Table 4 Overarching principles and communication, shared decision-making, self-management, and patient education in PsA recommendations

1

1. Early diagnosis and optimum management of psoriatic arthritis have a great impact on disease progression and severity

2. The targeted subjects are patients who have psoriatic skin lesions and/or any psoriatic inflammatory musculoskeletal disorders

3. Treatment strategies are treat-to-target, and the targets should be sustained clinical remission or low disease activity.

4. The goals of treating patients with PsA are to control signs and symptoms; to prevent structural damage; to avoid comorbid conditions and drug toxicities; and to optimize function, growth and development, quality of life, and social participation.

5. It's advisable to use the cost effective therapy whenever possible.

6. Treatment to target by regularly assessing disease activity and adapting therapy accordingly is important to achieve these goals.

7. The primary target for treatment of patients with PsA is disease sustained remission, (clinical, ultrasonographic and functional)

8. Alternative target is reaching Minimal (or low) disease activity (clinical, ultrasonographic, and functional) particularly in patients with resisted, long-standing disease

9. Consider making the target remission rather than low disease activity for people with adverse/poor prognostic factors (> 5 active joints, radiographic damage, elevated acute phase reactants, extra-articular manifestations especially dactylitis)

10. In adults with active PsA, measure disease activity and screening for extra-articular manifestations monthly by specialist until the target of remission or low disease activity is achieved.

11. Monitor for comorbidities: obesity, DM, hypertension, gout, and metabolic syndrome.

4

C

8.74±0.45

100

2

4

C

8.53±±0.69

100