Psoriatic arthritis (PsA) affects approximately ≥130 individuals per 100,000, a prevalence that has been on the rise over the past decade, mirroring the increase in plaque psoriasis rates globally.
The escalation of this chronic and debilitating condition has spurred the development of a robust array of treatment options, notably biologic agents and targeted therapies, which have become integral components of treatment protocols alongside traditional steroid therapies.
However, beyond the pharmacological arsenal, a clinician’s understanding of PsA’s diverse presentation, its associated comorbidities, and the response to suggested therapies is pivotal in effectively managing the condition. At the recent American Academy of Physician Associates (AAPA) 2024 Conference & Expo in Houston, TX, Benjamin J. Smith, DMSc, PA-C, provided insights into effective PsA management during an interview with HCPLive.
Smith emphasized the heterogeneous nature of PsA, stressing the importance of recognizing early signs and symptoms to prevent disease progression. “Patients may present with asymmetric joint involvement, affecting both upper and lower extremities, or with symmetrical involvement akin to rheumatoid arthritis. Some may exhibit spinal or axial symptoms,” Smith explained.
A commonly associated comorbidity of PsA is psoriasis, affecting approximately 3% of the White population and prevalent across diverse skin tones. Notably, around one-third of individuals with psoriasis will develop PsA.
“When considering psoriatic arthritis, it’s noteworthy that 85% of patients will first exhibit skin manifestations, followed by joint symptoms at varying intervals,” noted Smith. “The interplay between skin and joint symptoms presents an intriguing dynamic in disease progression.”
Comorbidity management stands as a cornerstone of PsA care, given its inflammatory nature, which can impact not only joint health but also cutaneous, cardiovascular, and psychosocial well-being. In the realm of biologic therapy, Smith emphasized the importance of considering comorbidities in tailoring treatment approaches for individual patients.
“In 2024, we are fortunate to have a plethora of therapeutic options that facilitate a patient-centered approach to treatment decisions,” Smith remarked. “Shared decision-making, encompassing discussions on administration routes, risks, benefits, and expectations, allows patients to actively participate in their care.”
The evolving landscape of PsA management underscores the significance of a holistic understanding of the condition, from its varied presentations to its intersection with comorbidities, guiding clinicians towards personalized treatment strategies for improved patient outcomes.