Treatment of psoriatic arthritis with biological agents

Psoriatic arthritis (PsA) is an inflammatory arthritis that occurs in individuals with psoriasis. The primary goals in the treatment of PsA are reduction of pain; improvement in the other signs and symptoms of disease, including skin and nail involvement; optimization of functional capacity and quality of life; and inhibition of the progression of joint damage. These goals should be achieved while minimizing potential toxicities from treatment. The management of PsA should simultaneously target arthritis, skin disease, and other manifestations of PsA, including involvement of the axial skeleton, dactylitis, enthesitis, and eye inflammation. In this respect targeted biological agents, primarily tumor necrosis factor inhibitors, have emerged as generally well tolerated and highly effective alternatives to traditional disease modifying antirheumatic drugs. Herein we review the evidence regarding the treatment of PsA arthritis with biological agents.