RT Journal Article T1 Management of particular clinical situations in psoriatic arthritis: an expert's recommendation document based on systematic literature review and extended Delphi process. A1 García-Vicuña, Rosario A1 Garrido, Noemí A1 Gómez, Susana A1 Joven, Beatriz A1 Queiro, Rubén A1 Ramírez, Julio A1 Rebollo, Francisco A1 Loza, Estíbaliz A1 Sellas, Agustí K1 Disease-modifying antirheumatic drugs K1 Manifestations K1 Psoriatic arthritis K1 Recommendations K1 Systematic literature review AB To establish practical recommendations for the management of patients with psoriatic arthritis (PsA) with particular clinical situations that might lead to doubts in the pharmacological decision-making. A group of six expert rheumatologists on PsA identified particular clinical situations in PsA. Then, a systematic literature review (SLR) was performed to analyse the efficacy and safety of csDMARDs, b/tsDMARDs in PsA. In a nominal group meeting, the results of the SLR were discussed and a set of recommendations were proposed for a Delphi process. A total of 65 rheumatologists were invited to participate in the Delphi. Agreement was defined if ≥ 70% of the participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grade of recommendation was established based on the Oxford Evidence-Based Medicine categorisation. Particular clinical situations included monoarthritis, axial disease, or non-musculoskeletal manifestations. The SLR finally comprised 131 articles. A total of 16 recommendations were generated, all but 1 reached consensus. According to them, it is crucial to carefully analyse the impact of individual manifestations on patients (disability, quality of life, etc.), but also to recognise the impact of each drug singularities on selected clinical phenotypes to adopt the most appropriate treatment strategy. Early diagnosis and treatment to target approach, along with a close risk management, is also necessary. These recommendations are intended to complement gaps in national and international guidelines by helping health professionals address and manage particular clinical situations in PsA. YR 2021 FD 2021-05-02 LK http://hdl.handle.net/10668/17731 UL http://hdl.handle.net/10668/17731 LA en DS RISalud RD Apr 17, 2025