Psoriasis, psoriatic arthritis, and rheumatoid arthritis: Is all inflammation the same?

https://doi.org/10.1016/j.semarthrit.2016.05.012Get rights and content
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Abstract

Objectives

To review the pathophysiology, co-morbidities, and therapeutic options for psoriasis, psoriatic arthritis and rheumatoid arthritis in order to further understand the similarities and differences in treatment paradigms in the management of each disease. New targets for individualized therapeutic decisions are also identified with the aim of improving therapeutic outcome and reducing toxicity.

Search strategy

Using the PubMed database, we searched literature published from 2000 to 2015 using combinations of the key words “psoriasis,” “psoriatic arthritis,” “rheumatoid arthritis,” “pathogenesis,” “immunomodulation,” and “treatment.”

Inclusion and exclusion criteria

This was a non-systematic review and there were no formal inclusion and exclusion criteria.

Data extraction

Abstracts identified in the search were screened for relevance and articles considered appropriate evaluated further. References within these selected articles were also screened. Information was extracted from 198 articles for inclusion in this report.

Data synthesis

There was no formal data synthesis. Articles were reviewed and summarized according to disease area (psoriasis, psoriatic arthritis, and rheumatoid arthritis).

Headline results

The pathophysiology of psoriasis, psoriatic arthritis, and rheumatoid arthritis involves chronic inflammation mediated by pro-inflammatory cytokines. Dysfunction in integrated signaling pathways affecting different constituents of the immune system result in varying clinical features in the three diseases. Co-morbidities, including cardiovascular disease, malignancies, and non-alcoholic fatty liver disease are increased. Increased understanding of the immunopathogenesis allowed development of targeted treatments; however, despite a variety of potentially predictive genetic, protein and cellular biomarkers, there is still significant unmet need in these three inflammatory disorders.

Keywords

Psoriasis
Psoriatic arthritis
Rheumatoid arthritis
Inflammation

Cited by (0)

Varinia Munoz, Ph.D., from Complete Medical Communications, provided medical writing support funded by Pfizer. In addition, Pfizer Inc. provided financial support for the symposium. The authors assumed full responsibility for article preparation and made the final decision to submit the article.