Date of Award

2027

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

Ashley Kernicky

Abstract

Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease that can cause progressive joint damage, functional impairment, and reduced quality of life. Methotrexate (MTX) is commonly used as a systemic therapy, while biologic therapies target specific inflammatory pathways. This review evaluated the efficacy and safety of biologic therapies compared with MTX in adults with PsA.

Methods: A PubMed/MEDLINE search identified studies evaluating biologic therapies and MTX in adults with PsA. Four publications were included based on methodological quality, clinical relevance, and applicability to the PICO question. Outcomes included joint symptoms, disease activity, physical function, radiographic progression, and adverse events.

Results: Biologic therapies demonstrated meaningful improvements in disease activity, joint symptoms, dactylitis, enthesitis, physical function, and radiographic progression. Golimumab added to MTX improved dactylitis compared with MTX-based therapy alone. Clinical guidelines also supported biologic therapy for patients with active or persistent disease. However, direct comparisons between biologic monotherapy and MTX were limited. No new or unexpected safety concerns were identified.

Discussion: Biologic therapies are effective treatment options for PsA, but available evidence does not establish universal superiority over MTX. MTX continues to have a role in PsA management, while biologic therapy may be appropriate based on disease severity and previous treatment response. Treatment should be individualized, and additional head-to-head studies comparing biologic therapy with MTX are needed.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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