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Treatment recommendations for psoriatic arthritis
C T Ritchlin1, A Kavanaugh, D D Gladman
1Clinical Immunology Research Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 695, Rochester, New York 14642, USA. christopher_ritchlin@urmc.rochester.edu
Annals of the Rheumatic Diseases
|October 28, 2008
Summary
This study provides evidence-based treatment recommendations for psoriatic arthritis (PsA) clinical manifestations. A consensus-driven framework aids clinicians in making personalized treatment decisions for psoriatic arthritis patients.
Area of Science:
- Rheumatology and Dermatology
- Clinical Practice Guidelines
- Evidence-Based Medicine
Background:
- Psoriatic arthritis (PsA) presents diverse clinical manifestations requiring tailored treatment strategies.
- Existing treatment guidelines for PsA require updates based on systematic literature reviews and expert consensus.
- The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) initiated a comprehensive review process.
Framework:
- Development of treatment recommendations for key PsA manifestations: peripheral arthritis, axial disease, skin and nail psoriasis, dactylitis, and enthesitis.
- Recommendations were derived from systematic literature reviews and refined through multidisciplinary expert consensus, including patients.
- A structured framework was established to integrate disease severity across different PsA manifestations.
Implementation:
- Formal literature reviews were conducted for each distinct clinical manifestation of PsA.
- Treatment recommendations were drafted by rheumatologists, dermatologists, and PsA patients.
- Consensus on 16 out of 19 drafted recommendations was achieved, with over 80% agreement.
Implications:
- The developed recommendations offer a standardized, evidence-based approach to managing PsA.
- A novel grid facilitates clinical decision-making by factoring disease severity into treatment choices.
- This framework supports periodic updates as new research emerges, ensuring continued relevance in PsA management.
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