New Insights into Pathogenesis, Diagnosis and Treatment of Psoriatic Arthritis

Farhad  Dadgar; Abdolrahman  Rostamian; Seyed Reza  Najafizadeh; Shafieh  Movaseghi; Zahra  Saffarian

doi:10.18502/ssu.v31i6.13471

Farhad Dadgar Department of Internal Medicine, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Abdolrahman Rostamian Department of Rheumatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Reza Najafizadeh Rheumatology Research Center, Vali-e-Asr Hospital ,Tehran University of Medical Sciences, Tehran, Iran.
Shafieh Movaseghi Department of Rheumatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Saffarian Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/ssu.v31i6.13471

Keywords: Psoriatic Arthritis, Screening tools, Pathogenesis, Treatment, Biomarkers.

Abstract

Introduction: Psoriatic Arthritis (PSA) is an inflammatory musculoskeletal disorder characterized by significant dysfunction in synovial tissue, tendons and axial sites. PSA is associated with metabolic comorbidities such as diabetes, obesity, congestive heart failure, fatty liver disease, depression and/or anxiety. Due to differences in the clinical manifestations of PSA, some patients are not diagnosed through clinical examination. Delayed psoriatic arthritis diagnosis or consultation has been related to low quality of life and increased frequency of comorbidities and persistent inflammatory state. The aim of the present study was to explore multiple etiologies of PSA, screening tools, and pharmaceutical therapy. Articles were searched from international databases including Magiran, Scopus, Google Scholar, PubMed, and Springer. The keywords of Psoriatic Arthritis, Screening tools, pathogenesis, treatment, and Biomarkers were used to extract articles.

Conclusion: Our study showed that heterogeneity in the etiology of PSA was a major reason for classification problems within this disease spectrum. The explanation for this disease heterogeneity may be focused on variations in genetic and environmental factors. Screening strategies (ex: CASPAR criteria and biomarkers) are a significant first step in early treatment. Moreover, many types of therapy are available to help decreased joint problems, muscle weakness, and disease severity. Detection of dependent factors related to PSA might help in the early intervention of these patients to address clinical and para-clinical issues.

Here we have provided an updated review of the early diagnosis, clinical features, pathogenesis, screening tools, biomarkers, and treatment recommendations, such as new biologic medications, for Psoriatic Arthritis.