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ambulance,10941480013353144206267292345405454507529
II.164614800133275376
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FN27681480013353123
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artritida804199001214880116149172205228284332
je1154199001212575
chronické1247199001214499131186241264309355404
imunitně16691990012123106161216239272327377
zprostředkované20641990012143100133187226260292342399446499546595650700
zánětlivé2782199001214392147198231254277325374
onemocnění31741990012155110161244299345400450505528
ze3720199001214393
skupiny340213001213985140196219274319
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Onemocnění13822130012169124174257311356411461516538
je1938213001212473
charakterizováno2029213001214499146178226272307356388411454508554602657711
postižením27572130012157112151184207249298353376458
kloubů,3233213001214671125180236291311
entezí35612130012150105137186228251
nebo3402270012155106163219
axiálního579227001214895119167190245268325381
skeletu979227001214086135159209243298
u12962270012155
pacientů13712270012157106151174224279312366
s17572270012140
psoriázou.1816227001215797152185208256299354409430
Kloubní2266227001215479134190246302325
projevy2611227001215790144168218266316
většinou2947227001214897130171194249304359
následují33262270012156104143166216274328352375
až3721227001214891
po3402410012157113
rozvoji478241001213388129180234258281
kožní7852410012147100142198221
psoriázy,1031241001215797152185208256300350366
u14222410012155
menší15032410012183134189228251
části1780241001214493132166189
pacientů19942410012157106151174224280312367
tomu2386241001213387171226
může26372410012184138181231
být28942410012156103139
i30592410012123
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Fenotyp3463241001214998154209242292349
psoriatické340255001215695149181204251283305349395443
artritidy800255001214879115146169202224280326
má11432550012183130
mnoho12902550012183137191246300
podob,16072550012157112168222278297
odrážející19212550012155111143190233282305327371394
kombinaci2332255001214699181237260314362405428
konkrétního2777255001214699154200233282315369392448502
muskuloskeletálního32962550012182136174220274297351390436484340269001212474107155179234256313368
projevu726269001215789144167217265320
a10642690012148
různých1130269001213287130185230274329
forem1477269001212983116166249
i17442690012123
tíže178526900121335698148
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psoriázy2189269001215696150183207254297347
a25542690012148
také2620269001213381128176
přítomnost2814269001215789113146199283338392432465
mimokloubních32972690012183106189244291316371426482340283001215579123178
projevů539283001215689144168218266321
nemoci.8802830012156106190245291314334
Různé12352830012154108151207257
projevy1513283001215689144168218266316
onemocnění18502830012154110161244299345400451506529
a23992830012149
zejména2468283001214393117200250306354
jejich284228300121257599122167222
kombinace30842830012147101184241265320368413462
a35662830012148
také3635283001213382128177
vývoj340297001214899150204228
v5922970012148
čase663297001214594133183
činí870297001214467122146
někdy10392970012156106153208256
terapeutické1318297001213483116164221272327360383428475523
rozhodování1865297001213387129185240297352399448503526
obtížným.24142970012155112146169212267313397418
Terapie2856297001214993126175231255305
onemocnění31852970012155110161244300345400451506529
je3738297001212474
komplexní,3403110012147101184241265315363419442462
jejím82531100121247598122205
cílem105331100121456893143227
je1303311001212474
dosažení14003110012156112151200243293349372
remise1795311001213282166189228278
nebo20963110012156106163219
alespoň2338311001214871122161218274329
nízké2690311001215679122169217
aktivity2930311001214995131154202226259309
onemocnění.32623110012155111161245300346401451507530550
Spektrum3403250012150107159206243276332416
léčebných784325001212475121171228285331375431
možností12443250012184140182238294334368392
se1664325001214091
v17843250012149
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letech2356325001212475109159205261
významně26453250012149100146202251335390441
rozšířilo.3115325001213388131172196231255279335354
V34983250012156
léčbě3583325001212475121178230
onemocnění3403390012154109159241296341395445499522
se879339001213989
uplatňují9853390012155111134182214268322345368
konvenční1370339001214699154200248303347401424
syntetické1811339001213987142174223255278322368416
chorobu2244339001214499153185239295350
modifikující26113390012183137194216245271316371394417461483
léky3112339001212372119168
(csDMARDs),3298339001212869109174253314367433472496515
jako340353001212472119173
je535353001212475
např.6323530012156104160193208
methotrexát,8633530012183134167223278310343393440488521542
významný1427353001214999144200248331386432
posun18813530012157113152207262
v21663530012148
terapii2236353001213383115164221244267
onemocnění25263530012155111161245300345401451506530
přineslo3078353001215790113168219258282337
zavedení3437353001214393140189246296352375
cílené34036700121446690139193242
léčby599367001212372116171216
v8313670012147
podobě8953670012156110166219275324
biologických1236367001215678132155208263286329374423465519
DMARDs17713670012166144204256321359
(bDMARDs)2147367001212883148227287338404442466
a26303670012147
nověji26933670012155108154202224247
cílených295636700121446690139193237280333
syntetických3306367001213985140171219251273317362411453506
DMARDs3403810012167147209262329369
(tsDMARDs).736381001212859100166247308361429468493512
Nesteroidní12753810012166116156190239272326350406462485
antirevmatika17873810012148103136159191241289373421453476523572
mohou23863810012184139195250305
krátkodobě2719381001214781129162208262319374431482
zmírnit32293810012143126149182238261294
symptomy3550381001214088172229340395001213387171216
onemocnění,5803950012155111161245300346401451507530550
nemají11543950012156106190238262285
však1463395001214887136182
vliv166939500121487395144
na18373950012155103
strukturální1964395001214074106161208244299331380403459482
progresi2469395001215790145202234284323346
ani28393950012148104127
kožní29903950012146100142198221
projevy,3235395001215790144168218266316332
jejich359139500121257599122167222
použití3404090012157113168211234267290
by6484090012157103
mělo7694090012184134158213
být10004090012157103140
omezeno11584090012154138189232282337392
pouze15684090012157113168211261
na18474090012156104
krátkodobé1969409001214681129161208262319374431482
užití2469409001215598121154177
u26644090012155
pacientů27374090012157106151174224279311366
s31214090012140
mírnou31794090012183106139195250305
formou3502409001212984117200256311
onemocnění.3404230012154109158241295339394443497520540
Lokální8974230012147100146194217271294
aplikace12084230012147103126149194242286334
glukokortikoidů1559423001215678132178230277329362397419465517540596649
může22254230012183136178227
zmírnit24694230012142124147179233256288
zánět2774423001214291145195227
a30184230012148
bolest,30834230012156111134184222255276
systémová3376423001213986125158206288342389436
terapie340437001213382115164220244294
není6534370012156106162185
doporučena8574370012156111168224257313358406462510
vzhledem1386437001214893149172222280330413
k18184370012147
limitované1884437001212447130153186240287336391442
účinnosti23444370012156100123179234289328362385
a27484370012148
bezpečnostním28154370012157108151208259305360415454488544567650
rizikům.348443700121335699122169224307329
Součástí3404510012150105161206255294329352
terapie720451001213483116165222246297
jsou1045451001212564120175
i12494510012123
nefarmakologická13014510012156107136186219303351398453477532589613658705754
opatření20844510012155113162195227277333357
a24694510012149
v25464510012149
neposlední26234510012156107164221260284334392448471
řadě3123451001213381138189
zohlednění3340451001214499155178229287343393449473
komorbidit,3404650012147101184239272329353410433466487
jako847465001212472119172
je1039465001212475
obezita,11334650012155112163207230263312333
onemocnění14864650012155110161244300345401451506529
kardiovaskulárního2035465001214796129185208263310359398444499523571603659682739795
systému2849465001214088127161211294349
nebo32184650012155106163219
deprese,34564650012157107164197247286337357
jejichž34047900121247598122166221264
výskyt626479001214898138184235271
je918479001212475
u10144790012155
psoriatické1090479001215796152185208256288311356403452
artritidy1563479001214880116149172205229285333
častější.1917479001214593132166215239278301321
Klíčová340495001246190118163221273326
slova:693495001244371130182235260
psoriatická980496001215796152185208256289312357403452
artritida,1461496001214880116149173206229285333354
spondyloartritidy,1844496001213996152208264312336392440473509541565598621678725741
biologická2614496001215780135160215272295340386435
terapie,3078496001213382115164220244294314
cílená342149600121446793143199247
terapie,3696496001213383340510001213381138162212232
switch.5935100012139114137171214269290
Targeted3405330012455102140199252290343403
treatment764533001243675129182219306359419455
of1240533001245792
psoriatic13525330012460104162200228281317346391
arthritis1763533001245391130190228256293321365
Psoriatic340551001215390145177200246278300344
arthritis701551001214879115169200223255278316
is1034551001212361
a11125510012147
chronic,1176551001214498130184238261304325
immune-mediated15185510012123105186240294344376459509565588635666715771
inflammatory2306551001212377105131178259341388420473505555
disease2878551001215578116165212250300
from3195551001212961115197
the3409551001213387136
group3562551001215587141195251
of340565001215584
spondyloarthritis.447565001213996152208264312336391440472508563596619652675714736
The12055650012150107157
disease1385565001215679118169217256306
is1714565001212362
characterized17995650012145100148180229274309358391415458507565
by23875650012157103
joint,2513565001212479103158190211
enthesis,27475650012150106138193244283306345366
or3136565001215588
axial3247565001214895119167190
skeleton3460565001214086135159210243297353
involvement340579001212379125179204252301385436491524
in892579001212479
patients9995790012157106139162212268300341
with1368579001217498131186
psoriasis.1583579001215796151185208256295318357379
Joint1990579001213792116171204
manifestations22225790012184132187210240290330364413445468524579618
usually2869579001215594148197220243291
occur31885790012155101145200232
after3448579001214978114164197
the3673579001213388139
development3405930012156107154203227283340423474530562
of927593001215484
skin1035593001214086111166
psoriasis,1226593001215796151184208256295318356377
although1628593001214872105160215270326382
in2034593001212479
a21375930012149
smaller22105930012140123171194217268301
subset2535593001214094151190241274
of2834593001215584
patients,29425930012157106139162212268300340361
this3328593001213388111150
may35035930012183131177
be37055930012156108
the340607001213388139
reverse.502607001213383130180212253303323
The8496070012150106157
phenotype10296070012157113164219274307357415466
of1519607001215584
psoriatic1626607001215797152185208256289312356
arthritis2006607001214881117172204228261284323
is2353607001212362
highly2439607001215578134189213260
variable,2723607001214897129153200257281332351
reflecting3098607001213383112139189235270293348404
a35266070012148
combination3598607001214599182340621001215780135183215238293349
of706621001215584
specific808621001213995146192215244270314
musculoskeletal11406210012183138177222276299354393440488512562596644667
manifestations18256210012183131186209238288328361410442465520575614
and24576210012148103159
various2634621001214896129152207262301
forms2952621001212984117200239
and32096210012148103159
severity3386621001214090137186219242275325
of3728621001215584
skin340635001214086111166
psoriasis,525635001215796151184208256295318357378
as922635001214887
well10286350012173123147170
as1217635001214887
the1323635001213388139
presence1481635001215689139179229285330379
of1879635001215584
extra-articular1982635001215097133165214246294327362385430485508556589
manifestations25906350012183131186209239289329362411444467522577616
of3225635001215584
the3328635001213388139
disease.3486635001215679118168216255306326
The3406490012150106157
different525649001215679109141192225274330362
presentations916649001215790139179229285317366399422477533571
of1516649001215584
the1628649001213388139
disease,1795649001215679118169217256306326
especially2150649001215089146197243266313337360407
their2586649001213388138162194
combinations,2809649001214498182239262318366398421476532571592
and34296490012148104160
their3618649001213388138162194
development3406630012156105152201224279335418468523554
over9126630012154100149181
time1110663001213356138188
can1315663001214592147
make14796630012183130176225
therapeutic1721663001213387137169217273323378410433477
decisions22156630012156106151173211234288343381
challenging.2613663001214599146169192242296352374429484505
Treatment3135663001214976125172204286336391423
of3575663001215483
the3675663001213387137
disease340677001215679117167215253303
is661677001212361
complex,740677001214497180237260310357379
with1136677001217497130184
the1338677001213387137
goal14936770012155110158181
being16926770012156107130185240
remission1950677001213281164187226264287341396
or2364677001215487
at2468677001214880
least2566677001212373121159193
low2776677001212478151
disease2944677001215679117167215253303
activity.3265677001214892127150198221254303319
In3602677001212378
recent3698677001213282340691001214491145176
years,533691001214693140171210230
the779691001213386135
spectrum930691001213994143187221253306387
of1333691001215482
treatment1431691001213364112159190271320374405
options18526910012154109141163216270307
has21766910012154101138
expanded2330691001215095151198251306355410
significantly.2757691001213960115168190218243286333387418440486501
Conventional32756910012156108162207255309340361415469515537
synthetic340705001213987143175230280313336380
disease-modifying738705001215679117167215254304337420475532555584634658713769
antirheumatic15247050012148103135158190245295350433480513535580
drugs2121705001215689144199238
(csDMARDs),2376705001212970110176256317370437476501519
such2913705001213993138192
as3123705001214887
methotrexate,32277050012183133167221276308341390437485517566586
are340719001214881130
used490719001215695145202
in712719001212479
the811719001213388139
treatment970719001213365115163196279329385417
of1407719001215584
the1511719001213389139
disease.1670719001215680118169217256306326
A20167190012162
major20987190012183131155210243
shift2361719001214095118147183
in2564719001212479
therapy2663719001213388139171220277323
was30067190012174122161
brought3187719001215790144200256311344
by35517190012156103
the3674719001213388139
introduction340733001212378110142196253307352387410464519
of877733001215583
targeted978733001213381113168218251300357
biological1353733001215680134158213269292336384407
DMARDs17787330012166146207260326366
(bDMARDs)2161733001212985151231292345412451476
and,26547330012148103159180
more28517330012183138170220
recently,3088733001213382127176231263286333349
targeted3454733001213382114169219252301358
synthetic340747001214088144176231282315338383
DMARDs7477470012167147209262329369
(tsDMARDs).1140747001212959100166247308362429468493512
Nonsteroidal16767470012166121177216250299332386410466514538
anti-inflammatory22387470012148103136159190215270299325373456540588620674707758
drugs3020747001215689144200239
(NSAIDs)3283747001212993142202225292332357
can3664747001214593149
briefly340761001215790113164193220267
alleviate63376100121487195145192216264297346
disease1005761001215679118168216255306
symptoms,1337761001213987171228261315399438459
but18227610012156112145
they1993761001213388138185
do22047610012156111
not23417610012155111143
affect2510761001214877110160206241
structural2777761001213973106161206241296329377401
progression3203761001215790145201234284323362385440496
or3725761001215588
skin340775001213985110165
manifestations,5227750012183131186209238287327360408441463518573612632
and11727750012148103159
their1348775001213388138161193
use1559775001215593143
should1720775001213994149203227283
be20207750012157108
limited2145775001212446129152184233290
to2453775001213386
short-term2557775001213994148181216244277326358442
use3016775001215594144
in3177775001212378
patients32737750012156105137160209265297337
with3627775001217497130184
DECLARATIONS:4070201008648871301662142563043393604124625014571201008514
Declaration406921500874987120141179206244271291333375
of445821500874066
originality:45382150087406888130150192230251271298337356
The406922600853473109
manuscript418922600855891130168195227249266306329
is452922600851744
original45842260085386178117133172205222
and481722600853472112
has49402260085387299
not50512260085387699
been516222600853975110149
published532322600853977117134150177216251291
or406923700853862
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