PsA - recent knowledge on pathogenesis, prognosis, assessment, and therapy

Recently, major advances have been made in the research of psoriatic arthritis at the histological, pathophysiological, and clinical levels.

This has allowed the development of new pharmaceutical drugs, particularly biologics. Based on histological and immunohistochemical

studies, the issues of including psoriatic arthritis in spondylarthritides and the relation to rheumatoid arthritis have been definitively solved.

At the clinical level, new classification criteria abbreviated as CASPAR have been outlined. The efficacy of TNFa inhibitors (infliximab,

etanercept, adalimumab) has been confirmed and the results of long-term studies have been published. However, not all the patients

treated respond to this therapy; according to the criteria used (ACR20; 50; and 70) it is about 60; 40; and 20% of patients, respectively.

This raises the need for developing new pharmaceutical drugs of this group. Typically, pharmaceutical drugs are tested in PsA that have

worked in the treatment of rheumatoid arthritis. Recently, they have included golimumab, ustekinumab, and prospectively the JAK3

oral signalling molecule inhibitor and SYK-kinase inhibitor. The latest trend is an effort to interfere with the development of destruction

by selective inhibition of osteoclastogenesis with an antibody against RANKL – denosumab.

Keywords: psoriatic arthritis, pathophysiology, tendon-synovial complex, GRAPPA, biological therapy of PsA.