medwireNews: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has released up-to-date evidence-based guidelines for the management of psoriatic arthritis (PsA).
These recommendations are published in Nature Reviews Rheumatology and form an update to the 2015 guidelines. They were developed based on evidence identified through systematic searches that was assessed using GRADE methodology.
The authors, led by Laura Coates (University of Oxford, UK), say that their recommendations “utilize a domain-based approach,” with subcommittees developing guidance spanning the six domains of PsA: peripheral arthritis; axial disease; enthesitis; dactylitis; skin psoriasis; and nail psoriasis. The recommendations also cover comorbidities with a potential influence on treatment, which are categorized into PsA-related conditions (inflammatory bowel disease [IBD] and uveitis) and other comorbidities.
“The subcommittees had strong representation from rheumatology and dermatology, and the related condition group also invited experts from the field of uveitis and IBD to ensure that multidisciplinary views were incorporated,” write Coates et al.
The authors provide a treatment schema summarizing their recommendations for all the different domains of PsA and related conditions. They stress that “[g]iven the heterogeneity of disease presentation of PsA, individualization of therapy is crucial.”
Coates et al recommend that “[c]hoice of therapy for an individual should ideally address all disease domains active in that patient, supporting shared decision-making.”
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