Novel pharmacotherapies and breakthroughs in psoriatic arthritis treatment.

INTRODUCTION: Psoriatic arthritis (PsA) is a systemic inflammatory disease affecting joints, entheses, skin, nails, and spine, often accompanied by comorbidities such as obesity, metabolic syndrome, and cardiovascular disease. Despite therapeutic advances, progressive joint damage, functional impairment, and reduced quality of life remain major concerns.

AREAS COVERED: This review highlights recent and emerging therapies in PsA, including newer biologic DMARDs (risankizumab and bimekizumab), tyrosine kinase 2 (TYK2) inhibitors, dual Janus Kinase (JAK) 1/TYK2 inhibitors, interleukin-23 receptor (IL-23 R)-targeted peptides, Affibody® molecules, and IL-17A/IL-17F-inhibiting nanobodies. Metabolic-targeted approaches, particularly glucagon-like peptide-1 receptor agonists (GLP-1RAs), offer potential benefits in obesity-driven disease. Evidence from randomized controlled trials (RCTs) and observational studies is summarized, encompassing efficacy across disease domains, safety profiles, and durability of response. Dual-pathway targeting for refractory cases is also discussed.

EXPERT OPINION: Advances in mechanism-based and metabolic-targeted therapies enable more individualized PsA management, improving the likelihood of achieving treatment targets. Ongoing challenges include early recognition, treatment of refractory disease, and long-term safety assessment. Progress in patient-centered therapy selection and precision medicine is expected to enhance outcomes, reduce disease burden, and optimize healthcare resources. Emerging pharmacotherapies continue to expand the treatment landscape, supporting a shift toward more effective, durable, and personalized management strategies.