Management of Psoriatic Arthritis with Pharmacological Therapies: An Integrative Review

• DOI: https://doi.org/10.22533/at.ed.15951425120314

• Palavras-chave: "Psoriatic Arthritis", "Treatment", "Biologic Therapy", "DMARDs", "IL-17", "TNF-α"

• Keywords: "Psoriatic Arthritis", "Treatment", "Biologic Therapy", "DMARDs", "IL-17", "TNF-α"

• Abstract:

  The treatment of psoriatic arthritis (PsA) involves a multifaceted approach, with an emphasis on modulating the immune response to reduce joint and skin inflammation. Pharmacological management includes the use of non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying drugs (DMARDs), biological therapies and targeted synthetic drugs. NSAIDs are generally indicated for symptomatic relief, but do not affect the progression of the disease. Conventional DMARDs, such as methotrexate and leflunomide, play an important role in modulating the immune response, while biologics, which act specifically on inflammatory cytokines such as TNF-α, IL-17 and IL-23, offer effective options for patients with severe or refractory forms. The evolution of therapies, including new classes of targeted synthetic drugs, has contributed significantly to the control of PsA, but treatment remains challenging due to the variability in individual responses to drugs.
  An integrative review on the treatment of PsA is essential to consolidate current knowledge on the efficacy and safety of the various therapeutic options. By integrating data from different studies and systematically comparing them, it is possible to identify the most effective therapies, as well as better understand adverse effects, the impact on comorbidities and the improvement in patients' quality of life. This also makes it possible to analyze the effectiveness of different therapeutic classes in specific scenarios, such as in patients refractory to methotrexate or those with comorbidities such as obesity and cardiovascular disease. Integrating this evidence can provide a clearer vision of how to adapt treatment to the individual needs of each patient, taking into account responses to treatment, adverse effects and the presence of other health conditions.
  In addition, an integrative review on the topic is crucial to explore the gaps in knowledge and highlight areas that need further investigation, such as personalizing treatment based on biomarkers and directly comparing different biological therapies. The treatment of PsA is dynamic and requires continuous adjustments, and it is crucial that new research explores how to improve efficacy, reduce side effects and optimize access to treatments, especially in contexts of health systems with limited resources. Therefore, by bringing together a comprehensive overview of the available evidence, an integrative review can be a valuable guide to guide future research and improve therapeutic strategies in the management of psoriatic arthritis.