Czech Rheumatological Society recommendations for the treatment of psoriatic arthritis

Authors: J. Štolfa;  J. Vencovský;  K. Pavelka
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 20, 2012, No. 1, p. 13-18.
Category: Recommendations for Treatment


Psoriatic arthritis (PsA) is at present regarded as multifaceted disease with multiple manifestations. Apart from inflammatory involvement of joint or tendon synovium (arthritis and tenosynovitis respectively) inflammation of the attachment of the tendon into the bone (enthesitis) and diffuse swelling of the whole digit (dactylitis) may participate on clinical manifestation of PsA. Psoriatic skin involvement is essential for the diagnosis, be it present at the examination, or in the past, or even in first degree relatives. It would be therefore more appropriate to call it „psoriatic disease“. This complexity is after all reflected in the new classification criteria for PsA (CASPAR.). It has also its consequences in the assessment of disease activity which, besides of arthritis should also assess the other manifestations mentioned above. Experts of GRAPPA (Group for research and assessment of psoriasis and psoriatic arthritis) as well as of EULAR (European League against Rheumatism) are searching the best way to assess the activity of the disease in its complexity. The recommendations of the Czech Society of Rheumatology date back to the year 2005. These new developments led us to set up the new recommendations, which are mainly based on the EULAR ones. The therapy is divided in four levels, the indications for biological therapy are mentioned separately.

Key words:
psoriatic arthritis, classification criteria, enthesitis, dactylitis, recommendations of therapy, composite disease activity index, biologic therapy of PsA


1. Wright V, Moll JM. Psoriatic arthritis. Bull Rheum Dis 1971;21:627-32.

2. Helliwell PS, Taylor WJ. Classification and diagnostic criteria for psoriatic arthritis. Ann Rheum Dis 2005;64 Suppl 2:ii3-8.

3. Fournie B, Crognier L, Arnaud C, et al. Proposed classification criteria of psoriatic arthritis. A preliminary study in 260 patients. Rev Rhum Engl Ed 1999;66:446-56.

4. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54:2665-73.

5. Ritchlin CT, Kavanaugh A, Gladman DD, et al. Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2009;68:1387-94.

6. Mumtaz A, Gallagher P, Kirby B, et al. Development of a preliminary composite disease activity index in psoriatic arthritis. Ann Rheum Dis 2011; 70:272-7. Erratum in: Ann Rheum Dis 2011;70(4):716.

7. Mumtaz A, FitzGerald O. Application of GRAPPA psoriatic artritis treatment recommendations in clinical practice. Curr Rheumatol Rep 2010;12: 264-71.

8. Coates LC, Mumtaz A, Helliwell PS, et al. Development of a disease Severity and responder index for psoriatic arthritis (PsA)-report of the OMERACT 10 PsA special intrest group. J Rheumatol 2011;38:1496-501.

9. Gossec L, Smolen JS, Gaujoux-Viala C, et al. European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. Ann Rheum Dis 2012 Jan;71:4-12.

10. Štolfa J, Pavelka K, Vencovský J. Standardní postupy v léčbě psoriatické artritidy. Čes Revmatol 2005; 3:97-105.

11. Coates LC, Cook R, Lee KA, Chandran V, Gladman DD. Frequency, predictors, and prognosis of sustained minimal disease activity in an observational psoriatic arthritis cohort. Arthritis Care Res (Hoboken) 2010 ;62:970-6.

12. Coates LC, Helliwell PS. Validation of minimal disease activity Criteria for psoriatic arthritis using international trial data. Arthritis Care Research 2010; 965-969.

13. Ash Z, Gaujoux-Viala C, Gossec L, et al. A systematic literature review of conventional and biologic drug therapies for the treatment of psoriatic arthritis: current evidence informing the EULAR recommendations for the management of Psoriatic arthritis. Ann Rheum Dis 2011; [Epub ahead of print].

14. Ceponis A, Kavanaugh A. Use of methotrexate in patients with psoriatic arthritis. Clin Exp Rheumatol 2010; 28 (Suppl. 61):S132-S137.

15. Gomez –Reino J, Carmona L. Switching TNF antagonists in patientes with chronic arthritis:an observational study od 488 patients over a four-year period. Arthritis Res Ther 2006;8:R29.

16. Saad A, Ashcroft DM, Watson KD, et al. Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologic register. Arthritis Res Ther 2009;11:R52.

Dermatology & STDs Paediatric rheumatology Rheumatology
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account