TY - JOUR
T1 - Management of Peripheral Arthritis in Patients With Psoriatic Arthritis
T2 - An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
AU - Leung, Ying Ying
AU - Korotaeva, Tatiana V.
AU - Candia, Liliana
AU - Molano, Wilson Bautista
AU - Ruderman, Eric M.
AU - Perez-Alamino, Rodolfo
AU - Olsder, Wendy
AU - Möller, Burkhard
AU - Grazio, Simeon
AU - Gudu, Tania
AU - Mody, Girish M.
AU - Pineda, Carlos
AU - Raffayova, Helena
AU - Rohekar, Sherry
AU - Goldenstein-Schainberg, Claudia
AU - Gutierrez Urena, Sergio R.
AU - Casasola Vargas, Julio César
AU - Meghnathi, Bhowmik
AU - Prasad, Roopa
AU - Richette, Pascal
AU - Miranda, Jose Roberto S.
AU - Malliotis, Nikolas
AU - Lindqvist, Ulla
AU - Simon, David
AU - Ezeonyeji, Amara
AU - Soriano, Enrique R.
AU - FitzGerald, Oliver
N1 - Publisher Copyright:
Copyright © 2023 by the Journal of Rheumatology.
Publisher Copyright:
© 2023 Journal of Rheumatology. All rights reserved.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - OBJECTIVE: We aimed to compile evidence for the efficacy and safety of therapeutic options for the peripheral arthritis domain of psoriatic arthritis (PsA) for the revised 2021 Group in Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations. METHODS: A working group consisting of clinicians and patient research partners was convened. We reviewed the evidence from new randomized controlled trials (RCTs) for PsA treatment from February 19, 2013, to August 28, 2020. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-informed approach to derive evidence for the classes of therapeutic options for 3 patient groups: (1) naïve to treatment, (2) inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and (3) inadequate response to biologic DMARDs (bDMARDs). Recommendations were derived through consensus meetings. RESULTS: The evidence review included 69 RCTs. We derived GRADE evidence for each class of therapeutic options and achieved consensus for the recommendations. For patients naïve to treatment, the working group strongly recommends csDMARDs (methotrexate, sulfasalazine, leflunomide) and phosphodiesterase 4 inhibitors, and emphasizes regular assessment and early escalation to achieve treatment target. bDMARDs (tumor necrosis factor inhibitors [TNFi], interleukin 17 inhibitors [IL-17i], IL-12/23i, IL-23i) and Janus kinase inhibitors (JAKi) are also strongly recommended. For patients with inadequate response to csDMARDs, we strongly recommend TNFi, IL-17i, IL-12/23i, IL-23i, and JAKi. For those who had prior experience with bDMARDs, we strongly recommend a second TNFi, IL-17i, IL-23i, and JAKi. The evidence supporting nonpharmacological interventions was very low. An expert panel conditionally recommends adequate physical activity, smoking cessation, and diet to control weight gain. CONCLUSION: Evidence supporting optimal therapy for the peripheral arthritis domain of PsA was compiled for the revised 2021 GRAPPA treatment recommendations.
AB - OBJECTIVE: We aimed to compile evidence for the efficacy and safety of therapeutic options for the peripheral arthritis domain of psoriatic arthritis (PsA) for the revised 2021 Group in Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations. METHODS: A working group consisting of clinicians and patient research partners was convened. We reviewed the evidence from new randomized controlled trials (RCTs) for PsA treatment from February 19, 2013, to August 28, 2020. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-informed approach to derive evidence for the classes of therapeutic options for 3 patient groups: (1) naïve to treatment, (2) inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and (3) inadequate response to biologic DMARDs (bDMARDs). Recommendations were derived through consensus meetings. RESULTS: The evidence review included 69 RCTs. We derived GRADE evidence for each class of therapeutic options and achieved consensus for the recommendations. For patients naïve to treatment, the working group strongly recommends csDMARDs (methotrexate, sulfasalazine, leflunomide) and phosphodiesterase 4 inhibitors, and emphasizes regular assessment and early escalation to achieve treatment target. bDMARDs (tumor necrosis factor inhibitors [TNFi], interleukin 17 inhibitors [IL-17i], IL-12/23i, IL-23i) and Janus kinase inhibitors (JAKi) are also strongly recommended. For patients with inadequate response to csDMARDs, we strongly recommend TNFi, IL-17i, IL-12/23i, IL-23i, and JAKi. For those who had prior experience with bDMARDs, we strongly recommend a second TNFi, IL-17i, IL-23i, and JAKi. The evidence supporting nonpharmacological interventions was very low. An expert panel conditionally recommends adequate physical activity, smoking cessation, and diet to control weight gain. CONCLUSION: Evidence supporting optimal therapy for the peripheral arthritis domain of PsA was compiled for the revised 2021 GRAPPA treatment recommendations.
UR - http://www.scopus.com/inward/record.url?scp=85145425830&partnerID=8YFLogxK
U2 - 10.3899/jrheum.220315
DO - 10.3899/jrheum.220315
M3 - Review article
C2 - 36243409
AN - SCOPUS:85145425830
SN - 0315-162X
VL - 50
SP - 119
EP - 130
JO - The Journal of rheumatology
JF - The Journal of rheumatology
IS - 1
ER -