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PsA Targeted Therapy Options — SCE Rheumatology MCQ

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HardSpondyloarthropathyPsA Targeted Therapy OptionsSCE Rheumatology

A patient with psoriatic arthritis has persistent enthesitis and dactylitis despite an adequate conventional DMARD trial, with objective inflammation and major functional impact. What is the next treatment principle?

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Correct answer: E — Escalate to an eligible biologic or targeted synthetic DMARD

Enthesitis and dactylitis are treatment domains in PsA. Persistent active disease after conventional therapy warrants consideration of a licensed biologic or targeted synthetic DMARD, chosen by the full phenotype, comorbidity, previous therapy and preference.

Reference: 2022 BSR psoriatic arthritis guideline — executive summary (Published May 2022; corrected January 2023): https://academic.oup.com/rheumatology/article/61/9/3514/6594893; NICE TA768: upadacitinib for active psoriatic arthritis (Published February 2022): https://www.nice.org.uk/guidance/ta768/chapter/1-Recommendations