Abstract

Background: psoriatic arthritis is a long term inflammatory arthritis. Psoriatic arthritis is leading to bone erosion, joint destruction and associated with nail diseases, dactylitis, enthesitis, sponnylitis and uveitis. Aim of this study was to review the new lines of treatment for psoriatic arthritis with or without skin affection. Treatment, the underlying process in psoriatic arthritis is inflammation; so, treatments are directed to reduce and control inflammation. Although no clear correlation exists between joint inflammation and the skin in every patient, the skin and joint aspects of the disease often must be treated simultaneously. However, only certain therapies are effective for psoriasis and psoriatic arthritis. Systemic agents, can be used for both skin and joint manifestations, it includes methotrexate and ciclosporin. For the biologic agents, the tumour necrosis factor inhibitors such as adalimumab, etanercept, infliximab, golimumab and certolizumab are effective. Ustekinumab is a recently agent belonging to the group of anti-IL-12p40 antibodies and has been shown to be efficacious. Newer drugs in the treatment which have shown efficacy for both psoriasis and psoriatic arthritis consist of the anti-IL-17 agent, secukinumab, and a phosphodiesterase-4 inhibitor, apremilast. As well as the oral JaK inhibitor, tofacitinib, have very limited but promising data.

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