| Abstract [eng] |
Psoriatic arthritis remains a significant economic and social burden. It is estimated that up to 30% of cases are diagnosed late, and the chronic and progressive course of the disease leads to disability, reduced work capacity and increased risk of comorbidities. Timely and tailored treatment can slow the progression of the disease, improve quality of life and reduce the burden of psoriatic arthritis on the patient and the health system. Objectives. To identify the current therapeutic approaches to psoriatic arthritis by reviewing scientific literature, analysing the current therapeutic options and limitations, and identifying new innovations that may improve the diagnosis and effectiveness of psoriatic arthritis treatment. Methodology. A literature review was performed to select and analyse the scientific literature published in the MEDLINE database in the last 5 years. The literature review included systematic reviews, meta-analyses, guidelines and literature reviews on psoriatic arthritis and its treatment. Results. The diagnosis of psoriatic arthritis is based on clinical, radiological and laboratory criteria, and the aim of treatment is to achieve minimal disease activity. Since psoriatic arthritis is heterogeneous in its clinical presentation and is often accompanied by comorbidities the treatment strategy must be individualised. Non-steroidal anti-inflammatory drugs and glucocorticoids are used for symptomatic treatment in the initial phase of the disease, but do not achieve disease modifying control. The first-line disease-modifying drugs are traditional synthetic drugs, which are effective mainly for the peripheral form of the disease. If the disease progresses or if initial therapy is ineffective, biological disease-modifying agents are prescribed: TNF-α inhibitors are effective in most patients, IL-17 inhibitors are suitable for patients with prominent axial lesions, and IL-23 inhibitors may be advantageous for patients with both articular and cutaneous symptoms. An alternative to biological therapies is targeted synthetic disease-modifying drugs, which may be effective in patients who have not responded to other treatments. Personalised treatment approaches and biomarker research may enhance disease stratification and treatment selection, but further large-scale clinical trials are needed. Conclusions. The diagnosis and treatment of psoriatic arthritis remains challenging due to the heterogeneity of the disease, the lack of specific biomarkers, and the heterogeneous response to therapy. Therefore, it is important to further improve early diagnostic methods and individualise treatment strategies. Although biological and targeted disease-modifying agents have significantly improved PsA control in recent decades, further research is needed to optimise treatment algorithms. In the future, personalised medicine could improve the quality of life and outcome of psoriatic arthritis patients. |
