Psoriatic arthritis

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Consensus Definitions on Difficult to Treat Psoriatic Arthritis

Jack Cush, MD

A substantial number of patients with psoriatic arthritis (PsA), have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states: complex-to-manage PsA and treatment-refractory PsA.

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CBC & Psoriasis - case–control study 60 pts: 30 PsA & 30 PSO pts showed that PsA showed elevated WBCs, neutrophils, monocytes & inflammatory markers (NLR, MLR, SII, SIRI, & decr PMR (all p < 0.001). NLR 100% Dx accuracy (AUC = 1.000). WBC > 6.7, MLR > 0.17, & PMR ≤ 503 were https://t.co/AB7iFiMuSM
Dr. John Cush @RheumNow( View Tweet )
DERM on RheumNow (November 2025) The Derm on RheumNow podcast is a collection of Citations and Content curated for dermatologists – addressing Psoriasis, PsA, CLE, vasculitis, HS, other CTD skin disorders. dermatology drugs, biiologics, JAKs - their use, efficacy and side https://t.co/mX0Hv1RRF9
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RheumNow Live 2026 is coming February 7th and 8th to Dallas, Texas - and registration is now open! Ready for the most interactive, engaging and practice-changing rheumatology meeting of the year? This year’s program covers vasculitis, autoimmune disease, PsA, RA outcomes, https://t.co/cftvdSn3t7
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Turkey Tryptophan (11.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

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RheumNow Live 2026 is coming February 7th and 8th to Dallas, Texas - and registration is now open! This year’s program covers vasculitis, autoimmune disease, PsA, RA outcomes, spondyloarthritis, and much more. Reserve your spot today at https://t.co/o78Pc8LPsQ https://t.co/GOUW5Od9Hy

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Study of 452 #PsA pts who failed 1st line TNFi Rx (LOE) - 275 Cycled to another TNFi vs 177 Swapped to an IL-17i. Higher Retention in Swap (78%) vs cycled (68%) PsA pts (p < 0.001) @12 mos (60 v 40%@3yrs). Tx failure predicted by cycling, Dz Activity, Rx year, axial & mixed https://t.co/VQLBlBEw4W
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Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR https://t.co/EoCTNKk265

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CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
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Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes. https://t.co/raruHn5Txx https://t.co/bp1rWyWS7y

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RNL 25 Replay: Psoriatic Arthritis Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit https://t.co/o78Pc8LPsQ for complete details. https://t.co/ri0E9Z7GWG https://t.co/RPdwjE9eNB

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APEX Study: Inhibition of structural damage progression with Guselkumab in PsA Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active PsA and shown to have both clinical and radiographic benefits at weeks 24 and 48. https://t.co/iNEziysnVZ https://t.co/XgFGFfGf3b

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APEX Study: Inhibition of structural damage progression with Guselkumab in Psoriatic Arthritis

Jack Cush, MD

Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active psoriatic arthritis (PsA) and shown to have both clinical and radiographic benefits at weeks 24 and 48.

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IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the IL-23R, is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies. https://t.co/fYXULrMD16
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GLP-1 Receptor Agonists in PsA: Mortality and MACE Dr. Antoni Chan reports on abstract 0849 (Mortality and Major Adverse Cardiac Events (MACE) with GLP-1 Receptor Agonists in Psoriatic Arthritis), presented at #ACR25. https://t.co/XNyt3UIjgp https://t.co/RUnZCjXF9T

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#ACR25 PsA Topic Panel A focused conversation on the latest in psoriatic arthritis care - from emerging data and treatment strategies to real-world challenges in diagnosis and management. Hear expert perspectives, clinical pearls, and what's shaping PsA practice right now. https://t.co/PP0fkweXsZ
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New Approaches to Therapy in PsA Dr. Arthur Kavanaugh offers an overview of new approaches to therapy in psoriatic arthritis, at #ACR25. https://t.co/9vHgQ6S2JD https://t.co/5mvX1rOrIP

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Late-Breaking Trials in axSpA and PsA https://t.co/EWeF0nkb1h https://t.co/HgY0be0PDX

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Diagnostic Delays in PsA: A Radiographic Perspective Dr. Brian Jaros reports on abstract 1713 (Diagnostic Delay in Psoriatic Arthritis and its Impact on Radiological Outcomes: A Systematic Review and Meta-analysis of 23,894 Patients), presented at #ACR25. https://t.co/iLllm7DcCF
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IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the IL-23R, is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies. https://t.co/MyqCjilYGL
Dr. John Cush @RheumNow( View Tweet )
IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and https://t.co/7awBk16ZrQ
Dr. John Cush @RheumNow( View Tweet )
Weight Loss as a Therapeutic Goal in PsA PsA is a complex inflammatory disease often complicated by obesity, which not only worsens disease activity but also impairs treatment response. At #ACR25, 3 compelling studies spanning pharmacologic, lifestyle, and longitudinal https://t.co/Q6IFGn5zCI
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PsA: Impact of Sex Dr. Arthur Kavanaugh highlights the importance of sex on disease characteristics and response to therapy in psoriatic arthritis, reporting from #ACR25. https://t.co/QtU4iATexR https://t.co/uCJsxYpFTc

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syringe, pill, DMARD, Treatment, therapy

What should head-to-head studies in inflammatory arthritis teach us?

Janet Pope, MD, MPH, FRCPC

The multimillion dollar question for inflammatory arthritis prescriptions is: which drug should I use next?

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Psoriatic Arthritis: Which biologic agent is the best first choice? A growing arsenal of therapeutic targets in psoriatic arthritis (PsA) has enhanced the landscape of treatment in patients with this disease. https://t.co/pRMyPCvMrN https://t.co/nOgnf5F3Pw

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Recent Blogs

Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis

Robert Chao, MD
heel enthesitis spur calcaneal
A colleague of mine once told me an interesting story of how her father, who was a doctor, misdiagnosed his wife with fibromyalgia when she actually had psoriatic arthritis with enthesitis all along. I would venture out and say that the average physician would have trouble evaluating enthesitis because even we, as rheumatologists do!  Read Post

Best of 2022: Toss of a Coin - How do You Choose PsA Medication?

M. Elaine Husni, MD, MPH
Coin toss
When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they?  Read Post
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