Journal article : Review
State of the art and novel treatments in psoriatic arthritis
- Abstract:
- Psoriatic arthritis (PsA) is a heterogeneous, immune-mediated inflammatory disease characterised by multidomain clinical involvement, including peripheral arthritis, enthesitis, axial disease, dactylitis, and skin and nail manifestations, alongside a substantial burden of comorbidity. Over the recent decades, therapeutic options for PsA have expanded, with the introduction of multiple biologic and targeted compounds targeting tumour necrosis factor, the IL-23/IL-17 axis, and Janus kinase signalling. These advances have improved outcomes for many patients; however, incomplete responses, domain-specific refractory disease, treatment intolerance, and loss of efficacy remain common. In addition, current treatment strategies are largely reactive, reflecting limited ability to predict treatment response or align immune mechanism with clinical phenotype. This review summarises the current PsA treatment landscape and its limitations, and examines emerging therapeutic directions that aim to address disease heterogeneity and unmet need. These include combinatorial and sequential treatment strategies, next-generation biologics and oral agents, immunometabolic modulation, selective targeting of pathogenic immune cell populations and upstream inflammatory, immune tolerance-based approaches. It is with hope that these developments highlight a shift from incremental therapeutic expansion towards a integrated, targeted and ultimately, more informed treatment approach.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Accepted manuscript, pdf, 521.7KB, Terms of use)
-
- Publisher copy:
- 10.1016/j.berh.2026.102135
Authors
+ National Institute for Health and Care Research
More from this funder
- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- NIHR304262
- Publisher:
- Elsevier
- Journal:
- Best Practice and Research: Clinical Rheumatology More from this journal
- Article number:
- 102135
- Publication date:
- 2026-04-08
- Acceptance date:
- 2026-03-25
- DOI:
- EISSN:
-
1532-1770
- ISSN:
-
1521-6942
- Pmid:
-
41956930
- Language:
-
English
- Keywords:
- Subtype:
-
Review
- Pubs id:
-
2406443
- Local pid:
-
pubs:2406443
- Deposit date:
-
2026-06-09
- ARK identifier:
Terms of use
- Copyright holder:
- Elsevier Ltd.
- Copyright date:
- 2026
- Rights statement:
- © 2026 Published by Elsevier Ltd.
- Notes:
- The author accepted manuscript (AAM) of this paper has been made available under the University of Oxford's Open Access Publications Policy, and a CC BY public copyright licence has been applied.
- Licence:
- CC Attribution (CC BY)
If you are the owner of this record, you can report an update to it here: Report update to this record