The 2022 British Society for Rheumatology guideline for the treatment of psoriatic arthritis with biologic and targeted synthetic DMARDs

PsA is a chronic, inflammatory, musculoskeletal disease affecting approximately one quarter of people with the skin condition psoriasis [1, 2]. PsA is a highly heterogeneous disease, encompassing diverse musculoskeletal manifestations or ‘domains’ resulting from disease activity in different tissues. These include peripheral arthritis, spondylitis (axial inflammation), dactylitis (inflammation of the whole digit) and enthesitis (inflammation where a tendon, ligament or joint capsule insert to the bone). Unlike RA, there is a significant variability in clinical presentation of PsA. Individuals with PsA may have different domains involved and drugs have different levels of effectiveness on each domain. It is therefore essential that clinical guidelines for the treatment selection in PsA include disease phenotype and differential effect of medication.