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Clinical Challenges: Treatment of Psoriatic Arthritis

MedPage Today discusses treatment options for Psoriatic Arthritis (PsA) and considerations for developing a treatment plan according to HSS rheumatologist Dee Dee Wu, MD and others.

The initial evaluation of the patient involves determining the extent of illness both from a skin perspective and from an arthritic perspective, explained Dr. Wu. "We need to address both, ideally with a single medication.” Initial treatment particularly for patients with milder disease, can involve an oral DMARD [disease-modifying antirheumatic drug] such as methotrexate. Other oral options that can address both the skin and arthritic symptoms include apremilast and tofacitinib, noted Dr. Wu.

An important consideration when choosing a treatment is the presence of comorbidities. Patients also could have conditions such as cancer or congestive heart failure and could have contraindications to certain medications, said Dr. Wu. "There really is no set algorithm in terms of deciding on treatment because it's individualized to the patients' symptoms and their other medical conditions. You don't want to overtreat but you don't want to undertreat either, so that's where the finesse come in," she counseled.

Read the full article at MedPagetoday.com.