What Is ‘Optimal Control’ in Psoriatic Arthritis?
Usually, doctors aim to treat psoriatic arthritis using what’s known as a treat-to-target approach — meaning they set a specific goal that makes sense for a patient, then adjust treatment as needed to achieve that goal.
While many doctors use minimal disease activity as the main measure of psoriatic arthritis control, “Others may use informal targets and rely on a physical exam and patient reported satisfaction,” says Rebecca Gordon, MD, a rheumatologist at UCHealth Cherry Creek Medical Center in Denver. Tolerating medications well is another important measure that isn’t a component of minimal disease activity, Dr. Gordon says.
Some practical outcomes indicating minimal disease activity, or good control of psoriatic arthritis, include:
- Minimal or no joint swelling or pain
- Small area, or no area, of skin with active psoriasis
- Minimal or no pain in areas where tendons join bones (enthesitis)
- Minimal or no swollen “sausage fingers” or toes (dactylitis)
- Minimal or no systemic symptoms, like fatigue or brain fog
Above all, your psoriatic arthritis shouldn’t get in the way of daily activities, says Eric Ruderman, MD, a rheumatologist at Northwestern Medicine in Chicago. “I think function is a really important target,” he says. “We want to get the disease controlled enough that it doesn’t limit the things they do.”
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