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Psoriasis: HELP
Articles by Philip J. Mease
Based on 167 articles published since 2008
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Between 2008 and 2019, P. Mease wrote the following 167 articles about Psoriasis.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Guideline Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. 2018

Smolen, Josef S / Schöls, Monika / Braun, Jürgen / Dougados, Maxime / FitzGerald, Oliver / Gladman, Dafna D / Kavanaugh, Arthur / Landewé, Robert / Mease, Philip / Sieper, Joachim / Stamm, Tanja / Wit, Maarten de / Aletaha, Daniel / Baraliakos, Xenofon / Betteridge, Neil / Bosch, Filip van den / Coates, Laura C / Emery, Paul / Gensler, Lianne S / Gossec, Laure / Helliwell, Philip / Jongkees, Merryn / Kvien, Tore K / Inman, Robert D / McInnes, Iain B / Maccarone, Mara / Machado, Pedro M / Molto, Anna / Ogdie, Alexis / Poddubnyy, Denis / Ritchlin, Christopher / Rudwaleit, Martin / Tanew, Adrian / Thio, Bing / Veale, Douglas / Vlam, Kurt de / van der Heijde, Désirée. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria. · Health Consult, Vienna, Austria. · Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany. · Department of Rheumatology, Paris Descartes University, Paris, France. · Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland. · Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada. · Division of Rheumatology, University of California, San Diego, CA, USA. · Amsterdam Rheumatology & Immunology Center, Amsterdam, The Netherlands. · Division of Rheumatology Research, Swedish-Providence St. Joseph Health System, University of Washington, Seattle, WA, USA. · Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany. · Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. · Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands. · Neil Betteridge Associates, UK. · Ghent University Hospital, Ghent, Belgium. · Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · Department of Medicine, University of California, San Francisco, CA, USA. · Department of Rheumatology, UPMC Univ Paris 06, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Institute of Molecular Medicine, University of Leeds, Leeds, UK. · Seayn Medical, Voorschoten, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · University Health Network and University of Toronto, Toronto, Ontario, Canada. · University of Glasgow, College of Medical Veterinary and Life Sciences, Glasgow, UK. · A.DI.PSO. (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), Rome, Italy. · Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK. · Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA. · German Rheumatism Research Centrer, Berlin, Germany. · Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center Rochester, New York, NY, USA. · Division of Internal Medicine and Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands. · Department of Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. ·Ann Rheum Dis · Pubmed #28684559.

ABSTRACT: Therapeutic targets have been defined for axial and peripheral spondyloarthritis (SpA) in 2012, but the evidence for these recommendations was only of indirect nature. These recommendations were re-evaluated in light of new insights. Based on the results of a systematic literature review and expert opinion, a task force of rheumatologists, dermatologists, patients and a health professional developed an update of the 2012 recommendations. These underwent intensive discussions, on site voting and subsequent anonymous electronic voting on levels of agreement with each item. A set of 5 overarching principles and 11 recommendations were developed and voted on. Some items were present in the previous recommendations, while others were significantly changed or newly formulated. The 2017 task force arrived at a single set of recommendations for axial and peripheral SpA, including psoriatic arthritis (PsA). The most exhaustive discussions related to whether PsA should be assessed using unidimensional composite scores for its different domains or multidimensional scores that comprise multiple domains. This question was not resolved and constitutes an important research agenda. There was broad agreement, now better supported by data than in 2012, that remission/inactive disease and, alternatively, low/minimal disease activity are the principal targets for the treatment of PsA. As instruments to assess the patients on the path to the target, the Ankylosing Spondylitis Disease Activity Score (ASDAS) for axial SpA and the Disease Activity index for PSoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA) for PsA were recommended, although not supported by all. Shared decision-making between the clinician and the patient was seen as pivotal to the process. The task force defined the treatment target for SpA as remission or low disease activity and developed a large research agenda to further advance the field.

2 Guideline Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis. 2016

Coates, Laura C / Kavanaugh, Arthur / Mease, Philip J / Soriano, Enrique R / Laura Acosta-Felquer, Maria / Armstrong, April W / Bautista-Molano, Wilson / Boehncke, Wolf-Henning / Campbell, Willemina / Cauli, Alberto / Espinoza, Luis R / FitzGerald, Oliver / Gladman, Dafna D / Gottlieb, Alice / Helliwell, Philip S / Husni, M Elaine / Love, Thorvardur J / Lubrano, Ennio / McHugh, Neil / Nash, Peter / Ogdie, Alexis / Orbai, Ana-Maria / Parkinson, Andrew / O'Sullivan, Denis / Rosen, Cheryl F / Schwartzman, Sergio / Siegel, Evan L / Toloza, Sergio / Tuong, William / Ritchlin, Christopher T. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK. · University of California at San Diego. · Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington. · Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. · University of Southern California, Keck School of Medicine, Los Angeles. · Hospital Militar Central and Universidad Militar Nueva Grenada, Bogotá, Colombia. · Geneva University Hospital, Geneva, Switzerland. · Toronto Western Hospital, Toronto, Ontario, Canada. · University of Cagliari, Monserrato Campus, Cagliari, Italy. · Louisiana State University Health Sciences Center, New Orleans. · St. Vincent's University Hospital, The Conway Institute for Biomolecular Research, and University College Dublin, Dublin, Ireland. · University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada. · Tufts Medical Center, Boston, Massachusetts. · Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK, and Bradford Hospitals NHS Foundation Trust, Bradford, UK. · Cleveland Clinic Foundation, Cleveland, Ohio. · University of Iceland and Landspitali University Hospital, Reykjavik, Iceland. · University of Molise, Campobasso, Italy. · Royal National Hospital for Rheumatic Diseases, Bath, UK. · University of Queensland, Brisbane, Queensland, Australia. · University of Pennsylvania, Philadelphia. · Johns Hopkins University School of Medicine, Baltimore, Maryland. · Chapel Allerton Hospital, Leeds, UK. · St. Vincent's University Hospital, Dublin, Ireland. · Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. · Hospital for Special Surgery, New York, New York. · Arthritis and Rheumatism Associates, Rockville, Maryland. · Ministry of Health, San Fernando del Valle de Catamarca, Argentina. · University of California, Davis. · University of Rochester Medical Center, Rochester, New York. ·Arthritis Rheumatol · Pubmed #26749174.

ABSTRACT: OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSION: 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.

3 Guideline Treatment recommendations for psoriatic arthritis. 2009

Ritchlin, C T / Kavanaugh, A / Gladman, D D / Mease, P J / Helliwell, P / Boehncke, W-H / de Vlam, K / Fiorentino, D / Fitzgerald, O / Gottlieb, A B / McHugh, N J / Nash, P / Qureshi, A A / Soriano, E R / Taylor, W J / Anonymous6760613. ·Clinical Immunology Research Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 695, Rochester, New York 14642, USA. christopher_ritchlin@urmc.rochester.edu ·Ann Rheum Dis · Pubmed #18952643.

ABSTRACT: OBJECTIVE: To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion. METHODS: Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Treatment recommendations were drafted for each of the clinical manifestations by rheumatologists, dermatologists and PsA patients based on the literature reviews and consensus opinion. The level of agreement for the individual treatment recommendations among GRAPPA members was assessed with an online questionnaire. RESULTS: Treatment recommendations were developed for peripheral arthritis, axial disease, psoriasis, nail disease, dactylitis and enthesitis in the setting of PsA. In rotal, 19 recommendations were drafted, and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment decisions for the individual patient from an evidenced-based perspective. CONCLUSIONS: Treatment recommendations for the cardinal physical manifestations of PsA were developed based on a literature review and consensus between rheumatologists and dermatologists. In addition, a grid was established to assist in therapeutic reasoning and decision making for individual patients. It is anticipated that periodic updates will take place using this framework as new data become available.

4 Editorial New GRAPPA and EULAR recommendations for the management of psoriatic arthritis. 2017

Coates, Laura C / Gossec, Laure / Ramiro, Sofia / Mease, Philip / van der Heijde, Désirée / Smolen, Josef S / Ritchlin, Christopher / Kavanaugh, Arthur. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds UK. · Department of rheumatology, Sorbonne Universités, UPMC Univ Paris 06; AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. · Swedish Medical Center Seattle, WA, USA. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna. · 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria. · Allergy, Immunology & Rheumatology Division, University of Rochester Medical Center, Rochester, NY. · Division of Rheumatology, Allergy Immunology, University of California San Diego, USA. ·Rheumatology (Oxford) · Pubmed #28077693.

ABSTRACT: -- No abstract --

5 Editorial Do Biologic-treated Psoriatic Arthritis Patients with Spondylitis Respond Differently with or without Concomitant Methotrexate from Patients without Spondylitis? 2016

Mease, Philip J. ·Swedish Medical Center, Division of Rheumatology Research; University of Washington School of Medicine, Seattle, Washington, USA. pmease@philipmease.com. ·J Rheumatol · Pubmed #26932987.

ABSTRACT: -- No abstract --

6 Editorial Is there a role for rituximab in the treatment of spondyloarthritis and psoriatic arthritis? 2012

Mease, Philip J. · ·J Rheumatol · Pubmed #23204311.

ABSTRACT: -- No abstract --

7 Editorial The link between obesity and psoriatic arthritis. 2012

Cañete, Juan D / Mease, Philip. · ·Ann Rheum Dis · Pubmed #22798633.

ABSTRACT: -- No abstract --

8 Review Functional impairment measurement in psoriatic arthritis: Importance and challenges. 2018

Mease, Philip / Strand, Vibeke / Gladman, Dafna. ·University of Washington and Swedish Medical Center, 601 Broadway, Suite 600, Seattle, WA 98122. Electronic address: pmease@philipmease.com. · Stanford University, 306 Ramona Road, Portola Valley, CA 94028. · University of Toronto and Toronto Western Hospital, 399 Bathurst Street 1E-410B, Toronto, ON, Canada M5T 2S8. ·Semin Arthritis Rheum · Pubmed #30029795.

ABSTRACT: OBJECTIVES: Patients with psoriatic arthritis (PsA) experience substantial physical impairment. This is commonly assessed using the patient-reported Health Assessment Questionnaire-Disability Index (HAQ-DI), which was originally developed in rheumatoid arthritis. The purpose of this review is to examine the value and challenges of using the HAQ-DI in patients with PsA, and to discuss alternative measures of functional impairment in this condition. METHODS: A literature search was performed in the MEDLINE, BIOSIS Previews, Embase, Derwent Drug File, and SciSearch databases using relevant terms and key words. Additional references from personal libraries were identified by the authors. RESULTS: Although validated in PsA, the HAQ-DI has limitations, including marked floor effects, lack of responsiveness to treatment effects in later disease stages, and underestimation of physical impairment in patients whose symptoms are predominantly skin related. Nonetheless, it has been widely used in clinical trials of PsA treatment and is generally responsive to change with effective therapy, discriminating between active and placebo treatments. Other generic or arthritis-specific patient-reported questionnaires with a focus on physical impairment include the Medical Outcomes Study Short Form-36 Health Survey, the EuroQol-5D, the Arthritis Impact Measurement Scales, and the Routine Assessment of Patient Index Data 3. There are currently no PsA-specific instruments to assess physical function, but health-related quality-of-life questionnaires with elements related to functional impairment include the PsA Quality of Life questionnaire, the PsA Impact of Disease questionnaire, and VITACORA-19. As the available measures of physical impairment may not reflect the impact of all aspects of PsA on a patient, additional health-related quality-of-life instruments, such as the Dermatology Life Quality Index, may be used in parallel to obtain a more complete picture of the disease burden. CONCLUSIONS: The HAQ-DI is a valuable assessment tool that clinicians should continue to use in clinical trials and practice. Because instruments to specifically assess physical function in patients with PsA are currently lacking, clinicians should consider using a combination of instruments to conduct the most thorough evaluation possible.

9 Review Considerations for the definition of remission criteria in psoriatic arthritis. 2018

Mease, Philip J / Coates, Laura C. ·Swedish Medical Center, University of Washington, Seattle, United States of America. Electronic address: pmease@philipmease.com. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. ·Semin Arthritis Rheum · Pubmed #29566966.

ABSTRACT: OBJECTIVES: Psoriatic arthritis (PsA) is an autoimmune disease that can cause progressive structural damage of the joints and irreversible disability. The potentially achievable results of biologic therapy for PsA has led to the view that disease remission should be the goal of treatment. However, the heterogeneity of disease manifestations and need for validated outcome measures makes defining remission in PsA challenging. This article evaluates proposed criteria for defining remission in PsA and discusses how these criteria can be applied in clinical practice. METHODS: A primary literature search was conducted in PubMed to identify articles discussing potential PsA treatment goals or targets, including minimal disease activity. English-language publications from the last 10 years were included in this assessment. RESULTS: There are 5 clinical domains in PsA that must be considered when evaluating remission: synovitis, enthesitis, dactylitis, spondylitis, and psoriasis/nail psoriasis. Due to variability in the completeness of remission and time to achieve remission with different therapies between these domains, remission should be measured clinically through a combination of objective measures, or a composite assessment tool. Composite measures are more efficient than unidimensional instruments in measuring remission, but remission rates differ between the available composite indices. CONCLUSION: Although the concept of remission as a treatment goal in PsA is gaining acceptance among rheumatologists, further work is necessary to develop a broadly acceptable definition of remission.

10 Review A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative. 2018

Højgaard, Pil / Klokker, Louise / Orbai, Ana-Maria / Holmsted, Kim / Bartels, Else M / Leung, Ying Ying / Goel, Niti / de Wit, Maarten / Gladman, Dafna D / Mease, Philip / Dreyer, Lene / Kristensen, Lars E / FitzGerald, Oliver / Tillett, William / Gossec, Laure / Helliwell, Philip / Strand, Vibeke / Ogdie, Alexis / Terwee, Caroline B / Christensen, Robin. ·The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, DK-2000, Copenhagen, Denmark; Department of Rheumatology, Rigshospitalet, Gentofte Hospital, Kildegaardsvej 28, 2900 Hellerup, Denmark. · The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, DK-2000, Copenhagen, Denmark. · Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD. · Department of Rheumatology and Immunology, Singapore General Hospital, 20 College Rd, the Academia, S169856, Singapore. · Division of Rheumatology, Duke University School of Medicine, Advisory Services, QuintilesIMS, Durham, NC. · VU University Amsterdam, Department of Medical Humanities, Amsterdam, the Netherlands. · Division of Rheumatology and Krembil Research Institute, University Health Network, Toronto Western Hospital, 399 Bathurst St, 1E-410B, Toronto, Ontario, Canada M5T 2S8. · Division of Rheumatology Clinical Research, Swedish Medical Center, Seattle, WA. · Department of Rheumatology, St Vincent's University Hospital and Conway Institute for Biomolecular Research, University College Dublin, Ireland. · Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Pharmacy and Pharmacology, University of Bath, Bath, UK. · Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Pitie-Salpétrière Hospital, AP-HP, Rheumatology Department, 47-83 Bd de l'Hopital, Paris 75013, France. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Harehills Lane, Leeds LS7 4SA, UK. · Division of Immunology/Rheumatology, Stanford University, Palo Alto, CA. · Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. · VU University Medical Center, Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. · The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, DK-2000, Copenhagen, Denmark. Electronic address: Robin.christensen@regionh.dk. ·Semin Arthritis Rheum · Pubmed #29037523.

ABSTRACT: BACKGROUND: An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. OBJECTIVES: To synthesize the evidence on measurement properties of patient reported outcome measures (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. METHODS: A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. RESULTS: Fifty-five studies were included in the systematic review. Forty-four instruments and a total of 89 scales were analyzed. PROMs measuring COS domains with at least fair quality evidence for good validity and reliability (and no evidence for poor properties) included the Stockerau Activity Score for PsA (German), Psoriasis Symptom Inventory, visual analogue scale for Patient Global, 36 Item Short Form Health Survey Physical Function subscale, Health Assessment Questionnaire Disability Index, Bath Ankylosing Spondylitis Functional Index, PsA Impact of Disease questionnaire, PsA Quality of Life questionnaire, VITACORA-19, Functional Assessment of Chronic Illness Therapy Fatigue scale and Social Role Participation Questionnaire. CONCLUSIONS: At least one PROM with some evidence for aspects of validity and reliability was available for six of the eight mandatory domains of the PsA COS.

11 Review Fibromyalgia, a missed comorbidity in spondyloarthritis: prevalence and impact on assessment and treatment. 2017

Mease, Philip J. ·Rheumatology Clinical Research, Swedish Medical Center; University of Washington School of Medicine, Seattle, Washington, USA. ·Curr Opin Rheumatol · Pubmed #28394827.

ABSTRACT: PURPOSE OF REVIEW: Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA). RECENT FINDINGS: Fibromyalgia occurs in 2-8% of the general population. In AxSpA cohorts the prevalence has been reported in 4-25%, and in PsA, 16-22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus. SUMMARY: Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.

12 Review Management of psoriatic arthritis in 2016: a comparison of EULAR and GRAPPA recommendations. 2016

Gossec, Laure / Coates, Laura C / de Wit, Maarten / Kavanaugh, Arthur / Ramiro, Sofia / Mease, Philip J / Ritchlin, Christopher T / van der Heijde, Désirée / Smolen, Josef S. ·Sorbonne Universités, Université Pierre and Marie Curie - Paris 6, 4 Place Jussieu 75005, Paris, France; and at the Service de Rhumatologie, L'Assistance Publique - Hôpitaux de Paris, Pitié Salpêtrière Hôpital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Faculty of Medicine and Health, University of Leeds; and at the Leeds Musculoskeletal Biomedical Research Unit, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK. · Department of Medical Humanities, Vrije Universiteit Medical Centre, POBox 7057, 1007 MB Amsterdam, Netherlands. · Division of Rheumatology, Allergy &Immunology, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, California 92093-0656, USA. · Department of Rheumatology, Leiden University Medical Centre, POBox 9600, 2300 RC Leiden, Netherlands. · Rheumatology Clinical Research Division, Swedish Medical Center, 601 Broadway, Suite 600, Seattle, Washington 98102, USA. · Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, BOX 695, Rochester, New York 14642, USA. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; and at the 2nd Department of Medicine, Hietzing Hospital, Wolkersbergenstraße 1, 1130 Vienna, Austria. ·Nat Rev Rheumatol · Pubmed #27829672.

ABSTRACT: Psoriatic arthritis (PsA) is a heterogeneous, potentially severe disease. Many therapeutic agents are now available for PsA, but treatment decisions are not always straightforward. To assist in this decision making, two sets of recommendations for the management of PsA were published in 2016 by international organizations - the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). In both sets of recommendations, the heterogeneity of PsA is recognized and the place of various drugs in the therapeutic armamentarium is discussed. Such agents include conventional DMARDs, such as methotrexate, and targeted therapies including biologic agents, such as ustekinumab, secukinumab and TNF inhibitors, or the targeted synthetic drug apremilast. The proposed sequential use of these drugs, as well as some other aspects of PsA management, differ between the two sets of recommendations. This disparity is partly the result of a difference in the evaluation process; the focus of EULAR was primarily rheumatological, whereas that of GRAPPA was balanced between the rheumatological and dermatological aspects of disease. In this Perspectives article, we address the similarities and differences between these two sets of recommendations and the implications for patient management.

13 Review Biologic Therapy for Psoriatic Arthritis. 2015

Mease, Philip J. ·Clinical Rheumatology Research, Swedish Medical Center, 601 Broadway, Seattle, WA 98122, USA; University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA. Electronic address: pmease@philipmease.com. ·Rheum Dis Clin North Am · Pubmed #26476229.

ABSTRACT: Biologic medications, therapeutic proteins that inhibit or modulate proinflammatory immune cells and cytokines, have significantly altered clinicians' ability to effectively treat psoriatic arthritis (PsA). The first widely used biologics have been those targeting tumor necrosis factor alpha. Five agents (etanercept, infliximab, adalimumab, golimumab, and certolizumab) have shown significant benefit in all clinical domains of PsA as well as inhibiting progressive joint destruction. Treatment strategies such as treating PsA early in the disease course, treating to target and tight control, use of background methotrexate to reduce immunogenicity, and various cost-saving strategies are all being tested with biologic medicines for PsA.

14 Review A short history of biological therapy for psoriatic arthritis. 2015

Mease, Philip. ·Swedish Medical Center, Division of Rheumatology Research, Seattle, Washington University of Washington School of Medicine, Seattle, Washington, USA. pmease@philipmease.com. ·Clin Exp Rheumatol · Pubmed #26472182.

ABSTRACT: Psoriatic arthritis (PsA) is an inflammatory disease characterised by the clinical domains of arthritis, enthesitis, dactylitis, spondylitis, and psoriasis, often causing significant functional disability, loss of quality of life, and premature mortality. Prior to the introduction of targeted biologic medications, such as TNF inhibitors, the capacity to control disease activity was limited, with only modest effects noted in most patients with traditional oral medications such as methotrexate and sulfasalazine. The introduction of TNF inhibitors substantially changed the outlook of PsA patients, yielding significant response in all relevant clinical domains and demonstrating the capacity to inhibit progressive structural damage of joints. However, not all patients responded to these agents and many patients displayed initial response which waned over time, partly due to immunogenicity (development of antibodies which blocked full therapeutic effect of the biologic protein), or because of poor tolerability and/or adverse events. Thus, it has been important to develop new medicines which target other key cytokines and immunologic pathways, including ustekinumab which inhibits both IL12 and IL23 and thus is felt to work in both the TH1 and TH7 pathways of inflammation, has been approved for the treatment of PsA as well as psoriasis. IL17 inhibitors, including secukinumab and ixekizumab have demonstrated significant effectiveness in psoriasis and PsA; abatacept, which modulates T cell activity via inhibition the second signal of T cell activation is under study. This article provides an historical overview of this revolution; details of specific biological therapies will be provided in adjacent articles in this supplement.

15 Review Enhanced Patient Involvement and the Need to Revise the Core Set - Report from the Psoriatic Arthritis Working Group at OMERACT 2014. 2015

Tillett, William / Eder, Lihi / Goel, Niti / De Wit, Maarten / Gladman, Dafna D / FitzGerald, Oliver / Campbell, Willemina / Helliwell, Philip S / Gossec, Laure / Orbai, Ana-Maria / Ogdie, Alexis / Strand, Vibeke / McHugh, Neil J / Mease, Philip J. ·From the Royal National Hospital for Rheumatic Diseases, Bath, UK; Toronto Western Hospital; Psoriatic Arthritis Program, University Health Network, Toronto Western Research Institute, Toronto, Ontario, Canada; St. Vincent's University Hospital, Dublin, Ireland; Quintiles; Duke University School of Medicine; Durham, North Carolina, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; Chapel Allerton Hospital, Leeds, UK; Sorbonne Universités, Université Pierre et Marie Curie-Paris 6 (UPMC Univ Paris 6), Institut Pierre Louis d'Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France; Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, Maryland; Division of Immunology/Rheumatology, Stanford University School of Medicine, Portola Valley, California, USA; University of Bath, Bath, UK; Swedish Medical Center, University of Washington, Seattle, Washington; Hospital of the University of Pennsylvania (HUP), Philadelphia, Pennsylvania, USA.W. Tillett, MB, ChB, BSc, MRCP, PhD, Research Fellow, Royal National Hospital for Rheumatic Diseases; L. Eder, MD, PhD, Postdoctoral Research Fellow, Toronto Western Hospital; M. de Wit, PhD, OMERACT Patient Research Partner, The Netherlands; D.D. Gladman, MD, FRCPC, Director, Psoriatic Arthritis Program, University Health Network, Senior Scientist, Toronto Western Research Institute; O. FitzGerald, MD, FRCPI, FRCP( UK), Consultant Rheumatologist and Newman Clinical Research Professor, St. Vincent's University Hospital; N. Goel, MD, OMERACT Patient Research Partner, Quintiles, and Duke University School of Medicine; W. Campbell, BEd, LLB, OMERACT Patient Research Partner; P.S. Helliwell, DM, PhD, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital; L. Gossec, MD, PhD, Sorbonne Universités, UPMC Univ Paris 6, Institut Pierre Louis d'Epidémiologie et de Sant ·J Rheumatol · Pubmed #25934828.

ABSTRACT: OBJECTIVE: To discuss the need for revision of the "core set" of domains to be included for assessment in psoriatic arthritis (PsA) randomized controlled trials and longitudinal observational studies, review work undertaken since the 2012 meeting of Outcome Measures for Rheumatology 11 (OMERACT 11) to include patient perspectives in this revision, and reassess proposed composite measures in the context of new research data and the OMERACT Filter 2.0 framework. METHODS: The OMERACT 12 (2014) PsA working group presented work completed over the last 2 years to incorporate patient involvement in PsA outcomes research, review the endorsed PsA core set based on the patient perspective as well as new research findings, and further develop PsA responder indices. Breakout groups then discussed 2 topics: (1) the need to revise the PsA core set, and opportunities to add, move, or merge existing domains to improve existing redundancy; and (2) how to incorporate the core set in a composite index. Breakout groups fed back to the working group before participant voting. RESULTS: Meeting participants endorsed the need to revise the PsA core set according to the OMERACT Filter 2.0 framework (100%), and the inclusion of disease impact (94%) and fatigue (72%) in the inner circle. Breakout group feedback suggested the core set revision was an opportunity to consolidate pathophysiologic aspects such as arthritis, enthesitis, dactylitis, spondylitis as "inflammatory musculoskeletal disease," and nail and skin psoriasis as "psoriasis activity." CONCLUSION: Future work will focus on updating the PsA core set and development of responder indices with ongoing, meaningful involvement of patient research partners.

16 Review The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities. 2015

Østergaard, Mikkel / Bird, Paul / Gandjbakhch, Frédérique / Eshed, Iris / Haugen, Ida K / Haavardsholm, Espen A / Lillegraven, Siri / Foltz, Violaine / Glinatsi, Daniel / Peterfy, Charles / Ejbjerg, Bo / Bøyesen, Pernille / Mease, Philip J / Hermann, Kay-Geert / Emery, Paul / Genant, Harry K / Conaghan, Philip G. ·From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist, ·J Rheumatol · Pubmed #25684771.

ABSTRACT: OBJECTIVE: To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. METHODS: A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA), and its research priorities. RESULTS: The OMERACT RA MRI score (RAMRIS) evaluating bone erosion, bone edema (osteitis), and synovitis is now the standard method of quantifying articular pathology in RA trials. Cartilage loss is another important part of joint damage, and at the OMERACT 12 conference, we provided longitudinal data demonstrating reliability and sensitivity to change of the RAMRIS JSN component score, supporting its use in future clinical trials. The MRI group has previously developed a PsA MRI score (PsAMRIS). At OMERACT 12, PsAMRIS was evaluated in a randomized placebo-controlled trial of patients with PsA, demonstrating the responsiveness and discriminatory ability of applying the PsAMRIS to hands and feet. A hand OA MRI score (HOAMRIS) was introduced at OMERACT 11, and has subsequently been further validated. At OMERACT 12, good cross-sectional interreader reliability, but variable reliability of change scores, were reported. Potential future research areas were identified at the MRI session at OMERACT 12 including assessment of tenosynovitis in RA and enthesitis in PsA and focusing on alternative MRI techniques. CONCLUSION: MRI has been further developed and validated as an outcome measure in RA, PsA, and OA. The group will continue its efforts to optimize the value of MRI as a robust biomarker in rheumatology clinical trials.

17 Review Inhibition of interleukin-17, interleukin-23 and the TH17 cell pathway in the treatment of psoriatic arthritis and psoriasis. 2015

Mease, Philip J. ·Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA. ·Curr Opin Rheumatol · Pubmed #25599143.

ABSTRACT: PURPOSE OF REVIEW: In recent years, there has been an increasing understanding of the importance of the TH17 lineage of T cells and related cytokines, including interleukin (IL)17 and IL23, not only in the biology of innate host defense but also in the pathogenesis of inflammatory/autoimmune diseases. These diseases include psoriasis, psoriatic arthritis, the broader category of spondyloarthritides including ankylosing spondylitis and rheumatoid arthritis. It is postulated that in genetically predisposed individuals, external or internal stimuli such as microbial antigens, alterations in the intestinal microbiome, biomechanical stress and/or immunologic dysregulation may lead to an increased expression of cytokines such as IL23, which in turn stimulate the differentiation and activation of TH17 and other immune cells, which are a part of the innate immune system that trigger adaptive immune processes and chronic inflammatory diseases. Herein, we explore the effect of targeting this pathway therapeutically. RECENT FINDINGS: New drugs that are designed to inhibit steps in this pathway, the IL12/IL23 inhibitor, ustekinumab, the IL17A inhibitors secukinumab and ixekizumab, the IL17A receptor inhibitor, brodalumab, and the IL23 inhibitors guselkumab and tildrakizumab, have demonstrated significant effectiveness in treating these diseases, particularly psoriasis, psoriatic arthritis and ankylosing spondylitis. SUMMARY: This article reviews the relevant biology, efficacy and safety of new medications targeting the TH17 pathway, including inhibition of IL17 and IL23, particularly in psoriasis and psoriatic arthritis. Especially for patients who have not gained benefit from, lost effectiveness to or could not use antitumour necrosis factor (TNF) medications for safety or tolerability reasons, having effective medicines with an alternative mechanism of action will improve our ability to diminish disease activity impact on patient lives.

18 Review Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review. 2014

Acosta Felquer, Maria Laura / Coates, Laura C / Soriano, Enrique R / Ranza, Roberto / Espinoza, Luis R / Helliwell, Philip S / FitzGerald, Oliver / McHugh, Neil / Roussou, Euthalia / Mease, Philip J. ·From the Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; Academic Unit of Rheumatology, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College, Dublin, Ireland; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Barking Havering and Redbridge University Hospitals, NHS Trust; and Queens Mary's University of London, London, UK; and Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA.M.L. Acosta Felquer, MD, Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; L.C. Coates, MRCP, PhD, NIHR Clinical Lecturer, Leeds Institute; E.R. Soriano, MD, MSC, Jefe Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires; R. Ranza, MD, Academic Unit of Rheumatology, Universidade Federal de Uberlândia; L.R. Espinoza, MD, Section of Rheumatology, Louisiana State University Health Sciences Center; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; O. FitzGerald, MD, Department of Rheumatology, St. Vincent's University Hospital and Conway Institute for Biomolecular Research, University College; N. McHugh, FRCP, MD, Department of Pharmacy and Pharmacology, University of Bath; E. Roussou, MD, Consultant Rheumatologist, Barking Havering and Redbridge University Hospitals, NHS Trust and Clinical Senior Lecturer, Queens Mary's University of London; P.J. Mease, MD, Rhe ·J Rheumatol · Pubmed #25362711.

ABSTRACT: In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations.

19 Review Qualifying unmet needs and improving standards of care in psoriatic arthritis. 2014

Helliwell, Philip / Coates, Laura / Chandran, Vinod / Gladman, Dafna / de Wit, Maarten / FitzGerald, Oliver / Kavanaugh, Arthur / Strand, Vibeke / Mease, Philip J / Boehncke, Wolf-Henning / Langley, Richard G / Lubrano, Ennio / Maccarone, Mara / Schulze-Koops, Hendrik / Miceli-Richard, Corinne / Queiro, Ruben. ·Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK. ·Arthritis Care Res (Hoboken) · Pubmed #25047391.

ABSTRACT: -- No abstract --

20 Review Current concepts in psoriatic arthritis: pathogenesis and management. 2014

de Vlam, Kurt / Gottlieb, Alice B / Mease, Philip J. ·Department of Rheumatology, University Hospitals Leuven, Herestraat 419, BE-3000 Leuven, Belgium. Kurt.devlam@uzleuven.be. ·Acta Derm Venereol · Pubmed #24573106.

ABSTRACT: Psoriatic arthritis occurs in a subset of psoriasis patients and is therefore commonly encountered in dermatology practice. Although its exact pathogenesis is unknown, psoriatic arthritis is thought to share common mechanisms with psoriatic skin symptoms. Innate and adaptive immune responses are abnormally activated in psoriasis and may acquire the ability to attack peripheral joints and other sites following an environmental trigger (e.g. mechanical stress, trauma, infection) in genetically susceptible patients. The increased cardiovascular risk inherent in psoriasis appears further enhanced in psoriatic arthritis, likely reflecting the overall burden of systemic inflammation contributing to atherogenic processes. Basic research and clinical trials have suggested that tumour necrosis factor is important in psoriatic arthritis pathophysiology, and accumulating evidence suggests that Th17 cells and interleukin-17A may also be important. Basic research and clinical trials inform our understanding of psoriatic arthritis pathophysiology and, in turn, help dermatologists to make better treatment decisions.

21 Review Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. 2014

Mease, Philip J / Armstrong, April W. ·Swedish Medical Center and University of Washington, Seattle, WA, USA, pmease@philipmease.com. ·Drugs · Pubmed #24566842.

ABSTRACT: Psoriatic arthritis (PsA) is a chronic, systemic inflammatory disease. Up to 40 % of patients with psoriasis will go on to develop PsA, usually within 5-10 years of cutaneous disease onset. Both conditions share common pathogenic mechanisms involving genetic and environmental factors. Because psoriasis is typically present for years before PsA-related joint symptoms emerge, dermatologists are in a unique position to detect PsA earlier in the disease process through regular, routine screening of psoriasis patients. Distinguishing clinical features of PsA include co-occurrence of psoriatic skin lesions and nail dystrophy, as well as dactylitis and enthesitis. Patients with PsA are usually seronegative for rheumatoid factor, and radiographs may reveal unique features such as juxta-articular new bone formation and pencil-in-cup deformity. Early treatment of PsA with disease-modifying anti-rheumatic drugs has the potential to slow disease progression and maintain patient quality of life. Optimally, a single therapeutic agent will control both the skin and joint psoriatic symptoms. A number of traditional treatments used to manage psoriasis, such as methotrexate and cyclosporine, are also effective for PsA, but these agents are often inadequately effective, temporary in benefit and associated with significant safety concerns. Biologic anti-tumour necrosis factor agents, such as etanercept, infliximab and adalimumab, are effective for treating patients who have both psoriasis and PsA. However, a substantial number of patients may lose efficacy, have adverse effects or find intravenous or subcutaneous administration inconvenient. Emerging oral treatments, including phosphodiesterase 4 inhibitors, such as apremilast, and new biologics targeting interleukin-17, such as secukinumab, brodalumab and ixekizumab, have shown encouraging clinical results in the treatment of psoriasis and/or PsA. Active and regular collaboration of dermatologists with rheumatologists in managing patients who have psoriasis and PsA is likely to yield more optimal control of psoriatic dermal and joint symptoms, and improve long-term patient outcomes.

22 Review Development of a disease activity and responder index for psoriatic arthritis--report of the Psoriatic Arthritis Module at OMERACT 11. 2014

Coates, Laura C / FitzGerald, Oliver / Mease, Philip J / Gladman, Dafna D / Strand, Vibeke / Goel, Niti / Campbell, Ina / Krueger, Gerald / McHugh, Neil J / Helliwell, Philip S. ·From the Division of Rheumatic and Musculoskeletal Disease, University of Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute, University College Dublin, Dublin, Ireland; Seattle Rheumatology Associates, Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA; Division of Rheumatology, Department of Medicine, University of Toronto, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Immunology/Rheumatology, Stanford University, Palo Alto, California; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, and General Medicine Therapeutic Delivery Unit, Quintiles, Morrisville, North Carolina; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. ·J Rheumatol · Pubmed #24488420.

ABSTRACT: This module reflected work within the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop and validate composite disease activity measures in psoriatic arthritis (PsA). At the Outcome Measures in Rheumatology (OMERACT) 8 Meeting, a core set of domains to be assessed in randomized controlled trials (RCT) and longitudinal observational studies of PsA was agreed upon. At OMERACT 10, 5 proposed composite responder definitions for PsA were reviewed and discussed, including new data from the GRACE (GRAppa Composite Exercise) study. At OMERACT 11, ongoing retrospective analyses of RCT data using the 3 proposed measures (Composite Psoriatic Disease Activity Index, Psoriatic Arthritis Disease Activity Score, and Arithmetic Mean of the Desirability Function) were discussed in detail. There was agreement that developing composite outcome measures for use in RCT and longitudinal observational studies in PsA was important. Concerns were expressed regarding development of a single measure that encompassed diverse domains, such as joint counts, quality of life (QOL), and disability measures. It was emphasized that the use of any composite measure should include the ability to differentiate between activity in individual domains, such as enthesitis or psoriasis, such that the effect of each could be assessed independently. It was also agreed that patients would be systematically involved in further development and refinement of composite measures. Future plans include qualitative work with patients to explore their experience of disease activity and statistical modeling to explore how each of the proposed measures will perform in different disease subgroups.

23 Review Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis. 2014

Schoels, M M / Braun, J / Dougados, M / Emery, P / Fitzgerald, O / Kavanaugh, A / Kvien, T K / Landewé, R / Luger, T / Mease, P / Olivieri, I / Reveille, J / Ritchlin, C / Rudwaleit, M / Sieper, J / Smolen, J S / Wit, M de / van der Heijde, D. ·2nd Department of Internal Medicine, Center for Rheumatic Diseases, Hietzing Hospital, , Vienna, Austria. ·Ann Rheum Dis · Pubmed #23740234.

ABSTRACT: BACKGROUND: Current recommendations for the management of axial spondyloarthritis (SpA) and psoriatic arthritis are to monitor disease activity and adjust therapy accordingly. However, treatment targets and timeframes of change have not been defined. An international expert panel has been convened to develop 'treat-to-target' recommendations, based on published evidence and expert opinion. OBJECTIVE: To review evidence on targeted treatment for axial and peripheral SpA, as well as for psoriatic skin disease. METHODS: We performed a systematic literature search covering Medline, Embase and Cochrane, conference abstracts and studies in http://www.clinicaltrials.gov. RESULTS: Randomised comparisons of targeted versus routine treatment are lacking. Some studies implemented treatment targets before escalating therapy: in ankylosing spondylitis, most trials used a decrease in Bath Ankylosing Spondylitis Disease Activity Index; in psoriatic arthritis, protocols primarily considered a reduction in swollen and tender joints; in psoriasis, the Modified Psoriasis Severity Score and the Psoriasis Area and Severity Index were used. Complementary evidence correlating these factors with function and radiographic damage at follow-up is sparse and equivocal. CONCLUSIONS: There is a need for randomised trials that investigate the value of treat-to-target recommendations in SpA and psoriasis. Several trials have used thresholds of disease activity measures to guide treatment decisions. However, evidence on the effect of these data on long-term outcome is scarce. The search data informed the expert committee regarding the formulation of recommendations and a research agenda.

24 Review Methotrexate in psoriatic arthritis. 2013

Mease, Philip. · ·Bull Hosp Jt Dis (2013) · Pubmed #24219040.

ABSTRACT: Psoriatic arthritis (PsA) is a form of inflammatory arthritis that occurs in patients with psoriasis and is distinct from rheumatoid arthritis (RA). Methotrexate (MTX) is one of the most commonly used drugs for the treatment of PsA, yet there is scant controlled trial data to document its efficacy. Controlled trials have not demonstrated significant separation from placebo, but the studies have significant limitations which inhibit our ability to draw firm conclusions about the efficacy of MTX. A number of observational studies have described benefit for joint and skin disease. As yet unstudied, are the effects on enthesitis, dactylitis, and spondylitis of PsA. Psoriasis studies have shown modest benefit for psoriatic skin lesions. It is not yet known if MTX contributes an additive or synergistic benefit when used in combination with TNF inhibitors in PsA. The potential value of low dose MTX to suppress antibody formation against biologic therapies should be considered in a patient fail- ing benefit from such therapy. Although adverse effects are similar to those seen in RA treatment with MTX, awareness of the tendency for PsA and psoriasis patients to be obese and have non-alcoholic steatohepatosis, which may amplify transaminitis potential, should be borne in mind.

25 Review Psoriatic arthritis and spondyloarthritis assessment and management update. 2013

Mease, Philip. ·Swedish Medical Center, Seattle WA, USA. pmease@philipmease.com ·Curr Opin Rheumatol · Pubmed #23492739.

ABSTRACT: PURPOSE OF REVIEW: There have been numerous recent advances in our understanding about the epidemiology, pathophysiology, classification, assessment, and emerging treatments and treatment paradigms of psoriatic arthritis (PsA) and spondyloarthritis (SpA). This review provides an update on classification, assessment approaches, and treatments for these conditions. This is timely because it is becoming clear that the prevalence of the spondyloarthritides, including PsA, ankylosing spondylitis, and the broader categories of SpA may be present in 1-2% of the general population, more prevalent than rheumatoid arthritis (RA). RECENT FINDINGS: There are new classification criteria of axial and peripheral SpA as well as the CASPAR criteria for PsA, a new composite measure for ankylosing spondylitis and axial SpA, the ASDAS, new measures for the heterogeneous clinical domains of PsA, studies of biologic treatments of axial and peripheral SpA, and new drugs beyond anti-tumor necrosis factors for PsA and SpA. SUMMARY: New criteria, assessment tools, and therapies will aid research, diagnosis, and timely and targeted treatment to quantitated outcomes for PsA and SpA.

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