Psoriatic arthritis
The five clinical patterns, CASPAR classification, imaging clues, treat-to-target with methotrexate then a biologic chosen by domain (skin, gut, eye, spine), PBS rules and the comorbidities that change drug choice.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Inflammatory arthritis in up to 30% of people with psoriasis. Peak onset 30 to 55, men and women equally.
- The skin usually comes first, by about 10 years. In around 15%, arthritis precedes psoriasis, so ask about family history and look for hidden plaques.
- Think in domains: peripheral arthritis, axial disease, enthesitis, dactylitis, skin, nails, plus uveitis and IBD. The drug is chosen by the domains present.
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Sources
- Therapeutic Guidelines: Rheumatology (psoriatic arthritis)AU/NZTherapeutic Guidelines Limited (eTG complete), current online version, accessed November 2026
- Nash P et al. A review and recommendations on the management of psoriatic arthritis in Australia 2024. Intern Med J 2024;54:2037-53AU/NZInternal Medicine Journal (RACP), 2024
- PBS Schedule: severe psoriatic arthritis biological medicine restrictions (secukinumab item 10900Q, initial treatment)AU/NZAustralian Government Department of Health, Disability and Ageing, accessed 13 November 2026
- Gossec L et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update. Ann Rheum Dis 2024;83:706-19EULAR, 2023 update
- Coates LC et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021. Nat Rev Rheumatol 2022;18:465-79GRAPPA, 2021 (current; no later update published as of November 2026)
- Leung YY et al. The APLAR recommendations for the management of psoriatic arthritis. Int J Rheum Dis 2025;28:e70372Asia Pacific League of Associations for Rheumatology, 2025
- Taylor W et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study (CASPAR). Arthritis Rheum 2006;54:2665-73Arthritis and Rheumatism, 2006
- Last updated
- 14 November 2026
What changed
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