When psoriatic arthritis is accompanied by uveitis, the ocular comorbidity is a decisive factor in selecting therapy. The mode of action must address both the articular and the ocular manifestations.
This protocol applies to patients with psoriatic arthritis who have concurrent uveitis. Not all biologic options carry direct evidence of efficacy for uveitis — the presence of this ocular manifestation therefore steers the choice of treatment class.
In this setting, a specific class of biologic agent — chosen for its demonstrated direct efficacy on uveitis — is preferred. The complete evidence-based regimen, including agent selection and sequencing, is in the structured protocol below.
Treatment aims for improvement at 3 months, with a target of remission or low disease activity at 6 months, guided by regular disease activity assessment and appropriate adjustment of therapy.
DOI: 10.1136/ard-2024-225531
The choice of the mode of action should reflect non-musculoskeletal manifestations related to psoriatic arthritis; with uveitis to an anti-TNF monoclonal antibody.
Currently, the only mode of action with direct proof of efficacy on uveitis is TNF inhibition through monoclonal antibodies (ie, adalimumab and infliximab).
Thus, for patients with uveitis, an anti-TNF monoclonal antibody is preferred.
Treatment should be aimed at reaching the target of remission or, alternatively, low disease activity, by regular disease activity assessment and appropriate adjustment of therapy.
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