Abstract

Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease with various joint and skin manifestations and multiple associated comorbidities. The management of PsA is important not only in controlling disease activity and preventing subsequent damage but also in improving the quality of life and reducing mortality. Over the years, numerous drugs have been introduced into the therapeutic armamentarium of the disease. While non-steroidal anti-inflammatory drugs (NSAIDs) and conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) have contributed to management, it was not until the advent of biologics (and later on targeted synthetic DMARDs) that therapy was revolutionized, with the achievement of significantly better clinical and radiographic outcomes. Several drugs and treatment approaches are currently being tested in clinical trials at different phases. Despite all the success, there are still various challenges and unmet needs in the field of PsA, reflected by difficult-to-treat disease course, secondary failure of therapy, and lack of consensus on accepted treatment withdrawal protocols, among others. In this review, we have discussed the most recent advances in the therapy of psoriatic disease, with a particular focus on phase III studies completed (or ongoing) since 2020. We also mentioned the challenges and unmet needs in our clinical practice, which we expect current and future research to provide answers to.

Keywords: Psoriatic arthritis, psoriasis, advances, disease-modifying anti-rheumatic drugs, axial disease, withdrawal of therapy.