Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis

Laura C. Coates, Arthur Kavanaugh, Philip J. Mease, Enrique R. Soriano, Maria Laura Acosta-Felquer, April W. Armstrong, Wilson Bautista-Molano, Wolf Henning Boehncke, Willemina Campbell, Alberto Cauli, Luis R. Espinoza, Oliver Fitzgerald, Dafna D. Gladman, Alice Gottlieb, Philip S. Helliwell, M. Elaine Husni, Thorvardur J. Love, Ennio Lubrano, Neil McHugh, Peter NashAlexis Ogdie, Ana Maria Orbai, Andrew Parkinson, Denis O'Sullivan, Cheryl F. Rosen, Sergio Schwartzman, Evan L. Siegel, Sergio Toloza, William Tuong, Christopher T. Ritchlin

Research output: Contribution to journalArticle


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.

Original languageEnglish (US)
Pages (from-to)1060-1071
Number of pages12
JournalArthritis and Rheumatology
Issue number5
StatePublished - May 1 2016


ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

Coates, L. C., Kavanaugh, A., Mease, P. J., Soriano, E. R., Laura Acosta-Felquer, M., Armstrong, A. W., Bautista-Molano, W., Boehncke, W. H., Campbell, W., Cauli, A., Espinoza, L. R., Fitzgerald, O., Gladman, D. D., Gottlieb, A., Helliwell, P. S., Husni, M. E., Love, T. J., Lubrano, E., McHugh, N., ... Ritchlin, C. T. (2016). Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis. Arthritis and Rheumatology, 68(5), 1060-1071.