Psoriatic Arthritis – Review of the Immunologic, Clinic and Therapeutic Aspects of an Inflammatory Systemic Disease

Yolanda      Farhey

doi:10.2174/157339712801318966

Abstract

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. It may affect the peripheral joints, the spine and the entheses. Over the past several decades it revealed itself as a systemic disease as severe as Rheumatoid Arthritis (RA) though it is most of the times seronegative for rheumatoid factor. PsA causes impressive inflammation, deformities and joint damage leading to impaired quality of life and function. It is associated with increased morbidity and mortality risk. We have better insight into the inflammatory and immunologic mechanism involved in this condition, the inflammatory cells, cytokines, adhesion molecules which helped finding the targets for treatment. Over a decade ago with the discovery of the anti-tumor necrosis factor alpha (TNFα) inhibitors we finally found the treatment to reduce the progression of joint damage. Starting this treatment early in the course of disease prevents the joint damage, improves the functional capacity and the survival of the patients with PsA. The biologic medications are effective in reducing dactylitis and enthesitis which are rarely improved by conventional treatments.

Keywords: Psoriatic arthritis, enthesitis, spondylarthropathy, tumor necrosis alpha, synovitis, biologic treatment

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