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Precision medicine in psoriatic arthritis: How should we select targeted therapies?

Research output: Contribution to journalArticle

Hussein Al-Mossawi, Leonie Suzanne Taams, Carl S Goodyear, Bruce Kirkham, Iain McInnes, Stefan Siebert, Laura C Coates

Original languageEnglish
JournalThe Lancet Rheumatology
Publication statusAccepted/In press - 27 Jun 2019

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Abstract

Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis associated with psoriasis. Patients manifest variable presentations with potential involvement of peripheral joints, spine, tendons, skin and nails. In recent years there has been a rapid expansion in targeted treatment options for the condition but typically less than half of patients receiving therapy achieve an optimal treatment target. Many patients respond to second or third line biologic therapies, but we have little evidence to guide choice of therapeutics for the individual. At present, choice of therapy is driven by limited clinical phenotype, clinician familiarity and cost.
Here we review recent data that have highlighted the potential for personalised, or precision medicine in PsA and other forms of inflammatory arthritis, but this is still at a preliminary stage. In the future a combination of detailed immunophenotyping and sophisticated statistical analysis should be able to facilitate a personalised medicine approach in PsA following examples from other clinical areas such as oncology. This change in approach to the treatment of PsA has the potential to maximise outcomes for patients, providing optimal therapies without delay.

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