Psoriatic Arthritis: A Knowledge Check for Clinicians
Reviewed by: HU Medical Review Board | Last reviewed: August 2026 | Last updated: August 2026
Difficult-to-treat psoriatic arthritis (PsA) is now defined by international consensus – but applying those definitions at the bedside means separating true inflammatory refractoriness from the many non-inflammatory drivers of persistent symptoms. These 5 questions test how current evidence guides that assessment and the treatment decisions that follow.
Clinical Challenge
Which statement best captures the 2025 consensus distinction between treatment-refractory and complex-to-manage (or difficult-to-manage) PsA?
Clinical Challenge
Under the 2025 EULAR consensus, difficult-to-manage PsA generally requires prior failure of at least how many biologic or targeted synthetic DMARDs with different modes of action?
Clinical Challenge
A 48-year-old with established PsA reports persistent widespread pain and fatigue. Joint examination shows no swelling, C-reactive protein and erythrocyte sedimentation rate are normal, and recent imaging shows no active synovitis or enthesitis. Which assessment is most appropriate before intensifying therapy?
Clinical Challenge
In a patient with active PsA and coexisting inflammatory bowel disease, which targeted mechanism is generally the least preferred?
Clinical Challenge
Which validated composite reflects low disease burden across joints, skin, entheses, and patient-reported outcomes and is recommended as a treat-to-target goal in PsA?