Adam Dore, DO: Trends in the Treatment of Psoriatic Arthritis

HCPLive Rheumatology interviewed Adam Dore, DO, rheumatology division chief at Allegheny Health Network, to discuss recent developments in treating psoriatic arthritis (PsA) and his predictions for the advancement of care in the upcoming year.

What are some of the trends in PsA treatment you've observed in the past year?

Adam Dore, DO: Over the last several years, PsA has experienced significant growth, resulting in a wider range of biological options. It's been great to have more opportunities to personalize each patient's therapy plan. We assess different domains in PSA and try to identify the best biologic option that fulfills all of the patient's specific needs.

Are there any current trials or treatment options that you're particularly excited about?

That's a great question. Currently, the focus is more on finding individualized treatment choices and determining their effectiveness. Additionally, there's some interesting information suggesting the potential use of multiple biologics. We're exploring the safety and efficacy of combining different treatment choices for more challenging patients.

What are your thoughts on the importance of patient-reported outcomes in treating this patient population?

Patient-reported outcomes are incredibly important. We've realized it's crucial to consider our patients' subjective experiences, especially when objective measurements may be limited. If a patient isn't feeling well, regardless of the reason, their response to treatment will likely be affected. Therefore, incorporating patient-reported outcomes is essential in both clinical practice and clinical trials to ensure the best possible care for our patients.

Can you tell me more about treating patients with multiple biologics?

Currently, we're still in the process of understanding the safety and applicability of using multiple biologics. We're particularly interested in exploring this approach for patients who have already tried multiple biologics without achieving the desired results or improvement in their underlying disease. The idea is to be more aggressive in treatment by combining multiple effective choices, but we're not yet at the stage of implementing this widely.

What advancements do you predict for the upcoming year in terms of treatment and management of psoriatic arthritis?

I hope in the coming year, we'll gain a better understanding of how to effectively monitor psoriatic arthritis patients in real-life clinical practice. We're already comfortable with the "treat to target" approach in rheumatoid arthritis, but it becomes more challenging in psoriatic arthritis due to the multitude of domains involved. As we see more clinical trials utilizing the minimal disease activity score, it's worth exploring whether we can strive for that as a treatment target. I anticipate a greater emphasis on incorporating the "treat to target" approach into clinical practice to guide our treatment decisions.

Before we conclude, is there anything else you think our audience should know?

Regarding psoriatic arthritis, it can sometimes be a challenging diagnosis, while in other cases, it's more straightforward, especially in patients with aggressive disease. Recognizing the importance of treating this disease at the primary care, dermatology, and rheumatology levels is crucial. Collaboration among healthcare professionals is key in managing psoriatic arthritis effectively.

This transcript was edited for clarity.