Early psoriatic arthritis: should we treat it in the same way as we treat rheumatoid arthritis?

2015 Joint damage predicts functional limitation and mortality in psoriatic arthritis patients, but evidence from cohort studies supports the idea that early diagnosis and treatment are beneficial. Given the revolution in the treatment of rheumatoid arthritis, treating to targets and close control have become attractive concepts in the clinical management of psoriatic arthritis. The evidence in favor of the use of conventional disease modifying antirheumatic drugs is weak, but observational study results suggest that the early use of anti-TNF drugs should be encouraged. Ustekinumab and apremilast are useful alternatives for patients failing on previous anti-TNF therapy, and ampremilast can also be used for the first-line treatment of selected cases (i.e., patients who cannot tolerate other first-line treatments).