Best practice & research. Clinical rheumatology
February 24, 2026 · via Europe PMC
The challenges in managing Psoriatic Arthritis in resource poor settings.
Nkeck JR, Adebajo AO, Maharaj AB.
AI summary — for doctors, generated from the abstract only
This review identifies four critical challenge areas (epidemiological data gaps, diagnostic delays, restricted treatment access, and limited research capacity) hindering effective psoriatic arthritis management in resource-limited settings, and proposes strategies including strengthened care pathways, task-shifting, and improved drug access to address these inequities.
What was studied
A narrative review synthesizing published literature identified via PubMed, Medline, Google Scholar, and Embase, focusing on the management of psoriatic arthritis (PsA) in resource-limited settings.
Key findings
- A severe lack of robust population-based data on PsA prevalence, incidence, and phenotype in resource-limited settings hinders public health planning.
- Significant diagnostic delays occur due to scarcity of specialists, limited access to diagnostic tools, and unclear patient pathways, leading to missed therapeutic opportunities and increased structural damage.
- Access to conventional and advanced biologic/targeted therapies is severely restricted by high costs, limited availability, and insufficient health coverage, compounded by a lack of adapted treatment guidelines and multidisciplinary care infrastructure.
- Minimal local research capacity, few clinical trials, and limited funding stifle innovation and context-specific solution development in these settings.
Clinical relevance
The findings suggest that addressing PsA management in resource-limited settings requires strengthening health systems through clear care pathways, task-shifting and training for primary care providers, developing national registries and context-adapted guidelines, and advocating for improved drug access, which is directly relevant to clinicians and health policymakers working in these settings to reduce health inequities.
Who should care
Limitations
This is a narrative review rather than a systematic review with formal quality appraisal; it synthesizes existing literature and identifies challenges rather than presenting new primary data or testing specific interventions.
Psoriatic arthritis management in resource-limited settings faces compounding epidemiological, diagnostic, therapeutic, and research challenges that require multifaceted health system strengthening strategies to address.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Psoriatic arthritis (PsA) is a systemic autoimmune and auto-inflammatory disease associated with significant morbidity, increased mortality, and substantial socioeconomic burden globally. While therapeutic advances have improved outcomes, their implementation in resource-limited settings faces profound challenges.
Methods
This narrative review synthesises findings from relevant publications identified via PubMed, Medline, Google Scholar and Embase, focusing on the management of PsA in resource-limited settings.
Results
We identified four critical challenge domains. Epidemiological: a severe lack of robust population-based data on prevalence, incidence, and phenotype in resource-limited settings hinders public health planning.
Diagnostic
significant delays occur due to a scarcity of specialists, limited access to diagnostic tools, and unclear patient pathways, leading to missed therapeutic opportunities and increased structural damage. Therapeutic: access to conventional and advanced biologic/targeted therapies is severely restricted by high costs, limited availability, and insufficient health coverage. This is compounded by a lack of adapted treatment guidelines and multidisciplinary care infrastructure.
Research
minimal local research capacity, few clinical trials, and limited funding stifle innovation and context-specific solution development.
Conclusion
The effective management of PsA in resource-limited settings requires a multifaceted strategy. Key priorities include: strengthening health systems through clear care pathways; task-shifting and enhanced training for primary care providers; developing national registries and context-adapted guidelines; advocating for improved drug access and affordability; and fostering local research capacity. Addressing these challenges is essential to mitigate health inequities and improve outcomes for PsA patients in resource-limited settings.
DOI
10.1016/j.berh.2026.102123
PMID
41735122
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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