Targets to be treated for the different features of the disease and consequential potential treatment strategies.
| Disease Features | Which Target? | Which Treatment? |
|---|---|---|
| Cutaneous involvement | Clear or almost clear skin; PASI75, PASI90, PASI100; BSA < 3% | IL-17 inhibitors IL-12/23 inhibitors Anti-TNF Apremilast MTX Cyclosporine |
| Enthesitis involvement | No tender and swollen enthesis, LEI ≤ 1, pain-VAS ≤ 15, PtGA ≤ 20 | Anti-TNF IL-17 inhibitors IL-12/23 inhibitors JAK inhibitors Apremilast ABA |
| Articular involvement | No tender and swollen joints, DAPSA ≤ 4, ACR50 criteria, BASDAI ≤ 4 (for axial disease), absence of active dactylitis | MTX Anti-TNF IL-17 inhibitors IL-12/23 inhibitors JAK inhibitors Apremilast ABA |
| Extraarticular involvement (uveitis, IBD) | No uveitis flares, remission according to composite disease activity indices in IBD | MTX SSZ Anti-TNF (monoclonal antibodies) IL-12/23 inhibitors JAK inhibitors |
| Systemic involvement (systemic inflammation) Comorbidities | Control of systemic inflammation Reduce comorbidities in the future or better control of current comorbidities | Targeting key cytokines and cellular pathways |
PASI: Psoriasis Area Severity Index; BSA: body surface area; IL: interleukin; TNF: tumor necrosis factor; LEI: Leeds Enthesitis Index; VAS: visual analog scale; PtGA: patient’s global assessment; DAPSA: Disease Activity in Psoriatic Arthritis; ACR50 criteria: American College of Rheumatology 50% criteria; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; IBD: inflammatory bowel disease; MTX: methotrexate; ABA: abatacept; JAK: Janus kinase; SSZ: sulfasalazine.