Abstract
The 2017 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Amsterdam, the Netherlands, and was attended by rheumatologists, dermatologists, representatives of biopharmaceutical companies, and patients. As in previous years, GRAPPA members held a symposium for trainees to discuss their research in psoriatic disease with experts in the field. Other subjects featured during the annual meeting included a discussion of the history, clinical features, controversies, and immunogenetics of juvenile psoriatic arthritis; updates from working groups in Outcome Measures in Rheumatology and International Dermatology Outcome Measures; a discussion of the benefits and challenges of setting up a longitudinal psoriatic arthritis (PsA) database; 3 separate discussions of the effects of the microbiome on skin and joints in psoriasis and PsA; a discussion of options for assessing joints and entheses in PsA by ultrasonography and magnetic resonance imaging; an update on GRAPPA’s research and educational projects; a discussion of patient centricity, including the incorporation of patient research partners (PRP) into psoriasis and PsA research and educational efforts, from GRAPPA’s PRP; and a discussion of the GRAPPA-Collaborative Research Network’s inaugural meeting. In this prologue, we introduce the papers that summarize that meeting.
- PSORIASIS
- INTERNATIONAL DERMATOLOGY OUTCOME MEASURES
- PSORIATIC ARTHRITIS
- GRAPPA
- OUTCOME MEASURES IN RHEUMATOLOGY
The 2017 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Amsterdam, the Netherlands. Currently, there are 933 worldwide GRAPPA members, including investigators in rheumatology and dermatology (n = 632), representatives of biopharmaceutical companies (n = 211), patient research partners (PRP; n = 25), and other members (n = 65). Reports of previous yearly meetings have been published elsewhere1,2,3,4,5,6,7,8.
A Trainees Symposium was held prior to the annual meeting. Rheumatology and dermatology researcher-trainees from Europe, North America, and South America, who are current GRAPPA members or who were nominated by GRAPPA members, presented and discussed their studies with experts in the field. A total of 40 abstracts were submitted and ranked by a committee of reviewers. Six trainees with the highest-scored abstracts were invited to deliver oral presentations; all trainees presented posters that outlined key aspects of their research. Christopher T. Ritchlin (Rheumatologist, Rochester, New York, USA) and Wolf-Henning Boehncke (Dermatologist, Geneva, Switzerland) co-chaired the symposium in which GRAPPA members discussed the findings presented by trainees and suggested how trainees might further their current research projects9.
In a symposium on juvenile psoriatic arthritis (JPsA), several GRAPPA members discussed the history, clinical features, controversies, and immunogenetics of this condition. Their discussion included reports of conflicting HLA associations in JPsA, with both HLA class I and II allele associations suggested. They also discussed the JPsA associations with alleles of MEFV and NLRP3, genes that cause monogenic autoinflammatory disorders. They recommended an increased collaboration between pediatric and adult physicians, and comparative research on these clinically related conditions10.
The GRAPPA-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group is in the process of selecting core instruments for PsA clinical trials. During the annual meeting, the first set of candidate instruments to be taken through the OMERACT Filter 2.1 instrument selection process was discussed: 66/68 swollen/tender joint count, Spondyloarthritis Consortium of Canada Enthesitis Index, patient’s global assessment (GRAPPA and OMERACT formulations), Health Assessment Questionnaire–Disability Index, PsA Impact of Disease questionnaires 9 and 12, and Functional Assessment of Chronic Illness Therapy Fatigue11.
GRAPPA members have shown great interest in developing a common GRAPPA database. To address this interest, GRAPPA included a symposium at its 2017 annual meeting to examine the concepts of registries and databases. At this symposium, examples of existing databases were reviewed, and their challenges and achievements were discussed12.
In a symposium on the microbiome, the effects of the microbiome on the skin and joints in patients with psoriasis and PsA were discussed with particular reference to pathogenesis and treatment. It was concluded that a better understanding of microbe-host interactions could lead to novel diagnostic and therapeutic targets13,14,15.
The International Dermatology Outcome Measures (IDEOM) psoriasis working group presented an overview of IDEOM’s work to establish comprehensive psoriasis outcome measures. In addition, the working group discussed replacements for the Psoriasis Area and Severity Index (PASI) that can be used in clinical practice, including data that support the use of the physician’s global assessment × body surface area measurement score as a PASI surrogate; the contribution of skin disease to composite measures of PsA; and the National Psoriasis Foundation’s efforts to establish treat-to-target strategies for psoriasis care16.
Recent work on outcome measures from the GRAPPA ultrasound and magnetic resonance imaging (MRI) working groups was summarized. The working groups discussed how recent advances in imaging, including ultrasound and MRI, allow for the accurate evaluation of the extent of inflammation and damage in the peripheral joints, spine, and entheses. The group concluded that the development and validation of outcome measures are critical steps in creating standardized evaluations of musculoskeletal inflammation and damage in psoriatic patients17.
Members received updates on several ongoing educational and research efforts. Among them were updates on GRAPPA’s continued education efforts worldwide; GRAPPA’s continued research efforts, including the Biomarker Project, a collaborative research effort to identify and study biomarkers of joint damage; treatment recommendations, including recommendations and core principles related to biosimilars; efforts to update GRAPPA’s Website and to create a GRAPPA smart-phone application; and the Psoriasis and PsA Clinics Multicenter Advancement Network18.
PRP held another session at the annual meeting to discuss their involvement within GRAPPA since the GRAPPA 2016 annual meeting, as well as their evolution as a group since their first formal attendance at the GRAPPA 2013 annual meeting. PRP were educated on the Core Outcome Measures for PsA Clinical Trials (COMPACT) study and participated in focus groups to evaluate the content validity and feasibility of selected patient-reported outcome measurements19.
The GRAPPA-Collaborative Research Network (CRN) held its inaugural meeting over 2 days following the GRAPPA 2017 annual meeting. The GRAPPA-CRN aims to address gaps in the knowledge of the etiopathogenesis and management of psoriatic disease by using the large community of experienced investigators who are already collecting clinical phenotype data and biologic samples using validated techniques. The key immediate priorities to establish the CRN were discussed, and 4 CRN candidate flagship research areas were identified20.
At the conclusion of the GRAPPA meeting, members discussed future action items in a business meeting. The next annual meeting will be held in Toronto, Canada, in July 2018.
Acknowledgments
Special thanks go to Pam Love for her tireless organizational efforts, which kept the meeting running smoothly.
Footnotes
As part of the supplement series GRAPPA 2017, this report was reviewed internally and approved by the Guest Editors for integrity, accuracy, and consistency with scientific and ethical standards.
Financial support to enable these meetings was provided in 2017 by AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly & Company, Novartis, Pfizer, and UCB. In addition, the Innovation Partners in 2017 were Mallinckrodt, LEO Pharma, and Sun Pharma.
