ABSTRACT

Objective:

Recently, new treatment options were advanced for the management of psoriatic arthritis (PsA). In this study, we decided to develop national PsA treatment recommendation of Turkish Society for Rheumatology (TRD).

Methods:

In the April 2017, consensus meeting for PsA treatment recommendation were performed with 10 TRD steering committee members. In these meeting, international recommendations, such as EULAR and GRAPPA, discussed. Moreover, national PsA studies were reviewed. General treatment principles, using of NSAID, glucocorticoids, synthetic DMARDs and biological DMARDS were discussed. Flowchart of peripheral arthritis, enthesis, dactylitis, and axial involvement were also developed. Draft national PsA recommendation items were voted in TRD National Congress by 39 TRD members. Recommendation items were accepted if mean was 8 or more. Furthermore, for each recommendation items, percentage of acceptance were also calculated.

Results:

Six general treatment principals were developed andless approved ratio were found in the assessment of PsA outcomes. Two for each recommendation items were accepted for NSAID using and glucocorticoid using. Before biological DMARDS, synthetic DMARDs must be used. After synthetic DMARDs, anti-TNF drugs were the first biological treatment options. For anti-TNF using, 5 different items were defined. Patient who unresponsive or intolerant to anti-TNF drugs, anti-IL-17, anti-IL12/23, or JAK kinase inhibitors may be used without any order. Secukinumab may be used for the axial involvement of PsA patients.

Conclusion:

Turkish Society for Rheumatology PsA-2017 treatment recommendation were developed for both rheumatologist and physicians related with musculoskeletal diseases. In the future, TRD-PsA recommendation may be updated after collecting more experience about other than anti-TNF biological DMARDs.