S Ramiro
A1 M de Wit
A1 M Cutolo
A1 M Dougados
A1 P Emery
A1 R Landewé
A1 S Oliver
A1 D Aletaha
A1 N Betteridge
A1 J Braun
A1 G Burmester
A1 J D Cañete
A1 N Damjanov
A1 O FitzGerald
A1 E Haglund
A1 P Helliwell
A1 T K Kvien
A1 R Lories
A1 T Luger
A1 M Maccarone
A1 H Marzo-Ortega
A1 D McGonagle
A1 I B McInnes
A1 I Olivieri
A1 K Pavelka
A1 G Schett
A1 J Sieper
A1 F van den Bosch
A1 D J Veale
A1 J Wollenhaupt
A1 A Zink
A1 D van der Heijde
YR 2016
UL http://ard.bmj.com/content/75/3/499.abstract
AB Background Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations.Methods A systematic literature review was performed regarding pharmacological treatment in PsA. Subsequently, recommendations were formulated based on the evidence and the expert opinion of the 34 Task Force members. Levels of evidence and strengths of recommendations were allocated.Results The updated recommendations comprise 5 overarching principles and 10 recommendations, covering pharmacological therapies for PsA from non-steroidal anti-inflammatory drugs (NSAIDs), to conventional synthetic (csDMARD) and biological (bDMARD) disease-modifying antirheumatic drugs, whatever their mode of action, taking articular and extra-articular manifestations of PsA into account, but focusing on musculoskeletal involvement. The overarching principles address the need for shared decision-making and treatment objectives. The recommendations address csDMARDs as an initial therapy after failure of NSAIDs and local therapy for active disease, followed, if necessary, by a bDMARD or a targeted synthetic DMARD (tsDMARD). The first bDMARD would usually be a tumour necrosis factor (TNF) inhibitor. bDMARDs targeting interleukin (IL)12/23 (ustekinumab) or IL-17 pathways (secukinumab) may be used in patients for whom TNF inhibitors are inappropriate and a tsDMARD such as a phosphodiesterase 4-inhibitor (apremilast) if bDMARDs are inappropriate. If the first bDMARD strategy fails, any other bDMARD or tsDMARD may be used.Conclusions These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.