Effects of psoriatic arthritis‐targeted drugs on bone remodeling: Clinical evidence and molecular pathways

Abstract Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by diverse clinical manifestations. Of particular concern, osteopenia and osteoporosis are prevalent in 45.27% and 12.94% of PsA patients, respectively, suggesting a potential link between systemic inflammation and disrupted bone metabolism. While bone involvement in PsA has been widely investigated, a clear consensus on its underlying mechanisms and therapeutic implications remains lacking. Recent well‐designed randomized controlled trials have primarily examined the efficacy of targeted biologic therapies in managing PsA symptoms. However, their impact on bone remodeling—particularly the delicate balance between bone resorption and formation—is still not well understood. This review systematically assesses clinical evidence on bone mineral density changes in PsA patients compared to healthy controls and explores the molecular pathways through which targeted therapies (e.g., tumor necrosis factor‐α inhibitors, interleukin‐17/23 blockers, and Janus kinase inhibitors) may influence bone remodeling. By bridging mechanistic insights with clinical findings, this study seeks to clarify the osteoimmunological effects of PsA treatments and provide direction for future translational research.