Achieving Precision Medicine in Psoriatic Arthritis: Novel Treatment Strategies and Trial Designs.

Psoriatic arthritis (PsA) is an immune-mediated inflammatory arthropathy with phenotypic, pathogenetic, and radiologic heterogeneity. Over the last 20 years, a wide range of biologic disease modifying anti-rheumatic drugs (bDMARDs) have been licensed for the treatment of PsA. Precision medicine aims to choose the right treatment for the right patient at the right time. Current clinical trials are using biomarker-targeted treatment approaches to guide bDMARD selection. There is an ongoing debate as to whether a blood or tissue biomarker is the superior approach. Master protocol trials, including basket and umbrella trials, could revolutionize testing novel therapeutic strategies in PsA and spondyloarthropathies.