Psoriatic arthritis

Psoriatic arthritis presents a heterogeneous clinical picture and constitutes a great diagnostic and therapeutic challenge in daily practice. Enthesitis seems to play a central role in this inflammatory autoimmune disorder. The European League Against Rheumatism (EULAR) recommends a treat-to-target approach in terms of consistent treatment monitoring and adjustment at defined intervals. Gradually, administration of nonsteroidal anti-rheumatics should be followed by treatment with conventional synthetic and biological disease-modifying anti-rheumatic drugs (csDMARDs and bDMARDs) such as TNF-alpha-blockers, interleukin-17, and interleukin-12/23 inhibitors. However, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommends an individual therapeutic approach depending on the affected area.