Table 2

Research agenda for PsA

ThemeResearch questions
DiagnosisDefining screening strategies for PsA among psoriasis patients: is screening needed and if so, how and when?
Diagnosing PsA versus RA with concomitant psoriasis
PrognosisDefining prognostic factors related to the risk of progressive disease, structural damage and bad functional outcome in early (and established) PsA
Predicting response to treatment (predicting response to NSAID, to DMARD, to biological agents)
Assessment of spinal disease: defining the similarities and differences with ankylosing spondylitis
Defining disease severity
PathophysiologyDefining the relationship between inflammation and structural damage in PsA
Exploring juvenile PsA: is it different from adult-onset PsA?
Identification of new therapeutic targets
BiomarkersDetermining biomarkers related to damage, prognosis and treatment response
Treatment strategyDefining and evaluating the utility of tight control strategies in PsA
Assessing efficacy and safety of combinations of DMARD and of DMARD with biological agents
Evaluating the need for early treatment in PsA: who should be treated with DMARD? When to treat with DMARD?
OutcomesPatient-reported outcomes in PsA (which ones are important?), composite patient-reported scores in PsA, fatigue in PsA
Defining treatment targets
Defining (residual) active disease
Defining remission and predictors of remission
Synthetic DMARDNeed for more RCT with DMARD (eg, methotrexate) to obtain more data on efficacy and toxicity
Assessing efficacy and safety of combination therapy of synthetic DMARD
Need for DMARD studies in MRI-positive early axial PsA
Biological agentsEfficacy of combining DMARD with biological agents, compared with biological monotherapy and DMARD monotherapy
Defining the best indication for biological agents, when to start?
Defining the optimal duration of biological therapy, including addressing biological agent discontinuation (need for respective controlled trials)
Assessing the possibility of maintenance therapy with lower doses of biological agents
Assessing the efficacy and toxicity of new biological agents (including more data on ustekinumab, tocilizumab, abatacept, rituximab)
Through registry-based studies, assessing the safety of biological agents in PsA
Systemic glucocorticoidsAssessing the risk of skin flares related to systemic glucocorticoids and in particular at low doses
Assessing the benefit/risk ratio of long term glucocorticoid therapy
Assessing the efficacy and toxicity of intramuscular glucocorticoids in PsA
Other systemic treatmentsAssessing the efficacy of miscellaneous drugs, for example, oral vitamin D73 74
Local treatmentsRadiation synovectomy: evaluating its efficacy in monoarthritis of the knee
ComorbiditiesUnderstanding the risk of cardiovascular disease in PsA and the modification of such risk according to disease activity and therapy
Assessing the risk and consequences of metabolic syndrome in PsA
Addressing tolerated consumption of alcohol in PsA in particular when treating by methotrexate
ImagingDefining the optimal use of radiographic scores
Evaluating the usefulness of MRI and ultrasonography, as well as developing scoring techniques for these imaging modalities
  • DMARD, disease-modifying antirheumatic drug; NSAID, non-steroidal anti-inflammatory drug; PsA, psoriatic arthritis; RA, rheumatoid arthritis; RCT, randomised controlled trial.