Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
Division of Allergy-Immunology-Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; Program of Business, College of Business, Feng Chia University, Taichung, Taiwan.
J Formos Med Assoc. 2021 Mar;120(3):926-938. doi: 10.1016/j.jfma.2020.08.026. Epub 2020 Oct 2.
In Taiwan, the incidence and prevalence of psoriatic arthritis (PsA) have risen significantly in recent years. Moreover, data from the Taiwan National Health Insurance Research Database (NHIRD) show that more than 85% of PsA patients are treated with just non-steroidal anti-inflammatory drugs (NSAIDs) and/or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). Taiwanese clinicians have also expressed concerns regarding uncertainties in the diagnosis of PsA and the delayed, interrupted, and/or tapered use of biologics, as well as differences in therapeutic preferences between and within dermatologists and rheumatologists. To address these issues, the Taiwan Rheumatology Association and the Taiwanese Association for Psoriasis and Skin Immunology jointly convened a committee of 28 clinicians from the fields of rheumatology, dermatology, orthopedics, and rehabilitation, to develop evidence-based consensus recommendations for the practical management of PsA in Taiwan. A total of six overarching principles and 13 recommendations were developed and approved, as well as a treatment algorithm with four separate tracks for axial PsA, peripheral PsA, enthesitis, and dactylitis. Psoriasis (PsO) management was not discussed here, as the Taiwanese Dermatological Association has recently published a comprehensive consensus statement on the management of PsO. Together, these recommendations provide an up-to-date, evidence-based framework for PsA care in Taiwan.
在台湾，近年来银屑病关节炎（PsA）的发病率和患病率显著上升。此外，来自台湾全民健康保险研究数据库（NHIRD）的数据显示，超过 85%的 PsA 患者仅接受非甾体抗炎药（NSAIDs）和/或传统合成疾病修饰抗风湿药（csDMARDs）治疗。台湾临床医生还对 PsA 的诊断不确定性、生物制剂的延迟、中断和/或减量使用以及皮肤科医生和风湿病医生之间以及内部的治疗偏好差异表示担忧。为了解决这些问题，台湾风湿病学会和台湾银屑病和皮肤免疫学协会联合召集了一个由 28 名来自风湿病学、皮肤病学、骨科和康复领域的临床医生组成的委员会，为台湾的 PsA 实际管理制定循证共识建议。共制定并批准了六项总体原则和十三条建议，以及针对轴向 PsA、外周 PsA、附着点炎和指（趾）炎的四个独立治疗方案的治疗算法。这里没有讨论银屑病（PsO）的管理，因为台湾皮肤科协会最近发布了关于 PsO 管理的全面共识声明。这些建议共同为台湾的 PsA 护理提供了一个最新的、基于证据的框架。
