Abstract
The 2014 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in New York, New York, USA, and attended by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups. Summaries of presentations at that meeting are introduced, including the GRAPPA-organized Fellows Symposium adjacent to the 2014 Swiss Psoriasis Day in Geneva. At the GRAPPA meeting itself, a Trainees Symposium was organized for rheumatology fellows and dermatology residents to present their research work; several patient research partners (PRP) organized Building Bridges, a session of interactive dialogue regarding the roles and responsibilities of PRP and researchers participating in working groups at GRAPPA and elsewhere; and 5 dermatology sessions were held to report on the international dermatology outcome measures group. Among the meeting topics were dermatologists’ management of psoriatic arthritis (PsA); the unmet need for a comprehensive assessment tool for psoriasis; the Psoriasis Symptom Inventory; and the importance of treat-to-target strategies for managing psoriasis. Other presentations included an update of GRAPPA’s research initiative to develop evidence-based criteria to identify inflammatory arthritis, enthesitis, dactylitis, and spondylitis; the utility of magnetic resonance imaging in PsA; a review of the PsA working group at OMERACT (Outcome Measures in Rheumatology); and updates on several GRAPPA educational projects. Considerable time was allotted to discussions of GRAPPA’s efforts to update its treatment guidelines for PsA.
Members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) held their annual meeting in July 2014 in New York, New York, USA. Members include investigators in rheumatology and dermatology and representatives of biopharmaceutical companies or from patient service leagues (Table 1, Table 2). They discussed individual and collaborative research and education initiatives in psoriasis and psoriatic arthritis (PsA). Since GRAPPA was formed in 2003, its goals and list of core projects have been reported1,2,3,4,5 (also available from www.grappanetwork.org). A portion of the 2014 GRAPPA meeting was held in conjunction with members of the SPondyloArthritis Research & Treatment Network (SPARTAN).
Composition of GRAPPA members.
GRAPPA executive and steering committee membership.
Several GRAPPA members organized 2 fellows symposia in 2012 and 2013; and they continued this effort in October 2014 with a symposium adjacent to the Swiss Psoriasis Day in Geneva. Hervé Bachelez (Paris, France), Wolf-Henning Boehncke (Geneva, Switzerland), Carle Paul (Toulouse, France), and Philip S. Helliwell (Leeds, UK) formed the faculty. Of 12 abstracts received and ranked by an international jury, the 8 best-ranked ones were presented and discussed in detail at the symposium6.
The trainees symposium, an integral part of the annual GRAPPA meeting, provides an opportunity for trainees to discuss their research in psoriatic disease with experts in the field. In 2014, 26 rheumatology and dermatology researchers from Europe, and from North and South America, described their studies. A total of 42 abstracts were submitted and ranked by a committee of reviewers led by Christopher Ritchlin (Rochester, New York, USA). The 4 top-ranked abstracts were chosen for oral presentation; 22 additional abstracts were presented as posters. GRAPPA members provided feedback, including how to improve and further develop the research projects7.
For the second year, GRAPPA members included patient research partners (PRP) in their annual proceedings. At the 2014 meeting, the session Building Bridges included interactive dialogue on the roles and responsibilities of PRP and researchers in GRAPPA’s working groups, meetings, and governance arrangements; recommendations of the European League Against Rheumatism for the inclusion of patient representatives in scientific research; and recommendations of OMERACT (Outcome Measures in Rheumatology) for the involvement of PRP in working groups8.
Five dermatology sessions were held on the first day of the GRAPPA meeting. Alice Gottlieb (Boston, Massachusetts, USA) updated the group on International Dermatology Outcome Measures, a group formed to enhance outcomes and facilitate access to dermatologic care by creating standardized measures of disease progression and treatment efficacy that emphasize the patient perspective9. Next, Wolf-Henning Boehncke reminded the group of the need for dermatologists and rheumatologists to cooperate in the management of skin and musculoskeletal manifestations of PsA by using a comparison between Germany and Switzerland to discuss how to achieve this crucial cooperation10. A group led by Joseph Merola (Boston, Massachusetts, USA) and Abrar Qureshi (Providence, Rhode Island, USA) then stressed the need for an improved tool to more comprehensively assess the patient with psoriasis and suggested the B-SNIPI (Brigham Scalp, Nail, Inverse, Palmar-plantar Psoriasis Composite Index) as a complement to the PASI (Psoriasis Area and Severity Index)11.
Continuing the dermatology presentations, Philip J. Mease (Seattle, Washington, USA) introduced the PSI (Psoriasis Symptom Inventory) as a simple measure enabling patients to self-score psoriasis severity, reporting that it correlated with the PASI score in a psoriasis clinical trial and was validated to assess psoriasis in a PsA clinical trial12. Finally, Joel Gelfand (Philadelphia, Pennsylvania, USA) chaired a presentation and discussion of the importance of treat-to-target strategies for managing psoriasis13.
Dr. Mease also chaired a plenary session and breakout group discussions of GRAPPA’s continuing research initiative to develop evidence-based, practical, and reliable criteria that can be used to identify inflammatory arthritis, enthesitis, dactylitis, and spondylitis. The effort involves expert clinician nominal group exercises, patient focus groups, and Delphi exercises to identify core features of inflammatory disease, with a goal of developing simple clinical criteria and achieving timely and accurate diagnosis and referral of patients with inflammatory arthritis14.
Mikkel Østergaard (Copenhagen, Denmark) led a discussion on current knowledge and future perspectives of magnetic resonance imaging (MRI) in PsA clinical trials, with a focus on the peripheral disease manifestations. The session included presentation of the PsAMRIS (Psoriatic Arthritis Magnetic Resonance Image Score), developed by the international MRI in arthritis group of OMERACT, for evaluation of inflammatory and destructive changes in PsA hands15.
William Tillett (Bath, UK) and coauthors next updated the members on recent progress made by the PsA working group of OMERACT, specifically the Patient Involvement in Outcome Measures for PsA initiative to improve the incorporation of the patient perspective in PsA outcomes research. GRAPPA members of the OMERACT working group are working toward a goal of seeking endorsement of revisions to the PsA core set at OMERACT 201616.
Significant time at the GRAPPA annual meeting was dedicated to ongoing efforts to update the previous treatment recommendations originally published in 2009. The process is described in an article by Laura Coates (Leads, UK), et al; it included work by the domain subcommittees (peripheral arthritis, skin, nails, dactylitis, enthesitis, axial disease, and comorbidities) to appraise the evidence for individual therapies in PsA; these papers were published in 2014. The process continues with an updated literature review within each domain group and population of an overall flowchart, with a final summary paper on treatment recommendations to be submitted later in 201517.
A final article by Kristina Callis Duffin (Salt Lake City, Utah, USA) and Dr. Mease describes the status of GRAPPA’s many Internet-based and continuing medical education (CME) programs in psoriasis and PsA, including a video project and several CME-credit and non-credit initiatives to educate dermatologists, rheumatologists, and trainees18.
At the conclusion of the GRAPPA annual meeting, members discussed action items in a business meeting. The next annual meeting will be held in Stockholm, Sweden, in July 2015.
Acknowledgment
Special thanks to Pam Love for her tireless organizational efforts, which kept the meeting running smoothly; and to Linda Melvin, writer/editor for the GRAPPA 2014 articles.
Footnotes
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Financial support to enable these meetings was provided in 2014 by AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly & Company, Novartis, Pfizer, and UCB. In addition, Covagen and Crescendo were Innovation Partners in 2014.
