PMID- 38499325
OWN - NLM
STAT- Publisher
LR  - 20240318
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
DP  - 2024 Mar 18
TI  - EULAR recommendations for the management of psoriatic arthritis with 
      pharmacological therapies: 2023 update.
LID - ard-2024-225531 [pii]
LID - 10.1136/ard-2024-225531 [doi]
AB  - OBJECTIVE: New modes of action and more data on the efficacy and safety of 
      existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 
      recommendations for the pharmacological treatment of PsA. METHODS: Following 
      EULAR standardised operating procedures, the process included a systematic 
      literature review and a consensus meeting of 36 international experts in April 
      2023. Levels of evidence and grades of recommendations were determined. RESULTS: 
      The updated recommendations comprise 7 overarching principles and 11 
      recommendations, and provide a treatment strategy for pharmacological therapies. 
      Non-steroidal anti-inflammatory drugs should be used in monotherapy only for mild 
      PsA and in the short term; oral glucocorticoids are not recommended. In patients 
      with peripheral arthritis, rapid initiation of conventional synthetic 
      disease-modifying antirheumatic drugs is recommended and methotrexate preferred. 
      If the treatment target is not achieved with this strategy, a biological 
      disease-modifying antirheumatic drug (bDMARD) should be initiated, without 
      preference among modes of action. Relevant skin psoriasis should orient towards 
      bDMARDs targeting interleukin (IL)-23p40, IL-23p19, IL-17A and IL-17A/F 
      inhibitors. In case of predominant axial or entheseal disease, an algorithm is 
      also proposed. Use of Janus kinase inhibitors is proposed primarily after bDMARD 
      failure, taking relevant risk factors into account, or in case bDMARDs are not an 
      appropriate choice. Inflammatory bowel disease and uveitis, if present, should 
      influence drug choices, with monoclonal tumour necrosis factor inhibitors 
      proposed. Drug switches and tapering in sustained remission are also addressed. 
      CONCLUSION: These updated recommendations integrate all currently available drugs 
      in a practical and progressive approach, which will be helpful in the 
      pharmacological management of PsA.
CI  - (c) European Alliance of Associations for Rheumatology, EULAR 2024. Re-use 
      permitted under CC BY-NC-ND. No commercial re-use. No derivatives. See rights and 
      permissions. Published by BMJ on behalf of EULAR.
FAU - Gossec, Laure
AU  - Gossec L
AUID- ORCID: 0000-0002-4528-310X
AD  - INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique, Sorbonne 
      Universite, Paris, France laure.gossec@aphp.fr.
AD  - APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, 
      France.
FAU - Kerschbaumer, Andreas
AU  - Kerschbaumer A
AUID- ORCID: 0000-0002-6685-8873
AD  - Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, 
      Vienna, Austria.
FAU - Ferreira, Ricardo J O
AU  - Ferreira RJO
AUID- ORCID: 0000-0002-2517-0247
AD  - Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Higher 
      School of Nursing of Lisbon, Lisbon, Portugal.
AD  - Rheumatology Department, Centro Hospitalar e Universitario de Coimbra EPE, 
      Coimbra, Portugal.
FAU - Aletaha, Daniel
AU  - Aletaha D
AUID- ORCID: 0000-0003-2108-0030
AD  - Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, 
      Vienna, Austria.
FAU - Baraliakos, Xenofon
AU  - Baraliakos X
AUID- ORCID: 0000-0002-9475-9362
AD  - Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany.
FAU - Bertheussen, Heidi
AU  - Bertheussen H
AD  - EULAR Patient Research Partner, EULAR, Oslo, Norway.
FAU - Boehncke, Wolf-Henning
AU  - Boehncke WH
AD  - Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland.
FAU - Esbensen, Bente Appel
AU  - Esbensen BA
AUID- ORCID: 0000-0001-5331-8221
AD  - Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine 
      Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
AD  - Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
FAU - McInnes, Iain B
AU  - McInnes IB
AD  - College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, 
      UK.
FAU - McGonagle, Dennis
AU  - McGonagle D
AD  - LTHT, NIHR Leeds Biomedical Research Centre, Leeds, UK.
AD  - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 
      Leeds, UK.
FAU - Winthrop, Kevin L
AU  - Winthrop KL
AUID- ORCID: 0000-0002-3892-6947
AD  - Division of Infectious Diseases, School of Medicine, School of Public Health, 
      Oregon Health & Science University, Portland, Oregon, USA.
FAU - Balanescu, Andra
AU  - Balanescu A
AD  - Sf Maria Hospital, University of Medicine and Pharmacy Carol Davila Bucharest, 
      Bucharest, Romania.
FAU - Balint, Peter V
AU  - Balint PV
AD  - Medical Imaging Centre, Semmelweis University, 3rd Rheumatology Department, 
      National Institute of Musculoskeletal Diseases, Budapest, Hungary.
FAU - Burmester, Gerd R
AU  - Burmester GR
AUID- ORCID: 0000-0001-7518-1131
AD  - Department of Rheumatology and Clinical Immunology, Freie Universitat Berlin and 
      Humboldt-Universitat zu Berlin, Charite Universitatsmedizin Berlin, Berlin, 
      Germany.
FAU - Canete, Juan D
AU  - Canete JD
AUID- ORCID: 0000-0003-2606-0573
AD  - Arthritis Unit, Department of Rheumatology, Hospital Clinic Barcelona, Barcelona, 
      Spain.
AD  - FCRB, IDIBAPS, Barcelona, Spain.
FAU - Claudepierre, Pascal
AU  - Claudepierre P
AD  - Rheumatology, AP-HP, Henri Mondor University Hospital, Creteil, France.
AD  - EA Epiderme, UPEC, Creteil, France.
FAU - Eder, Lihi
AU  - Eder L
AUID- ORCID: 0000-0002-1473-1715
AD  - Department of Medicine, University of Toronto, Women's College Hospital, Toronto, 
      Toronto, Canada.
FAU - Hetland, Merete Lund
AU  - Hetland ML
AUID- ORCID: 0000-0003-4229-6818
AD  - The Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine 
      Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, 
      Denmark.
AD  - Department of Clinical Medicine, Faculty of Health and Medical Sciences, 
      University of Copenhagen, Copenhagen, Denmark.
FAU - Iagnocco, Annamaria
AU  - Iagnocco A
AUID- ORCID: 0000-0001-5592-724X
AD  - Academic Rheumatology Centre, Dipartimento Scienze Cliniche Biologiche, 
      Universita di Torino - AO Mauriziano Torino, Turin, Italy.
FAU - Kristensen, Lars Erik
AU  - Kristensen LE
AD  - The Parker Institute, Bispebjerg, Denmark.
AD  - Frederiksberg Hospital, Copenhagen University, Copenhagen, Denmark.
FAU - Lories, Rik
AU  - Lories R
AD  - Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering 
      Research Center, KU Leuven, Leuven, Belgium.
AD  - Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
FAU - Queiro, Ruben
AU  - Queiro R
AUID- ORCID: 0000-0002-8418-7145
AD  - Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Spain.
AD  - Translational Immunology Division, Biohealth Research Institute of the 
      Principality of Asturias, Oviedo University School of Medicine, Oviedo, Spain.
FAU - Mauro, Daniele
AU  - Mauro D
AUID- ORCID: 0000-0002-9022-8863
AD  - Department of Precision Medicine, University of Campania Luigi Vanvitelli, 
      Naples, Italy.
FAU - Marzo-Ortega, Helena
AU  - Marzo-Ortega H
AUID- ORCID: 0000-0002-9683-3407
AD  - LTHT, NIHR Leeds Biomedical Research Centre, Leeds, UK.
AD  - Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 
      Leeds, UK.
FAU - Mease, Philip J
AU  - Mease PJ
AUID- ORCID: 0000-0002-6620-0457
AD  - Rheumatology Research, Providence Swedish, Seattle, Washington, USA.
AD  - University of Washington School of Medicine, Seattle, Washington, USA.
FAU - Nash, Peter
AU  - Nash P
AUID- ORCID: 0000-0002-2571-788X
AD  - School of Medicine, Griffith University, Brisbane, Queensland, Australia.
FAU - Wagenaar, Wendy
AU  - Wagenaar W
AD  - Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 
      Tilburg, The Netherlands.
AD  - Young PARE Patient Research Partner, EULAR, Zurich, Switzerland.
FAU - Savage, Laura
AU  - Savage L
AD  - School of Medicine and Dermatology, Leeds Teaching Hospitals NHS Trust, 
      University of Leeds, Leeds, UK.
FAU - Schett, Georg
AU  - Schett G
AUID- ORCID: 0000-0001-8740-9615
AD  - Department of Internal Medicine 3, Rheumatology and Immunology and 
      Universitatsklinikum Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, 
      Erlangen, Germany.
FAU - Shoop-Worrall, Stephanie J W
AU  - Shoop-Worrall SJW
AUID- ORCID: 0000-0002-9441-5535
AD  - Children and Young Person's Rheumatology Research Programme, Centre for 
      Musculoskeletal Research, The University of Manchester, Manchester, UK.
FAU - Tanaka, Yoshiya
AU  - Tanaka Y
AUID- ORCID: 0000-0002-0807-7139
AD  - First Department of Internal Medicine, University of Occupational and 
      Environmental Health, Japan, Kitakyushu, Japan.
FAU - Van den Bosch, Filip E
AU  - Van den Bosch FE
AUID- ORCID: 0000-0002-3561-5932
AD  - Department of Internal Medicine and Pediatrics, VIB Center for Inflammation 
      Research, Ghent University, Gent, Belgium.
FAU - van der Helm-van Mil, Annette
AU  - van der Helm-van Mil A
AD  - Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
FAU - Zabotti, Alen
AU  - Zabotti A
AUID- ORCID: 0000-0002-0573-464X
AD  - Department of Medical and Biological Sciences, Azienda sanitaria universitaria 
      Friuli Centrale, Udine, Italy.
FAU - van der Heijde, Desiree
AU  - van der Heijde D
AUID- ORCID: 0000-0002-5781-158X
AD  - Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
FAU - Smolen, Josef S
AU  - Smolen JS
AD  - Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, 
      Vienna, Austria.
LA  - eng
PT  - Journal Article
DEP - 20240318
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
SB  - IM
OTO - NOTNLM
OT  - Biological Therapy
OT  - Biosimilar Pharmaceuticals
OT  - Psoriatic Arthritis
OT  - Treatment
COIS- Competing interests: No support to any author for the present work. Outside the 
      submitted work: LG: research grants: AbbVie, Biogen, Lilly, Novartis, UCB; 
      consulting fees: AbbVie, Amgen, BMS, Celltrion, Janssen, Lilly, MSD, Novartis, 
      Pfizer, UCB; non-financial support: AbbVie, Amgen, Galapagos, Janssen, MSD, 
      Novartis, Pfizer, UCB; membership on an entity's Board of Directors or advisory 
      committees: EULAR Treasurer. AK: speakers bureau, consultancy: AbbVie, Amgen, 
      Galapagos, Janssen, Eli Lilly, MSD, Novartis, Pfizer, UCB. RJOF: research grants: 
      Medac, Lilly; consulting fees: Sanofi. DA: research grants: Galapagos, Lilly; 
      consulting fees: AbbVie, Gilead, Janssen, Lilly, Merck, Novartis, Sanofi. XB: 
      research grants: AbbVie, MSD, Novartis; consultancies: AbbVie, Amgen, Celltrion, 
      Chugai, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB; 
      membership on an entity's Board of Directors or advisory committees: ASAS 
      President, EULAR President Elect. W-HB: honoraria: AbbVie, Almirall, BMS, 
      Janssen, Leo, Eli Lilly, Novartis, UCB; expert testimony: Novartis; participation 
      on a Data Safety Monitoring Board or Advisory Board: AbbVie, Almirall, BMS, 
      Janssen, Leo, Eli Lilly, Novartis, UCB. IBM: honoraria/consultation fees non-exec 
      roles: NHS GGC Board Member, Evelo Board of Directors, Versus Arthritis Trustee 
      Status; stock or stock options: Evelo, Cabaletta, Compugen, Causeway 
      Therapeutics, Dextera. DGM: research grants: Janssen, AbbVie, Lilly, Novartis, 
      UCB, BMS, Moonlake; consulting fees: Janssen, AbbVie, Lilly, Novartis, UCB, BMS, 
      Moonlake, Celgene; honoraria: Janssen, AbbVie, Lilly, Novartis, UCB, BMS, 
      Moonlake. KLW: research grants: BMS, Pfizer; consulting: Pfizer, AbbVie, 
      AstraZeneca, BMS, Eli Lilly, Galapagos, GlaxoSmithKline (GSK), Gilead, Novartis, 
      Moderna, Regeneron, Roche, Sanofi, UCB Pharma. AB: speakers fees: AbbVie, Amgen, 
      AlphaSigma, AstraZeneca, Angelini, Biogen, BMS, Berlin-Chemie, Boehringer 
      Ingelheim, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz, Teva, UCB, 
      Zentiva; consultancies: Akros, AbbVie, Amgen, AlphaSigma, Biogen, Boehringer 
      Ingelheim, Lilly, Mylan, MSD, Novartis, Pfizer, Roche, Sandoz, Sobi, UCB. PVB: 
      consulting fees: AbbVie, Janssen-Cilag, Pfizer; honoraria: AbbVie, Bausch Health, 
      Celltrion Healthcare, Eli Lilly, Gedeon Richter, IBSA Pharma, Infomed, 
      Janssen-Cilag, Novartis, Pfizer, Sandoz; payment for expert testimony: Gedeon 
      Richter; other: President, Hungarian Association of Rheumatologists. GRB: 
      honoraria and/or speaker fees: AbbVie, BMS, Janssen, Lilly, Novartis, Pfizer. 
      JDC: honoraria: UCB. PC: research grants: AbbVie, Amgen, Biogen, Jansen, Lilly, 
      Novartis, UCB; consulting fees: AbbVie, Amgen, Celltrion, Janssen, Lilly, MSD, 
      Novartis, Pfizer, UCB. LE: consultation fee/advisory board: AbbVie, Novartis, 
      Janssen, UCB, BMS, Eli Lilly; research/educational grants: AbbVie, Fresenius 
      Kabi, Janssen, Amgen, UCB, Novartis, Eli Lilly, Sandoz, Pfizer. MLH: grant 
      support: AbbVie, Biogen, BMS, Celltrion, Eli Lilly, Janssen Biologics BV, 
      Lundbeck Foundation, MSD, Pfizer, Roche, Samsung Bioepis, Sandoz, Novartis, 
      Nordforsk; honoraria: Pfizer, Medac, Sandoz; advisory board: AbbVie; past-chair 
      of the steering committee of the Danish Rheumatology Quality Registry (DANBIO, 
      DRQ), which receives public funding from the hospital owners and funding from 
      pharmaceutical companies; cochair of EuroSpA, partly funded by Novartis. AI: 
      research grants from AbbVie, Pfizer, Novartis; honoraria for lectures, 
      presentations, speakers bureaus from AbbVie, Alfasigma, BMS, Celgene, Celltrion, 
      Eli Lilly, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Sanofi Genzyme, 
      Sobi; EULAR Board Member; EULAR Congress Committee, Education Committee and 
      Advocacy Committee Advisor; EULAR Past President. LEK: consultancies: AbbVie, 
      Amgen, Biogen, BMS, Celgene, Eli Lilly, Pfizer, UCB, Sanofi, GSK, Galapagos, 
      Forward Pharma, MSD, Novartis, Janssen; has been representing rheumatology FOREUM 
      scientific chair. RQ: consultancy and/or speaker's honoraria from and/or 
      participated in clinical trials and/or research projects sponsored by AbbVie, 
      Amgen-Celgene, Eli Lilly, Novartis, Janssen, Pfizer, MSD, UCB. DM: honoraria: 
      UCB, Janssen, GSK, AstraZeneca, AbbVie; support to meetings: Janssen. HM-O: grant 
      support: Janssen, Novartis, UCB; honoraria and/or speaker fees: AbbVie, Biogen, 
      Eli Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda, UCB. PJM: grant support: 
      AbbVie, Acelyrin, Amgen, Bristol Myers Squibb, Eli Lilly, Genascence, Janssen, 
      Novartis, Pfizer, UCB; consulting fees: AbbVie, Acelyrin, Aclaris, Alumis, Amgen, 
      Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Genascence, Inmagene, 
      Janssen, Moonlake, Novartis, Pfizer, Takeda, UCB, Ventyx, Xinthera; honoraria: 
      AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, UCB. PN: consulting fees and 
      honoraria: AbbVie, Amgen, BMS, Lilly, Janssen, GSK, Novartis, UCB, Servatus; 
      boards: Amgen, BMS, Janssen, GSK, Novartis, UCB; GRAPPA Steering Committee, Chair 
      ASMPOC, ARA. LS: consulting fees: AbbVie, Almirall, Novartis, Janssen, Lilly, 
      UCB, Pfizer, Bristol Myers Squibb, Boehringer Ingelheim; honoraria: AbbVie, 
      Almirall, Novartis, Janssen, UCB, Pfizer, Takeda, Galderma, Biogen, Celgene, 
      Celltrion, Lilly, Sanofi, Bristol Myers Squibb, Boehringer Ingelheim; support to 
      attending meetings: AbbVie, Janssen, Lilly, Novartis, UCB, Galderma, Bristol 
      Myers Squibb, Boehringer Ingelheim; participation in boards: AbbVie, Almirall, 
      Novartis, Janssen, UCB, Pfizer, Galderma, Biogen, Lilly, Sanofi, Bristol Myers 
      Squibb, Boehringer Ingelheim; GRAPPA Executive Board (elected), British Society 
      for Medical Dermatology (BSMD) Committee. GS: honoraria: Novartis, Janssen. 
      SJWS-W: grant support: Medical Research Council (MR/W027151/1). YT: research 
      grants from Mitsubishi Tanabe, Eisai, Chugai, Taisho; speaking fees and/or 
      honoraria from Eli Lilly, AstraZeneca, AbbVie, Gilead, Chugai, Boehringer 
      Ingelheim, GlaxoSmithKline, Eisai, Taisho, Bristol Myers, Pfizer, Taiho. FEVdB: 
      consultancy honoraria from AbbVie, Amgen, Eli Lilly, Galapagos, Janssen, 
      Novartis, Pfizer, UCB. AZ: speakers bureau: AbbVie, Novartis, Janssen, Lilly, 
      UCB, Amgen; paid instructor for AbbVie, Novartis, UCB. DvdH: consulting fees 
      AbbVie, Argenx, Bayer, BMS, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, 
      Novartis, Pfizer, Takeda, UCB Pharma; Director of Imaging Rheumatology bv; 
      Associate Editor for Annals of the Rheumatic Diseases; Editorial Board Member for 
      Journal of Rheumatology and RMD Open; Advisor Assessment Axial Spondyloarthritis 
      International Society. JSS: research grants from AbbVie, AstraZeneca, Lilly, 
      Galapagos; royalties from Elsevier (textbook); consulting fees from AbbVie, 
      Galapagos/Gilead, Novartis-Sandoz, BMS, Samsung, Sanofi, Chugai, R-Pharma, Lilly; 
      honoraria from Samsung, Lilly, R-Pharma, Chugai, MSD, Janssen, Novartis-Sandoz; 
      participation in advisory board from AstraZeneca.
EDAT- 2024/03/19 00:42
MHDA- 2024/03/19 00:42
CRDT- 2024/03/18 20:43
PHST- 2024/01/15 00:00 [received]
PHST- 2024/02/26 00:00 [accepted]
PHST- 2024/03/19 00:42 [medline]
PHST- 2024/03/19 00:42 [pubmed]
PHST- 2024/03/18 20:43 [entrez]
AID - ard-2024-225531 [pii]
AID - 10.1136/ard-2024-225531 [doi]
PST - aheadofprint
SO  - Ann Rheum Dis. 2024 Mar 18:ard-2024-225531. doi: 10.1136/ard-2024-225531.