PHARMACOLOGICAL TREATMENT OF PATIENTS WITH PSORIATIC ARTHRITIS – SYMPTOMATIC DRUGS AND CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS

Liječenje bolesnika sa psorijatičnim artritisom treba biti što sveobuhvatnije, odnosno usmjeriti se na različite sastavnice bolesti (npr., periferni artritis, aksijalna bolest, daktilitis i/ili entezitis). U središtu pozornosti ovog rada jest medikamentno liječenje usmjereno ponajprije na zglobnu i okolnozglobnu bolest struktura lokomotornog sustava, i to na nesteroidne antireumatike (NSAR), neopioidne analgetike i konvencionalne sintetske lijekove koji mijenjaju tijek reumatske bolesti (engl. Disease-modifying antirheumatic drugs – DMARDs). Zbog brzog i učinkovitog djelovanja NSAR se vrlo često primjenjuju u liječenju koštano-mišićnih simptoma i znakova bolesti. DMARDs-i su indicirani u liječenju perifernog artritisa, daktilitisa i entezitisa iako su dokazi o njihovoj učinkovitosti sveukupno osrednji. Navedeno je uklopljeno u preporuke za liječenje bolesnika sa psorijatičnim artritisom uglednih međunarodnih organiza cija kao što su EULAR i GRAPPA.Treatment of patients with psoriatic arthritis should be comprehensive and focused on the diff erent patterns of the disease (e.g., peripheral arthritis, axial disease, dactylitis and/or enthesitis). Th is article focuses on the pharmacological treatment of psoriatic arthritis, covering both articular and extraarticular aspects of the musculoskeletal system by using nonsteroidal anti-infl ammatory drugs, nonopioid analgesics, and disease-modifying anti-rheumatic drugs (DMARDs). Due to their prompt anti-infl ammatory and analgesic eff ects, nonsteroidal anti-infl ammatory drugs are commonly used to treat musculoskeletal symptoms and signs of the disease. Conventional synthetic disease-modifying drugs are used for treatment of peripheral arthritis, dactylitis, and/or enthesitis, although evidence of their effi cacy is generally mediocre. Th is approach is incorporated in the recommendations for the treatment of patients with psoriatic arthritis issued by distinguished international organizations such as EULAR and GRAPPA