Managing comorbidities in psoriatic arthritis: A state-of-the-art approach to integrated care (2025)

Psoriatic arthritis (PsA) is a chronic immune mediated musculoskeletal condition that is associated with psoriasis. PsA is recognized not as an isolated articular disorder, but as a systemic inflammatory condition with interrelated involvement of the skin, joints, entheses, spine, and gut. The systemic nature of PsA extends beyond musculoskeletal and cutaneous involvement to include a broad spectrum of comorbid and related inflammatory conditions that contribute to disease burden, treatment complexity, and long-term outcomes. PsA is associated with significant comorbidities. This includes cardiovascular disease, obesity, diabetes, fatigue and sleep disorders, mental health disorders and end-organ complications involving the kidney, liver, and bone, as well as related immune-mediated conditions such as inflammatory bowel disease and uveitis. This chapter examines the comorbidity landscape in PsA and underscores its importance in guiding more integrated and effective care. There is particular emphasis on multi-disciplinary evaluation to guide management. We will also explore the updated guidelines for screening, diagnostics, and treatment recommendations in addition to updates in the digital age.