Since the second version of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations were published in 2015, therapeutic options for psoriatic arthritis (PsA) have advanced considerably. This work reviews the literature since the previous recommendations (data published 2013–2020, including conference presentations between 2017 and 2020) and reports high-quality, evidence-based, domain-focused recommendations for medication selection in PsA developed by GRAPPA clinicians and patient research partners. The overarching principles for the management of adults with PsA were updated by consensus. Principles considering biosimilars and tapering of therapy were added, and the research agenda was revised. Literature searches covered treatments for the key domains of PsA: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail psoriasis; additional searches were performed for PsA-related conditions (uveitis and inflammatory bowel disease) and comorbidities. Individual subcommittees used a GRADE-informed approach, taking into account the quality of evidence for therapies, to generate recommendations for each of these domains, which were incorporated into an overall schema. Choice of therapy for an individual should ideally address all disease domains active in that patient, supporting shared decision-making. As safety issues often affect potential therapeutic choices, additional consideration was given to relevant comorbidities. These GRAPPA treatment recommendations provide up-to-date, evidence-based guidance on PsA management for clinicians and people with PsA.

自 2015 年银屑病和银屑病关节炎研究与评估小组 (GRAPPA) 治疗建议第二版发布以来，银屑病关节炎 (PsA) 的治疗选择已经取得了显着进展。这项工作回顾了自之前建议（2013-2020 年发布的数据，包括 2017 年至 2020 年之间的会议演示）以来的文献，并报告了 GRAPPA 临床医生和患者研究制定的针对 PsA 药物选择的高质量、循证、以领域为中心的建议伙伴。成人银屑病关节炎治疗的总体原则以协商一致方式进行了更新。添加了考虑生物仿制药和逐渐减少治疗的原则，并修订了研究议程。文献检索涵盖了 PsA 关键领域的治疗方法：外周关节炎、轴病、附着点炎、指趾炎、皮肤和指甲牛皮癣；对银屑病关节炎相关疾病（葡萄膜炎和炎症性肠病）和合并症进行了额外的搜索。各个小组委员会使用基于 GRADE 的方法，考虑到治疗证据的质量，为每个领域提出建议，并将其纳入总体方案中。理想情况下，个人的治疗选择应该解决该患者活跃的所有疾病领域，支持共同决策。由于安全问题通常会影响潜在的治疗选择，因此需要额外考虑相关的合并症。这些 GRAPPA 治疗建议为临床医生和银屑病关节炎患者提供了最新的、基于证据的银屑病关节炎管理指南。以及皮肤和指甲牛皮癣；对银屑病关节炎相关疾病（葡萄膜炎和炎症性肠病）和合并症进行了额外的搜索。各个小组委员会使用基于 GRADE 的方法，考虑到治疗证据的质量，为每个领域提出建议，并将其纳入总体方案中。理想情况下，个人的治疗选择应该解决该患者活跃的所有疾病领域，支持共同决策。由于安全问题通常会影响潜在的治疗选择，因此需要额外考虑相关的合并症。这些 GRAPPA 治疗建议为临床医生和银屑病关节炎患者提供了最新的、基于证据的银屑病关节炎管理指南。以及皮肤和指甲牛皮癣；对银屑病关节炎相关疾病（葡萄膜炎和炎症性肠病）和合并症进行了额外的搜索。各个小组委员会使用基于 GRADE 的方法，考虑到治疗证据的质量，为每个领域提出建议，并将其纳入总体方案中。理想情况下，个人的治疗选择应该解决该患者活跃的所有疾病领域，支持共同决策。由于安全问题通常会影响潜在的治疗选择，因此需要额外考虑相关的合并症。这些 GRAPPA 治疗建议为临床医生和银屑病关节炎患者提供了最新的、基于证据的银屑病关节炎管理指南。