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Psoriatic Arthritis—New Insights, Challenges, Unmet Needs and Controversies
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Psoriatic Arthritis—New Insights, Challenges, Unmet Needs and Controversies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (20 May 2025) | Viewed by 2762

Special Issue Editor

Dr. Daniela Opris-Belinski

E-Mail Website
Guest Editor
Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: autoimmune disorders; inflammatory diseases; biologicals; connective tissue disorders; spondyloarthitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Psoriatic arthritis, as part of the whole psoriatic disease spectrum, is one of the most challenging immune-mediated inflammatory diseases (IMIDs). This is mainly due to the large heterogeneity of clinical rheumatological expression and its destructive potential, but also to the association of extra-musculoskeletal manifestations and comorbidities that could impact patient perspectives. The complexity of this condition explains the frequent need to utilize multidisciplinary teams, including rheumatologists, dermatologists, internal medicine specialists, cardiologists, psychotherapists, and more. Fortunately, it can be said without exaggeration that recent years have brought amazing therapeutic advances that have significantly changed the management and prognosis of these patients.

This Special Issue focuses on the latest advances in pathogenesis and treatment but also on clinical and management challenges, unmet needs, and controversies. The goal is to significantly improve knowledge about psoriatic disease and, consequently, to contribute to a better patient prognosis.

We kindly invite you to submit your original research, review articles, and spectacular case reports for this Special Issue.

Dr. Daniela Opris-Belinski
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • psoriatic arthritis
  • psoriasis
  • enthesitis
  • dactylitis
  • spondyloarthritis
  • radiological progression
  • biologics
  • JAK-inhibitors
  • immune-mediated inflammatory diseases
  • comorbidities

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Published Papers (3 papers)

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Research

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18 pages, 3036 KiB  
Article
Guselkumab in Psoriatic Arthritis: Therapeutic Impact on Axial and Peripheral Involvement—Monocentric Real-World Evidence
by Roberta Foti, Giorgio Amato, Elisa Visalli, Ylenia Dal Bosco, Francesco De Lucia, Angelo Montana, Giambattista Privitera, Placido Romeo, Fabio Aiello, Maria Gabriella Paolì and Rosario Foti
J. Clin. Med. 2025, 14(9), 3151; https://doi.org/10.3390/jcm14093151 - 1 May 2025
Viewed by 449
Abstract
Background: Axial involvement in psoriatic arthritis (axPsA) presents clinical and radiological differences from ankylosing spondylitis (AS), which may influence the therapeutic response. While Guselkumab has demonstrated efficacy in peripheral PsA, its role in axPsA is less well established, particularly in real-world settings. Objective: [...] Read more.
Background: Axial involvement in psoriatic arthritis (axPsA) presents clinical and radiological differences from ankylosing spondylitis (AS), which may influence the therapeutic response. While Guselkumab has demonstrated efficacy in peripheral PsA, its role in axPsA is less well established, particularly in real-world settings. Objective: To evaluate the positive effects of Guselkumab therapy in patients with psoriatic arthritis (PsA), 58.6% of whom have axial involvement, in a 12-month, single-center, longitudinal, prospective observational cohort study conducted in a real-life setting. Methods: A cohort of 99 patients with PsA, including 58 with axial involvement (axPsA), was treated with Guselkumab for 12 months. Treatment efficacy was assessed by evaluating the reduction in mBASDAI, ASDAS, DAPSA, VAS Pain, LEI, and HAQ scores. The Friedman test was used to analyze whether the overall changes from baseline to 12 months were statistically significant. Patients with axial involvement were assessed by MRI, with scores measured at baseline (t0), after 6 months (t6), and after 12 months (t12) of therapy. Statistical evaluation was conducted using the Friedman test, followed by pairwise comparisons of values obtained at different follow-up time points using the Wilcoxon signed-rank test. Additionally, the drug’s retention rate was examined using a Kaplan–Meier curve. Results: After 12 months of therapy, a statistically significant reduction was observed in all clinimetric parameters. Patients with axial involvement were also evaluated by MRI at baseline, after 6 months, and after 12 months of therapy. MRI images showed a reduction in bone marrow edema and a decrease in signal intensity, indicating a significant reduction in inflammation and confirming the drug’s efficacy. Retention rate values demonstrate that Guselkumab is well tolerated and effective in the long term for the majority of patients. Conclusions: This 12-month real-world study of 99 PsA patients confirms the efficacy of Guselkumab in reducing disease activity in both peripheral and axial forms. The findings align with previous RWE and clinical trials (DISCOVER-1 and -2), supporting its clinical utility in PsA and axPsA, with high treatment retention. Full article
(This article belongs to the Special Issue Psoriatic Arthritis—New Insights, Challenges, Unmet Needs and Controversies)
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11 pages, 1117 KiB  
Article
Additional Value of Ultrasound in Patients with Psoriatic Arthritis within Treatment Target
by Mihaela Agache, Claudiu C. Popescu, Luminița Enache, Corina Mogoșan, Emilio Filippucci and Cătălin Codreanu
J. Clin. Med. 2024, 13(15), 4567; https://doi.org/10.3390/jcm13154567 - 5 Aug 2024
Cited by 1 | Viewed by 1342
Abstract
Background: In psoriatic arthritis (PsA), musculoskeletal ultrasound is a complementary tool to physical examination, useful even in patients in remission to detect subclinical activity. Objectives: The objective of the study was to assess the ultrasound prevalence of active enthesitis and synovitis in patients [...] Read more.
Background: In psoriatic arthritis (PsA), musculoskeletal ultrasound is a complementary tool to physical examination, useful even in patients in remission to detect subclinical activity. Objectives: The objective of the study was to assess the ultrasound prevalence of active enthesitis and synovitis in patients who reached the therapeutic target. Methods: This cross-sectional study included patients with at least 6 months of therapy with a targeted synthetic or biological disease-modifying antirheumatic drug who were in treatment target (i.e., DAPSA < 14). Patients underwent bilateral clinical and ultrasound examination of the elbow lateral epicondyle, quadriceps insertion, distal patellar tendon insertion, and Achilles enthesis for assessing enthesitis, and hand and foot joints for assessing synovitis. Enthesitis and synovitis were considered active if the power Doppler signal showed at least a score of one. Results: The study included 51 PsA patients, women (52.9%), with an average age of 55 years. Although the patients were within the DAPSA treatment target, 21.6% had at least one painful enthesis at clinical examination, 19.6% had ultrasound evidence of at least one active enthesitis and 15.7% had ultrasound signs of at least one active synovitis. Conclusions: Among PsA patients thought to be within the therapeutic target, ultrasound detected a non-negligible percentage of active enthesitis and synovitis. Full article
(This article belongs to the Special Issue Psoriatic Arthritis—New Insights, Challenges, Unmet Needs and Controversies)
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Other

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33 pages, 1280 KiB  
Systematic Review
The Genetic Background of Ankylosing Spondylitis Reveals a Distinct Overlap with Autoimmune Diseases: A Systematic Review
by Theodora Zormpa, Trias Thireou, Apostolos Beloukas, Dimitrios Chaniotis, Rebecca Golfinopoulou, Dimitrios Vlachakis, Elias Eliopoulos and Louis Papageorgiou
J. Clin. Med. 2025, 14(11), 3677; https://doi.org/10.3390/jcm14113677 - 23 May 2025
Viewed by 210
Abstract
Background: Ankylosing Spondylitis (AS) is a rare autoinflammatory disorder affecting 0.1–1.4% of the population, with increasing recognition over the past 20 years. Although the specific causes of AS remain unclear, the presence of the HLA-B27 gene is associated with increased risk, though [...] Read more.
Background: Ankylosing Spondylitis (AS) is a rare autoinflammatory disorder affecting 0.1–1.4% of the population, with increasing recognition over the past 20 years. Although the specific causes of AS remain unclear, the presence of the HLA-B27 gene is associated with increased risk, though only 1–5% of carriers develop the disease. Despite extensive research, no definitive lab tests exist, and many patients are diagnosed years after symptom onset. Methods: In the present study, in order to investigate the disease’s genetic background in correlation with autoimmune diseases, a metanalysis has been performed following PRISMA guidelines using Scopus and PubMed publications towards extracting single-nucleotide polymorphisms (SNPs) of high importance for the disease. Moreover, the polymorphisms have been annotated and analyzed using information from several databases, including PubMed, LitVar2, ClinVar, and Gene Ontology. Results: From 1940 screened titles and abstracts, 57,909 studies were selected, with 539 meeting the inclusion criteria. The genetic background of AS is described through 794 genetic variants, of which 76 SNPs are directly associated with AS (Classes A and B), predominantly located in intronic regions. ERAP1 and IL23R emerged as key genes implicated in AS, while chromosomes 1, 2, and 5 accumulated the most associated SNPs. Functional enrichment revealed strong associations with immune regulation and interleukin signaling pathways, particularly IL6 and IL10 signaling. IL-6 promotes inflammation in AS, while IL-10 tries to suppress it, acting as an anti-inflammatory cytokine. Of the 78 AS-related SNPs, 16 were unique to AS, while 66 were common to autoimmune diseases, especially rheumatoid arthritis (RA) and psoriasis (PsO), suggesting genetic overlap between these diseases. Conclusions: This study creates a comprehensive genetic map of AS-associated SNPs, highlighting key pathways and genetic overlap with autoimmune diseases. These findings contribute to understanding disease mechanisms and could guide therapeutic interventions, advancing precision medicine in AS management. Full article
(This article belongs to the Special Issue Psoriatic Arthritis—New Insights, Challenges, Unmet Needs and Controversies)
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