Treatment
Table 3. Summary of GRADE Recommendations for
Therapies by Domain
Indication
Recommended
Strong
Recommended
Conditional
Not
recommended
Strong
No recs due
to lack of
evidence
Peripheral Arthritis
DMARD
Naïve
DMARDs
(MTX, SSZ,
LEF), TNFi
NSAIDs, oral CS,
IA CS, PDE4i
IL12/23i,
IL17i
Inadequately
Responsive
to DMARD
TNFi,
ustekinumab,
PDE4i
NSAIDs, oral CS,
IA CS, IL17i
Inadequately
Responsive
to Biologic
TNFi NSAIDs, oral CS,
IA CS, IL12/23i,
IL17i, PDE4i
Axial PsA
Biologic Naïve
(based on AS
literature)
NSAIDs,
Physiotherapy,
simple
analgesia,
TNFi
IL17i,
CS SIJ injections,
bisphosphonates,
[IL12/23i]
DMARDs,
IL6i, CD20i
Biologic
Inadequately
Responsive
(based on AS
literature)
Physiotherapy,
simple
analgesia
NSAIDs, TNFi,
IL12/23i, IL17i
Enthesitis TNFi,
IL12/23i
NSAIDs,
physiotherapy,
CS injections (with
extreme caution
since injecting
corticosteroids in
weight-bearing
entheseal sites can
lead to rupture of
entheses), PDE4i,
IL17i
DMARDs
Dactylitis TNFi (INF,
ADM, GOL,
CZP)
CS injections,
DMARDs (MTX,
LEF, SSZ), TNFi
(ETN), IL12/23i,
IL17i, [SEC], PDE4i
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