Biological agents have been a major breakthrough in the treatment of psoriatic arthritis in recent years and have achieved excellent efficacy. A class of agents that inhibit tumor necrosis factor-α (TNF-α) is commonly used. Generally, a course of treatment (three months) will result in significant improvement in the condition. However, biological agents are expensive and require regular injections for treatment. There are still many things to note when choosing a biological agent in order to maximize the drug efficiency ratio and treat the disease more safely. Studies have shown that tumor necrosis factor-α (TNF-α) plays a key role in the development of psoriasis and psoriatic arthritis, and biologics can block the inflammatory effect of TNF-α in the body, improve the joint swelling and pain caused by the disease, and treat psoriatic arthritis. It is characterized by its strong targeting, faster onset of action compared to traditional oral anti-rheumatic drugs, and better inhibition of bone and joint destruction caused by the disease. So, are all patients with psoriatic arthritis suitable for biologic treatment? Generally speaking, if a patient with psoriatic arthritis has a serious condition or the disease progresses rapidly and cannot be controlled by oral medication, treatment with biological agents can be considered; at the same time, patients with serious side effects from oral medication also need to consider treatment with biological agents. What is the difference between imported and domestic preparations? For the treatment of psoriatic arthritis, generally speaking, the cost of imported biological agents is about 1.5 to 2 times that of domestic ones. Domestic agents, such as Ixepro and Qiangke, generally cost about 20,000 yuan for three months of treatment with medication; while imported agents, such as Classic, Enzyme and Xiumeile, cost between 30,000 and 40,000 for three months. In terms of remission rate, although there are no studies formally comparing imported and domestic agents, personal clinical experience with domestic agents is still slightly inferior to imported agents; therefore, for patients who are financially acceptable, imported agents may be a better choice. Some patients with psoriatic arthritis have difficulty in getting regular injections because their homes are far from the hospital and they have difficulty moving around because of joint pain. For subcutaneous injections, if there is no injection reaction or a mild reaction after the first two injections in a large hospital, then you can consider purchasing the next injection at home; however, for intravenous injections, if an infusion reaction occurs, the lack of experience in prevention and treatment in a community hospital can pose a great danger to the patient. Therefore, for intravenous biologics, it is recommended that patients go to a large hospital for safety. Pre-screening for tuberculosis should be done before injecting biological agents Since biological agents will target to inhibit the effect of tumor necrosis factor in the body, resulting in the body’s reduced resistance to infection, infection is one of the common side effects. If the PPD skin test result is positive, it means there is a risk of tuberculosis infection and the patient needs to receive preventive anti-tuberculosis treatment; if it is strongly positive or active tuberculosis lesions are found in the chest X-ray, the patient should not be treated with biologics for the time being, but should first receive standardized anti-tuberculosis treatment. In addition, for patients with combined hepatitis B, treatment with nucleoside analogues of anti-hepatitis B virus is also required. As for the concern of many patients whether biologics will increase the risk of cancer, it is not considered to be very relevant. Although some foreign studies have found that long-term use of biologics increases the risk of lymphoma, most patients in China generally use biologics for only a few months, so there is no need to worry about this issue. How long can biologic treatment be stopped? Since biologics are expensive, the question of when they can be discontinued is also a concern for many patients and doctors. Most patients with psoriatic arthritis who receive 3 months of biologic treatment will have obvious efficacy, with significant improvement in skin lesions and joint swelling and pain, and improvement in blood test indicators. However, in general, oral anti-rheumatic drugs such as methotrexate, lorazepam, leflunomide, etc. should not be discontinued even during the treatment of biological agents, but should be adjusted by consulting a rheumatologist. If the disease continues to stabilize, the oral medication can be gradually reduced, and it is not necessary to keep the same treatment regimen all the time. It should be noted that even if a good remission of the disease is achieved through biologic treatment, if all treatment is stopped rashly, the disease will easily relapse, resulting in the abandonment of previous efforts, so patients should not take it lightly.