THE GROUP FOR RESEARCH AND ASSESSMENT OF PSORIASIS AND PSORIATIC ARTHRITIS (GRAPPA) TREAT-MENT RECOMMENDATIONS 2021
Authors: L. C. Coates et al.
Psoriatic arthritis with its different manifestations still represents a therapeutic challenge to both dermatologists and rheumatologists. The therapeutic armentarium for psoriatic arthritis has increased substantially and guidance is needed regarding the optimal therapeutic decision for an individual patient. The GRAPPA recommendations focus on individual disease manifestations and their last version dates back to 2015. A systematic literature search was conducted from the end of the previous recommendations through August 2020 and included conference abstracts from 2017–2020. Treatment recommendations were developed by individual groups and incorporated into the overall scheme. Optimal treatment should target all domains that impact an individual patient. The recommendations explicitely focus on peripheral arthritis, axial involvement, enthesitis, dactylitis, nail involvement and skin disease. In addition, recommendations address concomitant IBD and uveitis.
The EULAR recommendations for the treatment of psoriasis have been updated last year and, in contrast to the GRAPPA recommendations, use a more stepwise approach for the selection of drugs. The EULAR recommendations place JAK inhibitors behind biologicals. In contrast, the GRAPPA recommendations focus on individual disease manifestations without giving recommendations regarding the preferred sequence of drugs. They divide their recommendations «strong for», «conditional for», «conditional against» and «strong against».
We will be looking forward to reading the full length paper that is likely coming out soon!