Abstract: In recent years, significant progress has been made in targeted therapies, driven by a deeper understanding of PsA pathophysiology, particularly the elucidation of the pivotal role of the IL-23/Th17 axis. This review systematically summarizes the therapeutic advances in PsA. It covers the applications and limitations of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), such as methotrexate and leflunomide. It focuses on the clinical evidence and efficacy of biologic agents, including tumor necrosis factor (TNF) inhibitors, interleukin (IL)-12/23 inhibitors, IL-17 antagonists, and IL-23 inhibitors. Furthermore, it discusses the current status of targeted synthetic DMARDs (tsDMARDs), such as Janus kinase (JAK) inhibitors and the phosphodiesterase 4 inhibitor apremilast, as well as the development prospects of novel therapies including costimulation blockers, immune checkpoint modulators, and RORγt inhibitors.

Key words: psoriatic arthritis, biologic agents, Janus kinase inhibitors, phosphodiesterase 4 inhibitor apremilast