Multiple new treatments add complexity to selecting the best psoriatic arthritis treatment for each patient


M. Elaine Husni, MD, MPH
M. Elaine Husni, MD, MPH

A number of recent advancements have given rheumatologists many new tools for treating psoriatic arthritis (PsA). However, it’s not always clear which therapies to use and when. 


Rheumatologists looking for help making the best treatment decisions for their patients can turn to Optimizing Outcomes in Psoriatic Arthritis: A Domain-based Strategy. The session will take place from 1:00– 2:00 pm Tuesday Room B308, Building B, in the Georgia World Congress Center.


Presenter M. Elaine Husni, MD, MPH, Vice Chair of the Department of Rheumatic & Immunologic Diseases at the Cleveland Clinic, Ohio, said given the number of new therapeutics available for PsA, it’s important for rheumatologists to become familiar with the new options in terms of mechanisms of action, efficacy in various domains of disease presentations and side effects.


Dr. Husni, who will present “Comprehensive Initial Assessment and Outcomes with Defined Therapeutic Targets to Increase Remission Rate in PsA,” said the session provides a unique opportunity for clinicians to improve their understanding of the available treatments in a short amount of time.


“We used to have a much smaller array of drugs available to us, so treatment decisions were fairly straightforward,” she said. “The availability of so many new agents is exciting, but now it’s not always clear what to use, which can be confusing.”


Unlike psoriasis, which only involves the skin, psoriatic arthritis involves multiple domains, which complicates treatment choices. 


“It’s still a bit frustrating that despite the growing number of clinical trials and new drug approvals, we are still way behind psoriasis outcomes,” Dr. Husni said. “For our psoriatic arthritis patients with skin and joint involvement, we still don’t have control that is so good we can resolve the joint symptoms despite all the new treatment options.” 


For this reason, Dr. Husni and fellow presenter Philip Mease, MD, Clinical Professor at the University of Washington, Seattle, will demonstrate a domain-based, treat-to-target approach for treating PsA.


“We not only have to consider skin and joint involvement, but also other domains as well, including enthesitis and dactylitis,” Dr. Husni said. “There’s a lot of prognostic value to achieving a defined target. If you have a target to treat, you can personalize treatment based on the domain or domains most affected.”


Dr. Husni will outline the important domains and their assessment in patients with PsA. Then Dr. Mease will review which therapies work best for each domain during his talk, “Personalized Therapy in PsA: Targeting the Domains and Related Pathologic Pathways.”


“I wish we had one drug that would treat all the domains equally, but it’s not that straightforward,” Dr. Husni said.