Abstract
The 2019 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Paris, France, 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 composites workshop to review continuous composite measures; the GRAPPA-Collaborative Research Network’s third annual meeting; the need for a precision medicine approach to the treatment of psoriatic disease; updates from working groups in International Dermatology Outcome Measures and Outcome Measures in Rheumatology; a debate on the effectiveness of methotrexate in the treatment of psoriatic arthritis (PsA); updating recommendations for optimal treatment approaches for patients with PsA; an update on GRAPPA’s research and educational projects; and the GRAPPA ultrasound (US) working group’s goal to optimize the evaluation of enthesitis in patients with PsA using US through the development of a diagnostic US enthesitis tool. In this Prologue, we introduce the papers that summarize that meeting.
The 2019 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in July in Paris, France, and was attended by investigators in rheumatology and dermatology, representatives of biopharmaceutical companies, and patient research partners (PRP; Table 1), who discussed individual and collaborative research and educational initiatives in psoriasis and psoriatic arthritis (PsA). Currently, there are 981 international GRAPPA members, including investigators in rheumatology and dermatology (n = 673), representatives of biopharmaceutical companies (n = 212), PRP (n = 27), and other members (n = 69). Reports of previous yearly meetings have been published elsewhere1–10.
GRAPPA 2019 Annual Meeting attendance.
A Trainees Symposium was held prior to the annual meeting, in which 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 54 abstracts were submitted and ranked by a committee of reviewers. Five trainees with the highest-scored abstracts were invited to deliver oral presentations; all trainees presented posters that outlined key aspects of their research. Dr. Christopher T. Ritchlin (Rheumatologist, Rochester, New York, USA) and Dr. Wolf-Henning Boehncke (Dermatologist, Geneva, Switzerland) co-chaired the symposium. GRAPPA members discussed the findings presented by trainees and suggested how trainees might further their current research projects11.
During the 2019 GRAPPA annual meeting, a composites workshop was held in which a review of continuous composite measures was conducted during an introductory workshop, followed by 10 breakout group sessions, and a final plenary session for feedback and voting. Feedback and voting during the workshop showed that the GRAPPA membership supports the need for a continuous composite measure of disease activity for use in routine clinical care, the separate measurement of disease impact and activity, and the testing of modifications to candidate instruments rather than the development of new measures12.
A symposium was held that discussed the need for a precision medicine approach to the treatment of psoriatic disease that takes into account an individual patient’s variations in genes, proteins, environment, and lifestyle. In addition, reports on advances that are being made to address areas of unmet need in PsA, notably the use of proteomic approaches, were presented with suggestions that combine genetic and protein data (proteogenomics). Finally, a discussion was held on the progress that is being made in 2 large-scale, multipartner studies that are focused on the development of a precision medicine approach to the treatment of skin psoriasis13.
The GRAPPA-Collaborative Research Network (CRN) held its third annual meeting prior to the GRAPPA 2019 annual meeting. The GRAPPA-CRN group presented its progress in selecting a database platform; identifying items to include in an electronic case report form (eCRF); and developing standardized operating procedures (SOP) for the collection, processing, storage, and transport of biomaterial. A pilot investigator-initiated study was also proposed that would allow for the testing of both the eCRF and SOP14.
The effectiveness of methotrexate (MTX) in the treatment of PsA was debated. Clinical study data and the patient experience were discussed, and the efficacy, tolerability, and toxicity of MTX for both skin and musculoskeletal manifestations were discussed. A survey of attending GRAPPA members was held to collect data on the current and planned future use of MTX across the world15.
The International Dermatology Outcome Measures (IDEOM) psoriasis working group presented an overview of its work and discussed its efforts to agree on meaningful, valid, and feasible outcome measures in psoriasis. The PsA workgroup focused on the measurement of PsA symptoms in psoriasis clinical trials and the measurement of nonspecific musculoskeletal symptoms among patients with psoriasis in psoriasis longitudinal clinical trials and cohort studies16.
In a session that discussed the need to develop and update treatment recommendations for optimal treatment approaches for patients with PsA, the many recent, significant advances related to therapies and treatment approaches for PsA were discussed. Because of these advances, the process to update the recommendations has begun, and the basis for the approach that will be taken for the next version of the GRAPPA PsA treatment recommendations was reviewed.
The GRAPPA-Outcome Measures in Rheumatology (OMERACT) PsA working group reported at the 2019 GRAPPA annual meeting on its work to develop a core outcome set for PsA. The working group prioritized 4 domains, including musculoskeletal disease activity (enthesitis and dactylitis), fatigue, physical function, and structural damage17.
The GRAPPA ultrasound (US) working group presented its recent work and discussed its goal to create a sonographic enthesitis scoring system to optimize the evaluation of enthesitis in patients with PsA using US through the development of a diagnostic US enthesitis tool (DUET)18.
Members received updates on several ongoing educational and research efforts. Among them were updates on research and pilot research grants; GRAPPA’s PRP; education, including the slide collection; and additional efforts related to advancing the understanding of disease aspects, including axial and US enthesitis projects, as well as the early psoriatic disease systematic literature review and magnetic resonance imaging19.
At the conclusion of the GRAPPA meeting, members discussed future action items in a business meeting. The next annual meeting will be held in Brooklyn, New York, USA, in July 2020.
Acknowledgments
Special thanks go to Sharon Andrews for her tireless organizational efforts, which kept the meeting running smoothly.
Footnotes
As part of the supplement series GRAPPA 2019, 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 2019 by AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Gilead, Janssen, Eli Lilly & Co., Novartis, Pfizer, Sun Pharma, and UCB. In addition, our Innovation Partner in 2019 was Nordic Bioscience.
