Browsing by Author "Gladman, Dafna D"

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    ItemOpen Access
    Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
    (Therapeutic advances in musculoskeletal disease, 2021-01) Poddubnyy, Denis; Baraliakos, Xenofon; Van den Bosch, Filip; Braun, Jürgen; Coates, Laura C; Chandran, Vinod; Diekhoff, Torsten; van Gaalen, Floris A; Gensler, Lianne S; Goel, Niti; Gottlieb, Alice B; van der Heijde, Désirée; Helliwell, Philip S; Hermann, Kay Geert A; Jadon, Deepak; Lambert, Robert G; Maksymowych, Walter P; Mease, Philip; Nash, Peter; Proft, Fabian; Protopopov, Mikhail; Sieper, Joachim; Torgutalp, Murat; Gladman, Dafna D

    Background

    Involvement of the axial skeleton (sacroiliac joints and spine) is a relatively frequent manifestation associated with psoriatic skin disease, mostly along with involvement of peripheral musculoskeletal structures (peripheral arthritis, enthesitis, dactylitis), which are referred to as psoriatic arthritis (PsA). Data suggest that up to 30% of patients with psoriasis have PsA. Depending on the definition used, the prevalence of axial involvement varies from 25% to 70% of patients with PsA. However, there are currently no widely accepted criteria for axial involvement in PsA.Objective: The overarching aim of the Axial Involvement in Psoriatic Arthritis (AXIS) study is to systematically evaluate clinical and imaging manifestations indicative of axial involvement in patients with PsA and to develop classification criteria and a unified nomenclature for axial involvement in PsA that would allow defining a homogeneous subgroup of patients for research.

    Design

    Prospective, multicenter, multinational, cross-sectional study.

    Methods and analyses

    In this multicenter, multinational, cross-sectional study, eligible patients [adult patients diagnosed with PsA and fulfilling Classification Criteria for Psoriatic Arthritis (CASPAR) with musculoskeletal symptom duration of ⩽10 years not treated with biological or targeted synthetic disease-modifying anti-rheumatic drugs] will be recruited prospectively. They will undergo study-related clinical and imaging examinations. Imaging will include radiography and magnetic resonance imaging examinations of sacroiliac joints and spine. Local investigators will evaluate for the presence of axial involvement based on clinical and imaging information which will represent the primary outcome of the study. In addition, imaging will undergo evaluation by central review. Finally, the central clinical committee will determine the presence of axial involvement based on all available information.

    Ethics

    The study will be performed according to the ethical principles of the Declaration of Helsinki and International Council for Harmonisation Good Clinical Practice guidelines. The study protocol will be approved by the individual Independent Ethics Committee / Institutional Review Board of participating centers. Written informed consent will be obtained from all included patients.Registration: ClinicalTrials.gov ID: NCT04434885.
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    Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021.
    (Nature reviews. Rheumatology, 2022-08) Coates, Laura C; Soriano, Enrique R; Corp, Nadia; Bertheussen, Heidi; Callis Duffin, Kristina; Campanholo, Cristiano B; Chau, Jeffrey; Eder, Lihi; Fernández-Ávila, Daniel G; FitzGerald, Oliver; Garg, Amit; Gladman, Dafna D; Goel, Niti; Helliwell, Philip S; Husni, M Elaine; Jadon, Deepak R; Katz, Arnon; Laheru, Dhruvkumar; Latella, John; Leung, Ying-Ying; Lindsay, Christine; Lubrano, Ennio; Mazzuoccolo, Luis Daniel; Mease, Philip J; O'Sullivan, Denis; Ogdie, Alexis; Olsder, Wendy; Palominos, Penelope Esther; Schick, Lori; Steinkoenig, Ingrid; de Wit, Maarten; van der Windt, DA; Kavanaugh, Arthur; GRAPPA Treatment Recommendations domain subcommittees
    Since the second version of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations were published in 2015, therapeutic options for psoriatic arthritis (PsA) have advanced considerably. This work reviews the literature since the previous recommendations (data published 2013-2020, including conference presentations between 2017 and 2020) and reports high-quality, evidence-based, domain-focused recommendations for medication selection in PsA developed by GRAPPA clinicians and patient research partners. The overarching principles for the management of adults with PsA were updated by consensus. Principles considering biosimilars and tapering of therapy were added, and the research agenda was revised. Literature searches covered treatments for the key domains of PsA: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail psoriasis; additional searches were performed for PsA-related conditions (uveitis and inflammatory bowel disease) and comorbidities. Individual subcommittees used a GRADE-informed approach, taking into account the quality of evidence for therapies, to generate recommendations for each of these domains, which were incorporated into an overall schema. Choice of therapy for an individual should ideally address all disease domains active in that patient, supporting shared decision-making. As safety issues often affect potential therapeutic choices, additional consideration was given to relevant comorbidities. These GRAPPA treatment recommendations provide up-to-date, evidence-based guidance on PsA management for clinicians and people with PsA.
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    Management of Axial Disease in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations.
    (The Journal of rheumatology, 2022-11) Lubrano, Ennio; Chan, Jon; Queiro-Silva, Ruben; Cauli, Alberto; Goel, Niti; Poddubnyy, Denis; Nash, Peter; Gladman, Dafna D

    Objective

    Axial involvement in patients with psoriatic arthritis (PsA) is a common subset of this condition, but a unanimous definition has yet to be established. It has been defined by using different criteria, ranging from the presence of at least unilateral grade 2 sacroiliitis to those used for ankylosing spondylitis (AS), or simply the presence of inflammatory low back pain (IBP). Our aim was to identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA.

    Methods

    This systematic review is an update of the axial PsA (axPsA) domain of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

    Results

    The systematic review of the literature showed that new biologic and targeted synthetic disease-modifying antirheumatic drug classes, namely interleukin (IL)-17A and Janus kinase inhibitors, could be considered for the treatment of axPsA. This would be in addition to previously recommended treatments such as nonsteroidal antiinflammatory drugs, physiotherapy, simple analgesia, and tumor necrosis factor inhibitors. Conflicting evidence still remains regarding the use of IL-12/23 and IL-23 inhibitors.

    Conclusion

    Further studies are needed for a better understanding of the treatment of axPsA, as well as validated outcome measures.