Management of Psoriatic Arthritis with Diabetic Neuropathy in a Tertiary-Level Hospital

Open Access

Abstract

Introduction: Psoriatic arthritis (PsA) with diabetic neuropathy presents a complex therapeutic challenge because inflammatory joint disease and neuropathic complications require simultaneous and individualized management. Diabetes and its neurological complications may further influence treatment selection, symptom burden, functional status, and the need for foot care and multidisciplinary follow-up. This study aimed to assess the clinical characteristics and management practices of patients with coexisting psoriatic arthritis and diabetic neuropathy at a tertiary-level hospital. Methods & Materials: This cross-sectional observational study was conducted in the Department of Dermatology and Venereology at Monno Medical College & Hospital, a tertiary-level hospital, from July 2025 to June 2026. A total of 48 patients with coexisting psoriatic arthritis and diabetic neuropathy were enrolled using consecutive sampling. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Results: In this study, most had longstanding PsA and diabetes, with peripheral joint involvement predominant (56.3%). Numbness/tingling (77.1%) and reduced sensation (64.6%) were the most frequent neuropathic findings, while 60.4% had HbA1c ≥8.0%. NSAIDs (70.8%) and methotrexate (45.8%) were the most commonly used PsA treatments, whereas pregabalin (37.5%) was the leading neuropathic medication; biologic/targeted therapy was used in only 8.3%. Foot-care education was provided to 68.8%, and management intensity increased with greater neuropathy severity. Conclusion: The study showed that patients with coexisting psoriatic arthritis and diabetic neuropathy required integrated management of inflammatory disease, neuropathic symptoms, glycaemic control, and foot-related risks. Conventional DMARDs and NSAIDs predominated for PsA, while neuropathic agents and foot-care measures increased with neuropathy severity. Limited use of biologic therapy highlighted the need for individualized, multidisciplinary management.