Expert consensus on early diagnosis and treatment of psoriatic arthritis (2025 edition)

Abstract Background Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease associated with psoriasis (PsO), characterized by complex clinical manifestations, a protracted course, and a propensity for relapses. However, in China, there is a notable deficiency in the recognition and early diagnosis of PsA, with missed or incorrect diagnoses being relatively common. Therefore, this consensus aims to promote early diagnosis and optimise outcomes of patients with PsA. Methods This consensus was developed by the Expert Consensus Research Group on Early Recognition, Diagnosis, and Treatment of PsA, the Psoriatic Arthritis Group of the Committee of Rheumatology and Immunology, Cross‐Strait Medical and Health Exchange Association. The process involved collecting clinical questions through online questionnaires, followed by rounds of expert meetings and revisions. The evidence was systematically reviewed from databases such as PubMed, Embase, Web of Science, Cochrane Library, and Chinese databases, with the evidence quality and recommendation strength graded according to the 2011 Oxford Centre for Evidence‐Based Medicine levels. Results We distributed online questionnaires to the expert panel involved in the three rounds of surveys. At the end of the third round of surveys, four overarching principles and sixteen recommendations were collected. The level of agreement with these recommendations ranged from 83.33% to 100%. Consensus was reached on all 16 clinical recommendations identified by the Committee (i.e., ≥75% of respondents strongly agreed or agreed), and specific recommendations were formulated for the risk assessment and early screening of PsA, as well as the early treatment and management of PsA. Conclusion This consensus provides scientific evidence and guidance for the early recognition, diagnosis, and treatment of PsA, which is expected to raise clinical physicians' awareness of PsA, reduce misdiagnosis, and improve patients' quality of life and prognosis.