The Management of Psoriatic Arthritis: A Review

What Would Dr. Orbai Do?

So how does Dr. Orbai think about her patients when it comes to choosing therapy? To guide her choice, she always defines:

• The target tissue(s)/domains affected;
• New manifestations of disease vs. reactivation;
• The patient’s prior treatment history and responses;
• The patient-reported outcome (PRO) profile: disease impact and symptom experience; and
• Safety considerations.

Conclusion

PsA has a diverse phenotype, and disease domains help us choose therapies most likely to be effective for each specific patient. When selecting a therapy, consider the patient’s worst disease domain and maximize coverage for other affected domains. Then, select the most effective bDMARD for those domains. Finally, consider each patient’s co-morbidities, preferences and safety context to narrow down options.

Samantha C. Shapiro, MD

Samantha C. Shapiro, MD, is a clinician educator who is passionate about the care and education of rheumatology patients. She writes for both medical and lay audiences and practices telerheumatology.

References

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