Common Symptoms and Treatments in Psoriatic Arthritis

EP: 1.Background on PROs in Psoriatic Arthritis

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EP: 2.Common Symptoms and Treatments in Psoriatic Arthritis

Pain emerges as the primary symptom driving patients to seek rheumatological care. It manifests in joints and enthesial insertion sites with profound functional implications. Dr. Mease illustrates this with specific examples, such as a patient with Achilles tendon inflammation requiring an orthopedic boot or a violinist unable to perform due to index finger dactylitis. These real-world scenarios demonstrate how various clinical domains can severely impact patients’ ability to perform standard activities of daily living and maintain their professional responsibilities.

The symptom constellation includes debilitating morning stiffness that leaves patients feeling like “the Tin Man in ‘The Wizard of Oz,’” along with pervasive fatigue that extends beyond physical discomfort to contribute to depression and significantly diminish quality of life. This fatigue often prevents patients from engaging in desired activities and maintaining their full capacity in work and family life, creating a cascade of functional limitations that extend far beyond the visible manifestations of the disease.

Treatment evolution in psoriatic arthritis has progressed dramatically from the limited options of the 1980s, when gold injections and basic medications provided inadequate disease control. The biologic era, beginning with TNF inhibitors like etanercept in 2000, revolutionized treatment outcomes by targeting specific inflammatory pathways, including TNF, IL-17 and IL-23. This expanded therapeutic armamentarium has become crucial because patients may lose response to initial treatments or experience side effects requiring medication switches, necessitating multiple therapeutic options to achieve optimal long-term disease management and maintain treatment goals over time.