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Practice Guideline
. 2025 Aug;28(8):e70372.
doi: 10.1111/1756-185x.70372.

The APLAR Recommendations for the Management of Psoriatic Arthritis

Ying-Ying Leung  1   2 , Paul Bird  3 , Muhammad Haroon  4 , Mitsumasa Kishimoto  5 , Kichul Shin  6 , Ashish Jacob Mathew  7 , Heizel Reyes  8 , Jeffrey Chau  9 , Dennis Neuen  10 , Praveena Chiowchanwisawakit  11 , Asal Adnan Ridha  12 , Chuanhui Xu  13   14 , William Taylor  15 , Fariz Yahya  16 , Ho So  17 , Sho Fukui  18 , Nguyen Van Hung  19   20 , Soosan G Soroosh  21 , Cesarius Singgih Wahono  22 , Lydia Say Lee Pok  16 , Juan Raphael Gonzales  23 , Yi Wei Yeo  2   24 , Chathurika Dandeniya  25 , Akimichi Morita  26 , Perdana Aditya Rahman  22 , Shahlaa Basim  27 , Kalum Deshapriya  28 , Eman Satti  29 , Nguyen Duc Phong  19 , Min Jung Kim  30 , Avanish Jha  7 , Priyanka Moovara Cackamvalli  29 , Ahmed Rafique  31 , Md Nazrul Islam  32 , Lai-Shan Tam  17
Affiliations
Practice Guideline

The APLAR Recommendations for the Management of Psoriatic Arthritis

Ying-Ying Leung et al. Int J Rheum Dis. 2025 Aug.

Abstract

Objectives: Under the auspices of the Asia-Pacific League of Associations for Rheumatology (APLAR), we aimed to develop broad, evidence- and consensus-based guidelines to aid health professionals managing patients with psoriatic arthritis (PsA) in the region.

Methods: A working group of 35 members comprising rheumatologists, dermatologists, and patient research partners from 18 APLAR countries was convened. The working group conducted systematic literature reviews to derive the quality of evidence via GRADE methods in supporting the efficacy and safety of classes of therapeutic agents for the management of active PsA, its comorbidities, and screening for specific infection concerns in the region. Recommendation statements on the principles of management and the best use of therapeutic drugs were developed. Consensus within the working group was achieved. An external voting panel, five from each of the 18 APLAR countries, was convened to confirm further agreement on the recommendation statements.

Results: The main literature review included 178 articles from clinical trials for PsA. Additional articles on the evidence for managing comorbidities, uveitis, inflammatory bowel disease, and screening for chronic hepatitis B and latent tuberculosis were reviewed. The working group discussed and reached consensus on eight management principles and 16 recommendation statements for managing PsA. Endorsement from an external voting panel (n = 90, response rate 80%) was achieved.

Conclusion: These first recommendations for the management of PsA patients in the APLAR regions were developed based on the best available evidence and region-specific considerations through discussion among rheumatologists, dermatologists, and patients, with strong agreement from an external expert panel.

Keywords: psoriatic arthritis; quality of evidence; treatment recommendation.

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References

    1. O. FitzGerald, A. Ogdie, V. Chandran, et al., “Psoriatic Arthritis,” Nature Reviews Disease Primers 7, no. 1 (2021): 1–17.
    1. T. Y. Zhu, E. K. Li, and L. S. Tam, “Cardiovascular Risk in Patients With Psoriatic Arthritis,” International Journal of Rheumatology 2012 (2012): 714321.
    1. M. Noviani, M. Feletar, P. Nash, and Y. Y. Leung, “Choosing the Right Treatment for Patients With Psoriatic Arthritis,” Therapeutic Advances in Musculoskeletal Disease 12 (2020): 1759720X20962623.
    1. United Nations Publication, “Economic and Social Commission for Asia and the Pacific (ESCAP) 2023. Asia‐Pacific Population and Development Report 2023 (ST/ESCAP/3112),” (2023).
    1. Y. Y. Leung, L. S. Tam, and E. K. Li, “The Perspective on Psoriatic Arthritis in Asia,” Current Rheumatology Reports 13, no. 4 (2011): 369–375.

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