Table 3.

Recommended treatments for PsA by disease domain involvement [3, 105, 144]

Disease domain	Treatment recommendationa
Enthesitisb	First line: NSAIDs, Inadequate response to NSAIDs: csDMARDs, TNFis, IL-12/23i, IL-17is, JAKi
Dactylitisb	First line: csDMARDs Inadequate response to csDMARDs/TNFis: switch TNFis, IL-17is, IL-12/23i
Peripheral arthritisb	First line: csDMARDs, TNFis, NSAIDs, Inadequate response to prior DMARDs: IL-12/23i, IL-17is, JAKi Inadequate response to prior DMARDs with skin involvement: IL-17is, IL-12/23i
Nail psoriasis	First line: TNFis, IL-12/23i, IL-17i Inadequate response to prior biologics: switch biologic or PDE4i
Axial disease	First line: NSAIDs Inadequate response to prior NSAIDs: TNFis Inadequate response to prior NSAIDs with skin involvements: IL-17is
Psoriatic skin disease	First line: topical treatments, csDMARDs, particularly MTX Inadequate response to csDMARDs: IL-17is, IL-12/23i, TNFis, PDE4ic

bDMARD biologic DMARD, CS corticosteroids, csDMARD conventional synthetic DMARD, DMARD disease-modifying antirheumatic drug, IL-12/23i interleukin-12/23 inhibitor, IL-17i interleukin-17 inhibitor, JAKi Janus kinase inhibitor, MTX methotrexate, NSAID nonsteroidal anti-inflammatory drug, PDE4i phosphodiesterase 4 inhibitor, PsA psoriatic arthritis, TNFi tumor necrosis factor inhibitor

^aTreatment recommendations do not include evidence for IL-23 inhibitors, as none were approved for PsA at the time of their publication

^bCS injections can be considered on an individual basis for peripheral arthritis, enthesitis, and dactylitis because of the potential for serious side effects and inadequate available evidence for efficacy

^cIn patients with mild disease