European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update

Gossec L, Smolen JS, Ramiro S, De Wit M, Cutolo M, Dougados M, Emery P, Landewe R, Oliver S, Aletaha D, Betteridge N, Braun J, Burmester G, Canete JD, Damjanov N, Fitzgerald O, Haglund E, Helliwell P, Kvien TK, Lories R, Luger T, Maccarone M, Marzo-Ortega H, Mcgonagle D, Mcinnes IB, Olivieri I, Pavelka K, Schett G, Sieper J, Van Den Bosch F, Veale DJ, Wollenhaupt J, Zink A, Van Der Heijde D (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Book Volume: 75

Pages Range: 499-510

Journal Issue: 3

DOI: 10.1136/annrheumdis-2015-208337

Abstract

Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations.A systematic literature review was performed regarding pharmacological treatment in PsA. Subsequently, recommendations were formulated based on the evidence and the expert opinion of the 34 Task Force members. Levels of evidence and strengths of recommendations were allocated.The updated recommendations comprise 5 overarching principles and 10 recommendations, covering pharmacological therapies for PsA from non-steroidal anti-inflammatory drugs (NSAIDs), to conventional synthetic (csDMARD) and biological (bDMARD) disease-modifying antirheumatic drugs, whatever their mode of action, taking articular and extra-articular manifestations of PsA into account, but focusing on musculoskeletal involvement. The overarching principles address the need for shared decision-making and treatment objectives. The recommendations address csDMARDs as an initial therapy after failure of NSAIDs and local therapy for active disease, followed, if necessary, by a bDMARD or a targeted synthetic DMARD (tsDMARD). The first bDMARD would usually be a tumour necrosis factor (TNF) inhibitor. bDMARDs targeting interleukin (IL)12/23 (ustekinumab) or IL-17 pathways (secukinumab) may be used in patients for whom TNF inhibitors are inappropriate and a tsDMARD such as a phosphodiesterase 4-inhibitor (apremilast) if bDMARDs are inappropriate. If the first bDMARD strategy fails, any other bDMARD or tsDMARD may be used.These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.

Authors with CRIS profile

Involved external institutions

Charité - Universitätsmedizin Berlin Germany (DE) Leiden University Netherlands (NL) Schön Klinik Hamburg Eilbek Germany (DE) St Vincent's University Hospital Ireland (IE) University Hospital Ghent Belgium (BE) Univerzita Karlova v Praze / Charles University in Prague Czech Republic (CZ) Ospedale San Carlo Italy (IT) University of Glasgow United Kingdom (GB) NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU) United Kingdom (GB) ADIPSO Associazione per la Difesa degli Psoriasici Italy (IT) Universitätsklinikum Münster Germany (DE) Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven Belgium (BE) Diakonhjemmet Hospital Norway (NO) University of Leeds United Kingdom (GB) Lund University / Lunds universitet Sweden (SE) University of Belgrade / Универзитет у Београду Serbia (RS) Hospital Clínic de Barcelona Spain (ES) Rheumazentrum Ruhrgebiet Germany (DE) European League Against Rheumatism (EULAR) Switzerland (CH) Medizinische Universität Wien Austria (AT) Amsterdam Rheumatology & immunology Center (ARC) Netherlands (NL) University of Paris 5 - René Descartes / Université Paris V René Descartes France (FR) University of Genova / Università degli Studi di Genova Italy (IT) University of Paris 6 - Pierre et Marie Curie / Université Paris VI Pierre et Marie Curie (UPMC) France (FR)

How to cite

APA:

Gossec, L., Smolen, J.S., Ramiro, S., De Wit, M., Cutolo, M., Dougados, M.,... Van Der Heijde, D. (2016). European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Annals of the Rheumatic Diseases, 75(3), 499-510. https://doi.org/10.1136/annrheumdis-2015-208337

MLA:

Gossec, Laure, et al. "European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update." Annals of the Rheumatic Diseases 75.3 (2016): 499-510.

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