Psoriatic arthritis management: a comparative analysis of PANLAR, EULAR, and GRAPPA treatment recommendations

Background: Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis associated with psoriasis, affecting multiple domains, including peripheral joints, axial skeleton, enthesis, dactylitis, and skin. Several multinational organizations, including European Alliance of Associations for Rheumatology (EULAR), Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), and Pan American League of Associations for Rheumatology (PANLAR), have established treatment recommendations to optimize patient care. However, differences may exist in their guidelines, reflecting methodology regional differences, expert consensus, and evolving evidence. Design and objectives: This review compares the treatment recommendations for PsA established by EULAR, GRAPPA, and PANLAR, highlighting similarities, differences, and challenges in achieving standardized treatment strategies worldwide. Methods: A comparative literature review analyzing key aspects of each guideline was performed. A systematic evaluation of the latest three multinational treatment recommendations was conducted, focusing on pharmacological and nonpharmacological management approaches. Differences in treatment sequencing, targeted therapies, and emphasis domains were examined. Results: While all three organizations emphasize a multidisciplinary and personalized approach to PsA treatment, some variations exist in the preferred sequencing of therapies, the role of targeted synthetic disease-modifying antirheumatic drugs, and the approach to extra-musculoskeletal manifestations. PANLAR provides a regional perspective with emphasis on access constraints, EULAR integrates real-world evidence and long-term safety data, and GRAPPA emphasizes domain-based treatment. Conclusion: While PANLAR, EULAR, and GRAPPA guidelines align in core treatment principles, key differences persist, influencing clinical decision-making. Greater international collaboration may enhance the harmonization of treatment recommendations, ensuring optimal patient outcomes globally.