title: Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis.
abstract: To 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).
  
  
  
  GRAPPA rheumatologists, dermatologists, and PsA patients drafted overarching principles for the management of PsA, based on consensus achieved at face-to-face meetings and via online surveys. We conducted literature reviews regarding treatment for the key domains of PsA (arthritis, spondylitis, enthesitis, dactylitis, skin disease, 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, using an online questionnaire.
  
  
  
  Six overarching principles had ≥80% agreement among both health care professionals (n = 135) and patient research partners (n = 10). We developed treatment recommendations and a schema incorporating these principles for arthritis, spondylitis, enthesitis, dactylitis, skin disease, nail disease, and comorbidities in the setting of PsA, using the Grading of Recommendations, Assessment, Development and Evaluation process. Agreement of >80% was reached for approval of the individual recommendations and the overall schema.
  
  
  
  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 health care providers, and patient research partners). Further updates are anticipated as the therapeutic landscape in PsA evolves.
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Coates
authors.affiliation: University of California at San Diego.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Enrique R
authors.initials: ER
authors.lastname: Soriano
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Maria
authors.initials: M
authors.lastname: Laura Acosta-Felquer
authors.affiliation: University of Southern California, Keck School of Medicine, Los Angeles.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.affiliation: Hospital Militar Central and Universidad Militar Nueva Grenada, Bogotá, Colombia.
authors.forename: Wilson
authors.initials: W
authors.lastname: Bautista-Molano
authors.affiliation: Geneva University Hospital, Geneva, Switzerland.
authors.forename: Wolf-Henning
authors.initials: WH
authors.lastname: Boehncke
authors.affiliation: Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Willemina
authors.initials: W
authors.lastname: Campbell
authors.affiliation: University of Cagliari, Monserrato Campus, Cagliari, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cauli
authors.affiliation: Louisiana State University Health Sciences Center, New Orleans.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Espinoza
authors.affiliation: St. Vincent's University Hospital, The Conway Institute for Biomolecular Research, and University College Dublin, Dublin, Ireland.
authors.forename: Oliver
authors.initials: O
authors.lastname: FitzGerald
authors.affiliation: University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada.
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
authors.affiliation: Tufts Medical Center, Boston, Massachusetts.
authors.forename: Alice
authors.initials: A
authors.lastname: Gottlieb
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK, and Bradford Hospitals NHS Foundation Trust, Bradford, UK.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: M Elaine
authors.initials: ME
authors.lastname: Husni
authors.affiliation: University of Iceland and Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Thorvardur J
authors.initials: TJ
authors.lastname: Love
authors.affiliation: University of Molise, Campobasso, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.affiliation: Royal National Hospital for Rheumatic Diseases, Bath, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: McHugh
authors.affiliation: University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Nash
authors.affiliation: University of Pennsylvania, Philadelphia.
authors.forename: Alexis
authors.initials: A
authors.lastname: Ogdie
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Orbai
authors.affiliation: Chapel Allerton Hospital, Leeds, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Parkinson
authors.affiliation: St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Denis
authors.initials: D
authors.lastname: O'Sullivan
authors.affiliation: Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Cheryl F
authors.initials: CF
authors.lastname: Rosen
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Sergio
authors.initials: S
authors.lastname: Schwartzman
authors.affiliation: Arthritis and Rheumatism Associates, Rockville, Maryland.
authors.forename: Evan L
authors.initials: EL
authors.lastname: Siegel
authors.affiliation: Ministry of Health, San Fernando del Valle de Catamarca, Argentina.
authors.forename: Sergio
authors.initials: S
authors.lastname: Toloza
authors.affiliation: University of California, Davis.
authors.forename: William
authors.initials: W
authors.lastname: Tuong
authors.affiliation: University of Rochester Medical Center, Rochester, New York.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Ritchlin
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000628:therapy*; D006801:Humans; D007270:Injections, Intra-Articular; D026741:Physical Therapy Modalities; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; C555450:secukinumab; D000069549:Ustekinumab