Group for research and assessment of psoriasis and psoriatic arthritis: treatment recommendations for psoriatic arthritis 2015

Laura C Coates, Arthur Kavanaugh, Philip J Mease, Enrique R Soriano, Maria Laura Acosta Felquer, April W Armstrong, Wilson Bautista Molano, Wolf-Henning Boehncke, Willemina Campbell, Alberto Cauli, Luis R Espinoza, Oliver FitzGerald, Dafna D Gladman, Alice Gottlieb, Philip S Helliwell, M Elaine Husni, Thorvardur J Love, Ennio Lubrano, Neil McHugh, Peter NashAlexis Ogdie, Ana-Maria Orbai, Andrew Parkinson, Denis O'Sullivan, Cheryl F Rosen, Sergio Schwartzman, Evan L Siegel, Sergio Toloza, William Tuong, Christopher T Ritchlin

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OBJECTIVE: Update the 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for the spectrum of manifestations affecting patients with psoriatic arthritis (PsA).

METHODS: GRAPPA rheumatologists, dermatologists, and PsA patients drafted overarching principles for the management of PsA patients based on consensus at face-to-face meetings and via online surveys. We published literature reviews regarding treatment for the key domains of PsA (arthritis, spondylitis, enthesitis, dactylitis, skin, and nail disease), and convened a new group to identify pertinent comorbidities and their effect on treatment. Finally, we drafted treatment recommendations for each of the clinical manifestations and assessed the level of agreement for the overarching principles and treatment recommendations among GRAPPA members, with an online questionnaire.

RESULTS: Six overarching principles had at least 80% agreement among both health care professionals (HCPs; n=135) and patient research partners (PRPs; n=10). We developed treatment recommendations and a schema incorporating these principles for arthritis, spondylitis, enthesitis, dactylitis, skin, and nail disease, and comorbidities in the setting of PsA, using the GRADE process. Over 80% agreement was reached for approval of the individual recommendations and the overall schema.

CONCLUSION: Herein, we present overarching principles and updated treatment recommendations for the key manifestations of PsA, including related comorbidities, based on a literature review and consensus of GRAPPA members (rheumatologists, dermatologists, other HCPs, and PRPs). Further updates are anticipated as the therapeutic landscape in PsA evolves.

Original languageEnglish
Pages (from-to)1060-1071
JournalArthritis & Rheumatology
Issue number5
Early online date23 Mar 2016
Publication statusPublished - May 2016


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