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PSORIATIC ARTHRITIS
Psoriatic arthritis is a chronic inflammatory arthropathy associated with cutaneous psoriasis.
It is a progressive disease with asymmetric joint distribution pattern and rheumatoid factor is negative.
It can develop at any time including childhood but most often occurs between 30-50 years old.
Symptoms may range from mild to very severe.

Patient Education

  • Explain what psoriatic arthritis is all about, its relation to psoriasis & its unpredictable, recurring nature
  • Explain that psoriatic arthritis is a long term, progressive disease but can be managed w/ appropriate therapy
  • Discuss the quality of life issues & reassure them that these issues may not be present in every case
    • Pain & fatigue
    • Employment problems & managing therapy while at work
    • Possible stigma & impact on daily tasks
    • Family life & relationships
    • Emotional issues (eg depression, anxiety & stress)
  • Inform about the increased risk of comorbid conditions (eg cardiovascular disease, diabetes) & the need for regular follow-up & screening
  • Encourage a healthy lifestyle
    • Regular exercise
    • Weight management (aim for BMI 18.5-24.9)
    • Smoking cessation
    • Alcohol restriction
    • Blood pressure control
  • Emphasize the goal of therapy is to control joint pain, stiffness & damage in order to improve the quality of life & prevent long-term disability
  • Discuss the various treatment options & ensure that the patient is part of the decision making
  • Explain the benefits, adverse effects & risks of therapy to help the patients make an informed consent
  • Explain the importance of compliance to the therapy & discuss how to overcome the potential problems about adherence
  • Discuss the requirements for monitoring & assessment of the disease & their results
  • Identify & avoid triggering factors
  • Develop strategies to cope w/ flare-ups
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Elvira Manzano, 17 Oct 2017
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Kavitha G. Shekar, 14 Jun 2016
The incidence of type 1 diabetes mellitus (T1D) was found to be higher in juvenile idiopathic arthritis patients (JIA) compared with the general population, said German researchers at the European League Against Rheumatism Annual Congress (EULAR 2016) held in London, UK.
Elaine Tan, 29 Jun 2017

Tofacitinib, a first-in-class Janus kinase (JAK) inhibitor, shows promise as an oral treatment with quick onset of action and sustained efficacy in patients with psoriatic arthritis (PsA) who do not respond adequately to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). 

Dr. Priscilla Wong, Dr. Lydia Tam, Prof. LS Tam, 10 Nov 2017
This case report highlights that psoriatic arthritis is a heterogenous disease affecting multiple disease domains, and effective treatment requires thorough assessment of each of these different domains.