Since the second version of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations were published in 2015, therapeutic options for psoriatic arthritis (PsA) have advanced considerably. This work reviews the literature since the previous recommendations (data published 2013–2020, including conference presentations between 2017 and 2020) and reports high-quality, evidence-based, domain-focused recommendations for medication selection in PsA developed by GRAPPA clinicians and patient research partners. The overarching principles for the management of adults with PsA were updated by consensus. Principles considering biosimilars and tapering of therapy were added, and the research agenda was revised. Literature searches covered treatments for the key domains of PsA: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail psoriasis; additional searches were performed for PsA-related conditions (uveitis and inflammatory bowel disease) and comorbidities. Individual subcommittees used a GRADE-informed approach, taking into account the quality of evidence for therapies, to generate recommendations for each of these domains, which were incorporated into an overall schema. Choice of therapy for an individual should ideally address all disease domains active in that patient, supporting shared decisionmaking. As safety issues often affect potential therapeutic choices, additional consideration was given to relevant comorbidities. These GRAPPA treatment recommendations provide up-to-date, evidence-based guidance on PsA management for clinicians and people with PsA.

自2015年发布银屑病和银屑病关节炎研究和评估小组 (GRAPPA) 第二版治疗建议以来，银屑病关节炎 (PsA) 的治疗选择已取得了长足的进步。这项工作审查了自上次建议以来的文献（2013年至2020年发表的数据，包括2017年至2020年的会议报告），并报告了 GRAPPA 临床医生和患者研究合作伙伴针对 PsA 药物选择提出的高质量、循证、以领域为重点的建议。以协商一致方式更新了成人 PsA 管理的总体原则。增加了考虑生物类似药和逐渐减量治疗的原则，并修订了研究议程。文献检索涵盖了 PsA 关键领域的治疗：外周关节炎、中轴疾病、起止点炎、指（趾）炎以及皮肤和指甲银屑病；还对 PsA 相关疾病（葡萄膜炎和炎症性肠病）和合并症进行了额外检索。单个小组委员会使用 GRADE 知情的方法，考虑治疗证据的质量，生成这些领域中每个领域的建议，并纳入总体模式中。理想情况下，个体治疗选择应解决该患者中活跃的所有疾病领域，支持共同决策。由于安全性问题通常会影响潜在的治疗选择，因此额外考虑了相关合并症。这些 GRAPPA 治疗建议为临床医生和 PsA 患者提供了最新的 PsA 管理循证指南。