Köhm M, Behrens F
Abteilung Rheumatologie, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt, Deutschland.
Projektgruppe Translationale Medizin und Pharmakologie (TMP), Fraunhofer IME, Frankfurt/Main, Deutschland.
Z Rheumatol. 2017 Aug;76(6):495-503. doi: 10.1007/s00393-017-0334-0.
Psoriatic arthritis (PsA) is a heterogeneous immune-mediated disease that usually involves the skin and joints but can also affect the entheses, spine and other extra-articular structures. Furthermore, it can be coupled with associated comorbidities. The selection of a patient-oriented and effective therapy is based on the extent of various manifestations of the disease as well as further influencing factors. Various recommendations for selection and control are available for deciding on a suitable treatment. The recommendations of the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) are most frequently used and are internationally acknowledged. Both recommendations were updated in 2016. German treatment recommendations are currently lacking. In analogy to the treat-to-target strategy in the treatment of rheumatoid arthritis, minimal disease activity should at least be achieved with the therapeutic intervention used if remission as the therapeutic target cannot be reached. New treatment options, which target different molecules, provide possibilities for a more differentiated therapy for improvement in the treatment of PsA patients.
银屑病关节炎(PsA)是一种异质性免疫介导疾病,通常累及皮肤和关节,但也可影响附着点、脊柱和其他关节外结构。此外,它还可能伴有相关的合并症。以患者为导向的有效治疗方案的选择基于疾病各种表现的程度以及其他影响因素。对于选择和控制治疗有各种建议,可用于决定合适的治疗方法。欧洲抗风湿病联盟(EULAR)和银屑病及银屑病关节炎研究与评估小组(GRAPPA)的建议最为常用且得到国际认可。这两项建议均于2016年更新。目前缺乏德国的治疗建议。类似于类风湿关节炎治疗中的达标治疗策略,如果无法实现缓解这一治疗目标,则应至少通过所采用的治疗干预达到最小疾病活动度。针对不同分子的新治疗选择为更有针对性地治疗银屑病关节炎患者提供了改善治疗的可能性。